| Theme | Endoscopic balloon dilation for small bowel stricture in Crohn's disease | |
|---|---|---|
| Title | Which procedure is preferable: prophylactic scheduled endoscopic or episodic balloon dilation? | |
| Publish Date | 2020/08 | |
| Author | Kenji Watanabe | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Mikio Kawai | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Koji Kamikozuru | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Keiko Yokoyama | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Koji Kaku | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Yusuke Takashima | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Kentaro Kojima | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Toshiyuki Sato | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| Author | Yoko Yokoyama | Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine |
| [ Summary ] | Small bowel lesions in Crohn's disease (CD) are commonly responsible for its intractable disease course. Objective monitoring of small bowel lesions through imaging modalities is essential because active lesions or strictures sometimes develop even in asymptomatic remission stages. Perforation is the most important adverse event of endoscopic balloon dilation (EBD). However, conservative follow-up of asymptomatic small bowel stricture can result in unfavorable prognosis due to the progressive nature of CD. Therefore, the scheduled prophylactic EBD proactive approach is more preferred over reactive EBD after an ileal failure. The scheduled prophylactic EBD seems to be a safe and eff ective procedure to prevent surgery for a long time period. Endoscopic procedures performed by experienced surgeons to treat diverse lesions and administration of high-quality medical treatment to induce endoscopic healing of the lesion are key factors of this proactive EBD strategy. | |