Endoscopic management of strictures in patients with Crohn's disease - A multi-center experience in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
119
Journal Issue
10
Pages
1500-1505
Date Issued
2020
Author(s)
Chang C.-W.
Chou J.-W.
Huang T.-Y.
Hsu W.-H.
Wang Y.-P.
Chen C.-C.
Chung C.-S.
Lin C.-P.
Lin W.-C.
Tai C.-M.
Wang H.-Y.
Chen M.-J.
Abstract
Background/Purpose: Inflammatory bowel disease (IBD) is a chronic gastrointestinal (GI) disorder that causes relapsing inflammation and severe mucosal damage in the intestine. Crohn's disease (CD)-related stricturing complications are a major cause of surgery, disability, and reduced quality of life. Endoscopic balloon dilation (EBD) has been shown to reliably delay or prevent surgery in patients with stricturing CD. However, cases of EBD performed for stricture in CD in Taiwan are rare. In this study, we want to evaluate the experiences regarding EBD for stricturing CD in Taiwan. Methods: We conducted a retrospective analysis of 9 medical centers in Taiwan. Patients with CD-related strictures who were treated with EBD were included and analyzed. Results: In nine medical centers, a total of 26 CD patients (19 male, 7 female, mean disease duration 75.4 ± 65.2 months) underwent 42 EBD procedures during the study period. Among the subjects, an 83.3% (35/42) EBD success rate was seen, but 26.9% (7/26) patients underwent surgery after ineffective EBD. In the surgery group, the the small bowel strictures was high compared with the non-surgery group (p = 0.01). There were no significant differences in disease phenotype, disease duration or history of fistulizing disease. In the surgery group, immunosuppressant use was high, and 5-aminosalicylic acid (5-ASA) use was low compared with the non-surgery group. After EBD, the physicians tended to change the drugs, especially increasing the use of biologic agents. Conclusion: EBD is a safe and effective procedure for CD-related stricture, with a 83.3% success rate in Taiwan. ? 2019 Formosan Medical Association
Subjects
Crohn's disease; Endoscopy; Stricture
SDGs
Other Subjects
acetylsalicylic acid; biological product; corticosteroid; immunosuppressive agent; mesalazine; adult; Article; biological therapy; clinical article; colon stenosis; controlled study; Crohn disease; disease duration; double balloon enteroscopy; endoscopic surgery; female; human; male; outcome assessment; phenotype; retrospective study; single balloon enteroscopy; Taiwan; complication; Crohn disease; gastrointestinal endoscopy; intestine obstruction; quality of life; treatment outcome; Crohn Disease; Endoscopy, Gastrointestinal; Female; Humans; Intestinal Obstruction; Male; Quality of Life; Retrospective Studies; Taiwan; Treatment Outcome
Publisher
Elsevier B.V.
Type
journal article