IBD Drive Time: Gursimran Kocchar, MD, on Medical and Endoscopic Management of Strictures

Yeah, most of the listeners, I think, are going to be doing balloon dilation.

And we're going to get back to some tips on the best practices for that.

But I want to make sure you agree with this statement is, you know, when I talk to patients, first of all, I can send every Crohn's patient for a balloon dilation before the procedure.

because you may find a stricture that you weren't suspecting and to see above that area to see if there's inflammation, to address current symptoms, potentially prevent obstruction.

I personally will dilate a stricture like that, but I think if you haven't told them that there's a 2% to 3% risk of bleeding or perforation, which are the standard complication rates of balloon dilation, you really shouldn't do it.

But what I was going to say is that I usually quote them that there's a rule of thirds.

A third of patients do great with a single balloon dilation.

A third of patients need multiple dilations to stay open.

And a third, it doesn't work at all.

So for that latter statement, do you generally agree that that's the efficacy of balloon dilation?

Absolutely.

I think that's a very good statement to give.

And I have a same practice like yours.

I almost always, even if I'm doing a routine procedure for follow up at two years, you know, I will consent them for balloon dilation just in case if we see something.

Because we have now good evidence to say that patients with Crohn's disease can have very poor symptom correlation.

So sometimes they may have a stricture in TI and they may not be having any symptoms.

You know, so I think it's important to do that.

But the numbers you gave, they are exactly the same numbers that I discuss with my patients in the clinic.