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Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study

Thomas Lambin1, Aurélien Amiot2, Carmen Stefanescu3

  • 1Department of Gastroenterology, Claude Huriez hospital, University of Lille, Lille, France.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|September 23, 2020
PubMed

Insights

Crohn's disease upper gastrointestinal tract strictures, often in the duodenum, can be managed with medical and endoscopic therapies. These treatments help avoid surgery in about half of patients, with anti-TNF therapy reducing surgical risk.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Inflammatory Bowel Disease Research

Background:

  • Limited data exists on Crohn's disease (CD) patients experiencing upper gastrointestinal tract (UGT) strictures.
  • Upper gastrointestinal tract strictures are a known complication of Crohn's disease.

Purpose of the Study:

  • To evaluate the management and outcomes of Crohn's disease patients with UGT strictures.
  • To assess the efficacy of different treatment modalities for UGT strictures in CD.
  • To identify predictors for surgical intervention in CD patients with UGT strictures.

Main Methods:

  • Retrospective multicenter study of CD patients with symptomatic, non-passable UGT strictures.
  • Primary endpoint: surgery-free survival post-stricture diagnosis.
  • Evaluation of medical, endoscopic, and surgical treatment efficacy and surgical predictors.

Main Results:

  • 60 CD patients with UGT strictures were analyzed; 60% were duodenal.
  • Surgery-free survival was 75% at 1 year and 64% at 5 years.
  • Anti-TNF treatment initiation was linked to a lower risk of surgery.

Conclusions:

  • Upper gastrointestinal tract strictures in Crohn's disease predominantly affect the duodenum.
  • Medical and endoscopic interventions successfully prevent surgery in approximately 50% of patients.
  • Effective management strategies exist for UGT strictures in Crohn's disease.
Abstract

Keywords:
Crohn's diseaseEndoscopic treatmentStrictureSurgeryUpper gastrointestinal tract

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