Abstract Background The development of intestinal strictures (IS) marks a critical stage in the progression of Crohn’s disease (CD). Despite therapeutic advances, IS remains a complex management challenge. Our aim was to determine the factors associated with response to medical treatment and need for surgery. Methods We conducted a retrospective study enrolling patients followed for stricturing CD between 2013 and 2023. We collected epidemiological data, characteristics of CD and IS, as well as therapeutic modalities. We identified factors associated with response to medical treatment and need for surgery. Results Eighty patients were included allowing the study of 88 IS. The mean age were 39 years, with a sex ratio M/F of 1.3. Thirty-nine percent of patients were active smokers. The median duration of CD progression was 24 months. The stricture was symptomatic in 88% of cases. High levels of C-reactive protein were observed in 84% of cases. On endoscopy, stricture involves the ileocecal valve in 38% of cases. The terminal ileum was the most frequent location on imaging. While surgical resection was needed in 26% of cases, medical treatment was initiated in 74% of patients, based on oral corticosteroids in 37% of cases and anti-Tumor Necrosis Factor Alpha (anti-TNFɑ) in 63% of cases in induction therapy. A response was achieved in 48% of cases. The distribution of patients who responded to medical treatment according to the type of maintenance therapy is shown in Figure 1. Surgical intervention was required in 53% of cases. The absence of active smoking (p = 0.003) and a CRP level 23.5 mg/L (p = 0.001) were independent factors associated with response to medical treatment. Treatment with corticosteroids versus anti-TNFɑ was independently associated with the need for surgery (p = 0.017). Conclusion Stricture is a frequent and severe complication of CD, often requiring a combined medical and surgical approach. Our findings highlight the need for early detection through clinical and paraclinical evaluation to inform timely and tailored therapeutic strategies. Conflict of interest: Dr. Dhib, Abir: No conflict of interest Hassine, Hajer: No conflict of interest Cherif, Dhouha: No conflict of interest Yacoub, Haythem: No conflict of interest Kchir, Hela: No conflict of interest Dabebbi, Hbiba: No conflict of interest Maamouri, Nadia: No conflict of interest
Dhib et al. (Thu,) studied this question.