2018 Volume 60 Issue 12 Pages 2485-2498
The most common reason for surgical treatment of Crohnʼs disease is small bowel stricture. Some evidence revealed the efficacy of immunomodulators and biologics in patients with inflammatory strictures but not in patients with fibrotic strictures. Endoscopic balloon dilatation (EBD) using balloon-assisted enteroscopy is recommended for the treatment of small bowel strictures to avoid intestinal resection, because of its safe, effective and minimally invasive nature. Once resected, the function of the intestinal tract cannot be recovered. The disadvantages of EBD include the need for repeated dilatations to avoid surgery. Although stricturotomy using a needle knife and stent placement instead of balloon dilatation have been introduced, these alternative methods are still challenging. Several novel drugs targeting fibrosis have been developed, and the clinical application of these drugs is awaited.
