Endoscopic balloon dilation of Crohn’s strictures is common. However, this procedure may not result in a long-term symptomatic benefit, sometimes leading to repeat dilation or surgery.
Long-acting steroid injection into strictures after dilation may decrease the need for further stricture dilation. This may improve the outcome in symptomatic patients.
In this study, researchers identified patients with Crohn’s disease who had received balloon dilation and triamcinolone injection for symptomatic anastomotic strictures.
The research team reviewed their case notes to determine the outcomes.
|50% of patients had sustained remission after a single dilation and steroid injection.|
The team’s results are published in the April issue of Endoscopy.
A total of 14 patients underwent 26 dilations, triamcinolone was injected in 20 of the procedures.
The team found that 50% of patients had sustained remission after a single dilation and steroid injection, with a median follow-up period of 16.4 months.
Overall, 29% of patients required more than 1 dilation (median 3 dilations) to control their symptoms, with a median follow-up period of 27.8 months.
However, the team found that endoscopic management failed in 3 patients. These patients were referred for surgery.
The researchers identified no complications due to dilation or triamcinolone injection.
Dr Brooker’s team concluded, “Triamcinolone injection into the stricture after dilation is safe, easy to perform, and may be a useful adjunct in the management of anastomotic Crohn’s strictures”.
“These data will require further support through a randomized and controlled trial.”