Intest Res  
Current status of endoscopic balloon dilation for Crohn’s disease
Fumihito Hirai
Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Correspondence to: Fumihito Hirai, Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Fukuoka 818-8502, Japan. Tel: +81-92-921-1011, Fax: 81-92-929-2630, E-mail: fuhirai@cis.fukuoka-u.ac.jp
Received: December 29, 2016; Accepted: January 2, 2017; Published online: March 20, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The therapeutic target in Crohn’s disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in Crohn’s disease. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn’s strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy (BAE) has recently been applied for small bowel Crohn’s strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn’s strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.
Keywords: Endoscopic balloon dilation; Crohn disease; Colorectal stricture; Ileo-colonic anastomotic stricture; Small bowel stricture


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