Stenosing Crohn's disease

Digestive stenosis (DS) is a frequent and serious complication of Crohn's disease (CD). Its management requires a multidisciplinary and individualized approach. Our objectives were to describe the characteristics of DS and to determine the factors associated with response to medical treatment and recourse to surgery. We included 80 patients with 88 DS, with a mean age of 39 and a M/F sex ratio of 1.3. Stenosis was symptomatic in 88% of cases. The last ileal loop was the most frequent location of SD. Surgical treatment was indicated immediately in 26% of cases, while medical treatment was initiated in 74% of patients, based on oral corticosteroid therapy (37%) or anti-TNF¿ (63%). A response was obtained in 48% of cases. Non-smoking status (p=0.003) and C-reactive protein < 23.5 mg/L (p=0.001) were independent factors in response to medical treatment. Treatment with corticosteroids versus anti-TNF¿ was independently associated with the use of surgery (p=0.017).