Endoscopic solutions for stricturing Crohn's disease

Intestinal stenosis is a frequent and oftentimes recurring problem in patients with Crohn's disease, accompanied by a high-risk for bowel resection and subsequent short bowel syndrome. Medical therapy has not proven successful, and even the most conservative surgical options are hampered by a definite mortality rate (and high recurrence rates) without doubt. Technical improvements in endoscopic devices over recent years have created an operative subspecialty (therapeutic endoscopy) that can be applied to several gastrointestinal diseases. Endoscopic balloon dilatation (EBD) for Crohn's disease has been developed to prevent or delay the need for surgical resection. The endoscopy-assisted dilatation is a safe and effective treatment modality for uncomplicated, short Crohn's strictures, and therefore should be offered to Crohn's disease patients. Here, we briefly review the current knowledge on hydrostatic balloon dilatation and present a relevant case from our clinical practice.