Related Experiment Video

Updated: Nov 20, 2025

A TNBS-Induced Rodent Model to Study the Pathogenic Role of Mechanical Stress in Crohn's Disease
05:08

A TNBS-Induced Rodent Model to Study the Pathogenic Role of Mechanical Stress in Crohn's Disease

Published on: March 1, 2022

4.2K

Therapeutic strategies for stricturing Crohn's disease in childhood: a systematic review

Jonathan J Neville1, Alexander Macdonald2, John Fell3

  • 1Department of Paediatric Surgery, Chelsea and Westminster Hospital, London, SW10 9NH, UK. jonathan.neville@nhs.net.

Pediatric Surgery International
|January 25, 2021
PubMed

Insights

Surgical resection is the most effective treatment for childhood stricturing Crohn's disease (CD), showing lower recurrence and complication rates. Further research is needed on medical therapies and endoscopic balloon dilatation (EBD) for pediatric CD strictures.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Gastroenterology
  • Inflammatory Bowel Disease Research

Background:

  • Childhood stricturing Crohn's disease (CD) leads to significant morbidity.
  • Interventions such as resection, stricturoplasty, and endoscopic balloon dilatation (EBD) are often necessary.
  • Optimal treatment strategies and timing for pediatric stricturing CD remain unclear.

Purpose of the Study:

  • To review existing therapies for pediatric stricturing Crohn's disease.
  • To evaluate the efficacy and outcomes of different intervention modalities.

Main Methods:

  • A systematic review adhering to PRISMA guidelines was conducted.
  • Data on demographics, stricture characteristics, interventions, and outcomes were extracted from 14 selected studies.
  • 177 patients with 183 strictures were included in the analysis.

Main Results:

  • Medical therapy showed limited efficacy (8% complete response).
  • Surgical resection (38%), stricturoplasty (28%), and EBD (12%) were performed.
  • Resection had the lowest recurrence (9%) and comparable complication rates (11%) versus stricturoplasty (38% recurrence, 15% complications) and EBD (47% recurrence, 6% complications).

Conclusions:

  • Surgical resection is associated with favorable outcomes in pediatric stricturing CD.
  • Evidence regarding adjuvant medical therapy and the role of EBD is limited.
  • A standardized reporting dataset for interventions in pediatric stricturing CD is proposed.
Abstract

Keywords:
Crohn’s diseaseEndoscopyPediatric surgeryStricturesStricturoplasty

More Related Videos

Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis09:44

Evaluating Therapeutic Interventions in the SHIP-deficient Mouse Model of Crohn Disease-like Ileitis and Fibrosis

Published on: October 14, 2025

172
Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis08:58

Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis

Published on: January 5, 2017

12.6K

Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
302
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
300
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
295
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
503
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
260
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
322