A new study has found that endoscopic balloon dilation is an efficacious and safe alternative to surgical resection of intestinal strictures in Crohn's disease (CD).

Researchers at Örebro University (Sweden) conducted a retrospective study of 178 patients (94 women) with CD who underwent endoscopic balloon dilation of intestinal strictures between 1987 and 2009, examining the short- and long-term efficacy and safety of the endoscopic balloon dilation technique. At first dilation, the median age of the patients was 45 years, and disease duration was 16 years; the average number of procedures per patient was 2.5. Relief of obstructive symptoms during the following month was achieved in 72.2%. In all, 776 dilations were performed, of which 621 (80%) were of anastomotic strictures.

The results showed that the technical success rate was 89%, while a subset of 75 patients underwent a further 246 dilations. At one year follow-up, 60/75 (80%) patients had undergone no further intervention or one additional dilation only. At five year follow-up, 52% of all patients required no further or one additional dilation only, whereas 36% had undergone surgical resection. The complication frequency was low, with bowel perforation (1.4%), major bleeding requiring blood transfusion (1%), minor bleeding (1.3%) and abdominal pain or fever (1.5%) the leading complications. There was no procedure-related mortality. The study was published in the July 2012 issue of Alimentary Pharmacology and Therapeutics.

“Bowel strictures are a major cause of morbidity, hospitalization, and surgery in Crohn’s disease,” said lead author Anders Gustavsson, MD, of the division of gastroenterology. “Endoscopic balloon dilation in selected patients is a nonsurgical alternative to surgical resection.”

Crohn's disease is a chronic inflammatory disorder, in which the body's immune system attacks the gastrointestinal (GI) tract, possibly directed at microbial antigens. CD may affect any part of the GI tract, from mouth to anus, causing a wide variety of symptoms, including abdominal pain, diarrhea, vomiting, or weight loss, but may also cause complications outside the GI tract such as skin rashes and arthritis.

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