Managing Fibrosis in Inflammatory Bowel Disease

Knowledge about intestinal strictures in the setting of inflammatory bowel disease (IBD) has grown in the past decade. In a review of those developments, an author group offers the following points about managing fibrosis in patients with IBD:

• Balloon dilation is indicated when symptomatic strictures are within reach of an endoscope, <5 cm in length, nonangulated, and not accompanied by complications.

• Symptomatic strictures ≥5 cm should be managed surgically, typically by strictureplasty. Most strictures do not recur after strictureplasty.

• Neither active inflammation at the stricture, nor the naive versus anastomotic status of a stricture, significantly affects outcomes or complication rates of dilation.

• Upper gastrointestinal and proximal smal…