The Safety of Dilation of Ileoanal Strictures With Mechanical or Balloon Dilation Is Similar Among Patients After Ileal Pouch–Anal Anastomosis

Darlington, Kimberly; Wang, Annmarie; Herfarth, Hans H; Barnes, Edward L.

doi:10.1093/ibd/izad051

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…In 2023, multiple studies were conducted to assess the effectiveness of existing management strategies and investigate potential new anti‐fibrotic treatments (Table 4 ). 23 , 73 , 74 , 75 , 76 , 77 , 78 , 80 , 81 , 82 , 83 …”

Section: Managementmentioning

confidence: 99%

“… 85 It is noted that this study focused solely on evaluating drugs for stricture treatment, but not fibrosis The anti‐fibrotic effects of some emerging drugs are in focus. CeO2 has the ability to suppress the expression of fibrosis‐related genes as well as serve as a contrast agent in CT. 74 Another drug, fraxinellone, has shown significant promise in preventing fibrosis by disrupting the TGF‐ β /Smad2/3 signaling pathway. 75 What's more, docosahexaenoic acid, an omega‐3 fatty acid, which derived from human milk was found to be anti‐ fibrotic.…”

Section: Managementmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal strictures in Crohn's disease: An update from 2023

Liu,

Huang,

Wang

et al. 2024

UEG Journal

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Crohn's disease (CD) is a chronic inflammatory disease that leads to intestinal stricture in nearly 35% of cases within 10 years of initial diagnosis. The unknown pathogenesis, lack of universally accepted criteria, and absence of an effective management approach remain unconquered challenges in structuring CD. The pathogenesis of stricturing CD involves intricate interactions between factors such as immune cell dysbiosis, fibroblast activation, and microecology imbalance. New techniques such as single‐cell sequencing provide a fresh perspective. Non‐invasive diagnostic tools such as serum biomarkers and novel cross‐sectional imaging techniques offer a precise understanding of intestinal fibrostenosis. Here, we provide a timely and comprehensive review of the worthy advancements in intestinal strictures in 2023, aiming to dispense cutting‐edge information regarding fibrosis and to build a cornerstone for researchers and clinicians to make greater progress in the field of intestinal strictures.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Intestinal strictures in Crohn's disease: An update from 2023

Liu,

Huang,

Wang

et al. 2024

UEG Journal

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Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies

Huang,

Abeshouse,

Lee

et al. 2024

Clin Colon Rectal Surg

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De novo Crohn's disease (CD) of the pouch or Crohn's-like Ileal Pouch Illness (CLIPI) is an increasingly common occurrence in an ever-growing ileal pouch population. Although currently undetermined if a subset of classic CD or a completely new entity, it primarily affects the prepouch afferent limb, pouch, and rectal cuff. Symptoms can mimic other more common disorders, such as pouchitis, and requires a thorough workup, including pouchoscopy with biopsy and often cross-sectional imaging, for the diagnosis to be made. There is an increased risk of long-term pouch failure in this population. Treatment is typically dependent upon the disease phenotype with surgical management considered in a step-up fashion. Medical management is primarily performed with “biologics,” such as antitumor necrosis factor agents, although data are limited due to the lack of randomized controlled trials. Surgical management for CLIPI can include endoscopic, anorectal, and abdominal approaches to assist as “pouch-salvage strategies.” The performance of advanced pouch-salvage techniques in the CLIPI population requires careful patient selection and should preferably be performed at high-volume pouch centers.

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Endoscopic Balloon Dilatation of Ileal Pouch-Anal Anastomosis Strictures in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Dahiya,

Jena,

Bapaye

et al. 2024

Inflammatory Bowel Diseases

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Background Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the treatment of choice for medically refractory inflammatory bowel disease (IBD). In this systematic review and meta-analysis, we assess outcomes and safety of endoscopic balloon dilatation (EBD) for IPAA strictures. Methods A systematic search of numerous databases was performed through June 2023 to identify studies reporting on the outcomes of EBD in pouch-related strictures. Outcomes included technical success, clinical success at index dilation and in pouch retention, recurrence of symptoms post-EBD, and adverse events of EBD. Meta-analysis was performed using a random-effects model, and results were expressed in terms of pooled rates along with relevant 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran Q statistical test with I2 statistics. Results Seven studies with 504 patients were included. The pooled rate of technical success and clinical success of index dilatation was 98.9% (95% CI, 94.8-99.8%; I20%) and 30.2% (95% CI, 7.1-71%; I20%), respectively. The pooled rate of clinical success in pouch retention without the need for additional surgery was 81.4% (95% CI, 69.6-89.3%; I272%). The pooled failure rate of EBD was 18.6% (95% CI, 10.7-30.4%, I272%). The pooled rate of recurrence of symptoms after index dilatation was 58.9% (95% CI, 33.3-80.5%; I213%). The pooled rate of serious adverse events was 1.8% (95% CI, 1-3.5%, I20%). No deaths related to EBD were reported. Conclusions Endoscopic balloon dilatation is safe and highly effective for management of IPAA strictures. Additional studies are needed to compare its efficacy with surgical interventions.

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The Safety of Dilation of Ileoanal Strictures With Mechanical or Balloon Dilation Is Similar Among Patients After Ileal Pouch–Anal Anastomosis

Cited by 5 publications

References 29 publications

Intestinal strictures in Crohn's disease: An update from 2023

Intestinal strictures in Crohn's disease: An update from 2023

Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies

Endoscopic Balloon Dilatation of Ileal Pouch-Anal Anastomosis Strictures in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

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