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Purpose of Review <p>Crohn’s disease (CD) often causes intestinal strictures that impair quality of life. Endoscopic balloon dilation (EBD) has long been the standard, but durability is limited. This review summarizes advances in endoscopic management, focusing on updates from 2019–2025.</p> Recent Findings <p>EBD achieves high technical success (90–95%) and short-term symptom relief (70–82%) but has recurrence rates up to 78% at two years. Endoscopic stricturotomy (ES) shows superior outcomes, with &gt; 90% technical success, ~ 15% one-year recurrence, and &gt; 70% five-year surgery-free survival. Hybrid ES + EBD approaches and novel stents—including fully covered self-expanding, biodegradable, and lumen-apposing devices—offer options for refractory lesions. Emerging imaging (EUS, elastography, hyperspectral imaging) and AI-assisted decision-making enhance stricture assessment, though data remain preliminary.</p> Summary <p>Advances in endoscopy and adjunctive technologies are shifting Crohn’s stricture management toward more precise and durable, minimally invasive therapies. Ongoing trials, including HEIST, will help define optimal strategies.</p>

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Recent Endoscopic Technological Advancements in Crohn's Stricture Dilation

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Andrei Savu,
  • Michael Helou,
  • Jamil Abdo,
  • Scott Piechocki,
  • Brandon Wuerth

摘要

Purpose of Review

Crohn’s disease (CD) often causes intestinal strictures that impair quality of life. Endoscopic balloon dilation (EBD) has long been the standard, but durability is limited. This review summarizes advances in endoscopic management, focusing on updates from 2019–2025.

Recent Findings

EBD achieves high technical success (90–95%) and short-term symptom relief (70–82%) but has recurrence rates up to 78% at two years. Endoscopic stricturotomy (ES) shows superior outcomes, with > 90% technical success, ~ 15% one-year recurrence, and > 70% five-year surgery-free survival. Hybrid ES + EBD approaches and novel stents—including fully covered self-expanding, biodegradable, and lumen-apposing devices—offer options for refractory lesions. Emerging imaging (EUS, elastography, hyperspectral imaging) and AI-assisted decision-making enhance stricture assessment, though data remain preliminary.

Summary

Advances in endoscopy and adjunctive technologies are shifting Crohn’s stricture management toward more precise and durable, minimally invasive therapies. Ongoing trials, including HEIST, will help define optimal strategies.