Endoscopic management of intestinal strictures in Crohnʼs disease

Crohn's disease complicated by strictures: a systematic review

“…There is no convincing evidence that such mucosal biopsies increase the risk of perforation with subsequent balloon dilatation. 121 The availability of deep enteroscopy, including double-balloon endoscopy makes dilatations in the more proximal upper small bowel feasible. 50122123 …”

European Crohn’s and Colitis Organisation Topical Review on Prediction, Diagnosis and Management of Fibrostenosing Crohn’s Disease

“…There is no convincing evidence that such mucosal biopsies increase the risk of perforation with subsequent balloon dilation. 134 Intra-lesional injection of steroids has been successfully used in other stricturing gastrointestinal conditions, such as peptic, corrosive, or anastomotic strictures or fibrosis post radiotherapy. 135,136,137,138 Triamcinolone is considered an appropriate agent given its prolonged local effect, believed to last for 3-4 weeks.…”

Dilate or wait for effective anti-inflammatory treatment for stenotic lesions associated with active inflammatory signs in Crohn's disease

“…Indeed, thorough histological sampling throughout the length of the stricture must be done during endoscopy to exclude obvious neoplasms, since some of these, especially those intrinsic colonic strictures, can harbour cancer 2. We also know that there are no convincing data that such biopsies increase the risk associated with balloon dilatation 3. In this article, there is a lack of information regarding precisely how many of the cases were biopsied and revealed preneoplastic findings or overt neoplasms.…”