• J Formos Med Assoc · Oct 2020

    Endoscopic management of strictures in patients with Crohn's disease - A multi-center experience in Taiwan.

    • Chen-Wang Chang, Chia-Hung Tu, Jen-Wei Chou, Tien-Yu Huang, Wen-Hung Hsu, Yen-Po Wang, Chih-Cheng Chen, Chen-Shuan Chung, Ching-Pin Lin, Wei-Chen Lin, Chi-Ming Tai, Horng-Yuan Wang, and Ming-Jen Chen.
    • Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan.
    • J Formos Med Assoc. 2020 Oct 1; 119 (10): 1500-1505.

    Background/PurposeInflammatory 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.MethodsWe conducted a retrospective analysis of 9 medical centers in Taiwan. Patients with CD-related strictures who were treated with EBD were included and analyzed.ResultsIn 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.ConclusionEBD is a safe and effective procedure for CD-related stricture, with a 83.3% success rate in Taiwan.Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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