Crohn's disease stricture evaluation and management

Crohn's disease (CD) is chronic inflammatory disease of the intestinal tract. Majority of Crohn's disease patients would go on to develop a complicated disease course over time including stricturing and penetrating disease. Stricturing CD requires a multidisciplinary approach between the surgical and medical team for comprehensive management. Despite significant advances in the therapeutic armamentarium for CD, there is no approved medical therapy and none on the horizon that can reverse fibrostenotic disease. Therefore, stricturing CD remains a therapeutic challenge and is associated with considerable morbidity and cost. Recent imaging technique such as MR enterography helps to better delineate stricturing disease. The therapeutic options for fibrostenotic CD comprise of endoscopic balloon dilation and surgical measures. Endoscopic balloon dilation delays the need for surgery, reduces the risk of short bowel syndrome, and has lower complication rate than surgery. The goal of this review is to present a comprehensive overview of the current knowledge, identification, and management of strictures in patient with CD, with a focus on the role of endoscopic therapy.