Managing Stricturing Crohn's Disease: Resect? Strictureplasty? Dilate?

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Crohn's disease (CD) is a chronic gastrointestinal disorder with varied presentations.
• Fibrostenotic strictures are a common complication, particularly in the small intestine, causing obstruction.
• No current medical therapies effectively prevent or reverse stricturing disease in CD.

Purpose of the Study:

• To review and discuss the management of stricturing Crohn's disease.
• To provide guidance on selecting appropriate treatment options for fibrostenotic strictures.
• To offer technical insights for managing complex cases of stricturing CD.

Main Methods:

• Review of endoscopic treatment modalities (dilation, stricturotomy, stenting).
• Overview of surgical interventions (resection, bypass, strictureplasty).
• Discussion of factors influencing treatment choice for stricturing CD.

Main Results:

• Endoscopic and surgical treatments are primary for symptom palliation and complication management.
• Treatment selection depends on disease complexity and patient factors.
• Technical considerations are crucial for successful outcomes in challenging strictures.

Conclusions:

• Management of stricturing Crohn's disease requires careful consideration of available endoscopic and surgical options.
• Optimal treatment strategies aim to alleviate symptoms and address complications effectively.
• Further research may explore novel therapeutic approaches for fibrostenotic strictures.