Balloon assisted enteroscopy and endoscopic balloon dilatation (EBD) is a safe and effective therapeutic option for management of small bowel strictures in Crohn’s disease. However, evidence for long-term clinical outcomes remains limited. Our aim was to evaluate the technical success and long-term clinical efficacy of EBD in small bowel Crohn’s disease. 

Retrospective cohort study of adult patients with small bowel Crohn’s disease who underwent enteroscopy between January 2015 - January 2025 at a single tertiary hospital. Clinical and endoscopic data at index procedure and follow up data were collected from electronic medical records.

68 patients underwent 168 procedures; 35 were females (51.5%) and 33 males with a mean disease duration of 14.7 years.  92 (54.7%) therapeutic procedures were performed for EBD. 28 (41.2%) patients required a single EBD, and 40 (58.8%) patients required multiple procedures with an average of 2 procedures. The mean dilation diameter achieved was 13 mm (9-16.5mm). EBD was successfully performed in 84.8%. There were 4 cases of bleeding (4.3%) and one anaesthetic complication (1.1%). No bowel perforation occurred. Clinical success defined as absence of obstructive symptoms was achieved in 90.2% of this cohort. Only 2 patients (2.2%) patients required surgery during follow up. The mean follow up was 60 months.

Most patients (77.9%) were receiving concurrent medical therapy for Crohn’s disease. Endoscopic findings led to a change in medical therapy following a third of EBD procedures.

Enteroscopy and endoscopic balloon dilatation is technically feasible and clinically effective for small bowel strictures in Crohn’s Disease. Long term clinical outcomes, with mean follow up period of 60 months, suggest minimal surgical rates following a combination of medical therapy and EBD.  Early endoscopic assessment also allows an opportunity to optimise medical therapy in a combined management approach, potentially delaying the need for surgical intervention.