✳️ Practical guidelines on endoscopic treatment for
Crohn's disease strictures:
▶️ Endoscopic Ballon Dilatation(EBD) is efficacious and safe for primary or anastomotic strictures <4-5 cm in length.
▶️ EBD is more efficacious and safer for a small number of strictures (n<4) in close proximity to each other than for multiple stricutres (n>4).
▶️ EBD should be avoided for strictures with deep ulcerations.
▶️ EBD might be less effective for strictures with prestenotic luminal dilation.
▶️ EBD is not recommended for patients with concurrent fistulae or abscesses adjacent to the intestinal strictures.
▶️ Avoid injection of steroids or anti-TNF.
▶️ Endoscopic electroincision can be done in patients with EBD-refractory strictures in centres with the necessary technical capabilities.
▶️ Electroincision can be particularly useful for anorectal strictures in patients with Crohn's disease.
▶️ Electroincisions can be made using various knives with an endoscopic retrograde cholangiopancreatography power setting (ie, Endocut mode).
▶️ Fully covered removable metal stents can be used for refractory strictures in selected patients if EBD and endoscopic electroincision are unsuccessful.
Crohn's disease strictures:
▶️ Endoscopic Ballon Dilatation(EBD) is efficacious and safe for primary or anastomotic strictures <4-5 cm in length.
▶️ EBD is more efficacious and safer for a small number of strictures (n<4) in close proximity to each other than for multiple stricutres (n>4).
▶️ EBD should be avoided for strictures with deep ulcerations.
▶️ EBD might be less effective for strictures with prestenotic luminal dilation.
▶️ EBD is not recommended for patients with concurrent fistulae or abscesses adjacent to the intestinal strictures.
▶️ Avoid injection of steroids or anti-TNF.
▶️ Endoscopic electroincision can be done in patients with EBD-refractory strictures in centres with the necessary technical capabilities.
▶️ Electroincision can be particularly useful for anorectal strictures in patients with Crohn's disease.
▶️ Electroincisions can be made using various knives with an endoscopic retrograde cholangiopancreatography power setting (ie, Endocut mode).
▶️ Fully covered removable metal stents can be used for refractory strictures in selected patients if EBD and endoscopic electroincision are unsuccessful.
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Practical_guidelines_on_endoscopic_treatment_for_Crohn’s_disease.pdf
8.9 MB
Practical guidelines on endoscopic treatment for Crohn’s disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group.
The Lancet
✳️ Clinical #Pearls : In a patient with cirrhosis and an esophageal variceal bleed, prevention of rebleeding after endoscopic variceal band ligation involves both beta-blocker therapy and repeat endoscopic band ligation.
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PracticalGuidetoBestPracticesinAlcohol_AssociatedLiverDisease.pdf
2.6 MB
Practical Guide to Best Practices in Alcohol-Associated Liver Disease.
Thieme-connect 2026
✳️ Iron deficiency anemia (IDA) is the type of anemia typically seen in chronic blood loss from gastric ulcers, duodenal ulcers, or colonic polyps.This anemia is characteristically microcytic and hypochromic due to depleted iron stores from ongoing blood loss.
▶️ Chronic gastrointestinal bleeding is the most important cause of iron deficiency in men and postmenopausal women. Each mL of blood contains 0.4–0.5 mg of iron, so even occult bleeding from these lesions progressively depletes iron stores.
▶️ In patients with IDA referred for endoscopy, potentially bleeding lesions are identified in 62% of cases, including peptic ulceration in 19%.
▶️ Common upper gastrointestinal causes include erosions or ulcers related to aspirin and NSAIDs, as well as peptic ulcer disease, while lower gastrointestinal causes include colorectal cancer, angiodysplasia, and colonic polyps.
▶️ Recurrent blood loss accounts for up to 94% of IDA cases in adults. The diagnosis is established by a serum ferritin level less than 45 ng/mL (or less than 100 ng/mL in the presence of inflammation) along with anemia.
▶️ In men and postmenopausal women presenting with IDA, bidirectional endoscopy should be performed to identify the bleeding source.
▶️ Chronic gastrointestinal bleeding is the most important cause of iron deficiency in men and postmenopausal women. Each mL of blood contains 0.4–0.5 mg of iron, so even occult bleeding from these lesions progressively depletes iron stores.
▶️ In patients with IDA referred for endoscopy, potentially bleeding lesions are identified in 62% of cases, including peptic ulceration in 19%.
▶️ Common upper gastrointestinal causes include erosions or ulcers related to aspirin and NSAIDs, as well as peptic ulcer disease, while lower gastrointestinal causes include colorectal cancer, angiodysplasia, and colonic polyps.
▶️ Recurrent blood loss accounts for up to 94% of IDA cases in adults. The diagnosis is established by a serum ferritin level less than 45 ng/mL (or less than 100 ng/mL in the presence of inflammation) along with anemia.
▶️ In men and postmenopausal women presenting with IDA, bidirectional endoscopy should be performed to identify the bleeding source.
Refractory Constipation__CGH2026.pdf
3.6 MB
AGA Clinical Practice Update on Evaluation and Management of Refractory Constipation: Expert Review
AGA jan 2026
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