P1182 - Endoscopic Balloon Dilation Within 2 Years of Ileocolonic Resection in Crohn’s Disease Is Associated With Increased Corticosteroid Use, Hospitalizations, and Repeat Surgery

Thabet Qapaja, MD¹, Yazan Al Jabiri, MD¹, Mohammad Aldiabat, MD¹, Benjamin L. Cohen, MD², Florian Rieder, MD², Miguel Regueiro, MD³
1Washington University School of Medicine in St. Louis, St. Louis, MO; 2Cleveland Clinic Foundation, Cleveland, OH; 3Cleveland Clinic, Cleveland, OH

Introduction: Endoscopic balloon dilation (EBD) is commonly used to manage Crohn’s disease (CD) strictures. The long-term impact of EBD within 2 years of ileocolonic resection is unknown.

Methods: We conducted a retrospective cohort study using the TriNetX multi-institutional electronic health record database. Adult patients with CD who underwent ileocolonic resection were identified using CPT and ICD-10 procedure codes. Patients were stratified into two groups: those who underwent EBD within two years of surgery and those who did not. Propensity score matching (1:1) was performed to balance cohorts on demographics, comorbidities, CD disease characteristics, and medication history. Outcomes were assessed from 30 days to 5 years following the index date. Adjusted hazard ratios (aHRs) were calculated using Cox proportional hazards models.

Results: After matching, 199 patients were included in each group (EBD vs. no EBD). The EBD group had higher rates of corticosteroid use (52.3% vs. 37.2%; aHR 1.65, 95% CI 1.23–2.23, p=0.001), hospitalization (47.7% vs. 33.2%; aHR 1.53, 95% CI 1.11–2.09, p=0.008), and repeat bowel surgery (25.6% vs. 13.6%; aHR 1.96, 95% CI 1.23–3.12, p=0.004). ED visit rates were higher in the EBD group but not statistically different between groups (39.2% vs. 36.2%; aHR 1.03, 95% CI 0.75–1.42; p = 0.849). The specific type of postoperative stricture (e.g., anastomotic vs. primary CD) could not be determined.

Discussion: CD patients who underwent EBD within two years of ileocolonic resection had increased rates of corticosteroid use, hospitalization, and surgical resection. Patients requiring EBD postoperatively should undergo closer surveillance.

Figure: Table: Outcomes in Crohn’s Disease Patients With vs. Without Endoscopic Balloon Dilation (EBD) After Ileocolonic Resection


Figure: Table: Outcomes in Crohn’s Disease Patients With vs. Without Endoscopic Balloon Dilation (EBD) After Ileocolonic Resection

Disclosures:
Thabet Qapaja indicated no relevant financial relationships.
Yazan Al Jabiri indicated no relevant financial relationships.
Mohammad Aldiabat indicated no relevant financial relationships.
Benjamin Cohen: Abbvie – Advisory Committee/Board Member, Consultant, Speakers Bureau. ALPCO – Advisory Committee/Board Member, Consultant. Emmes Biopharma Services LLC – DSMB. J&J Innovative Medicine – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member. Takeda – Consultant, Speakers Bureau.
Florian Rieder: Adiso – Advisory Committee/Board Member, Consultant. Adnovate, Agomab, Allergan, AbbVie, Arena, Astra Zeneca, Bausch & Lomb, Boehringer-Ingelheim, Celgene/BMS, Celltrion, CDISC, Celsius, Cowen, 89Bio – Advisory Committee/Board Member, Consultant. Eugit, Ferring, Galapagos, Galmed, Genentech, Gilead, Gossamer, Granite, Guidepoint, Helmsley, Horizon Therapeutics, Image Analysis Limited – Advisory Committee/Board Member, Consultant. Landos, Jannsen, Koutif, Mestag, Metacrine, Mirum, Mobius, Mopac, Morphic, Myka Labs, Organovo, Origo, Palisade, Pfizer, Pliant, Prometheus Bioscience – Advisory Committee/Board Member, Consultant. Receptos, RedX, Roche, Samsung, Sanofi, Surmodics, Surrozen, Takeda, Techlab, Teva, Theravance, Thetis, Tr1x Bio, UCB, Ysios – Advisory Committee/Board Member, Consultant.
Miguel Regueiro: AbbVie – Advisory Committee/Board Member, Consultant. Amgen – Advisory Committee/Board Member, Consultant. BMS – Advisory Committee/Board Member, Consultant. Boehringer Ingelheim Pharmaceuticals Inc. – Advisory Committee/Board Member, Consultant. Celegene – Advisory Committee/Board Member, Consultant. Eli Lilly and Company – Advisory Committee/Board Member, Consultant. Genentech – Advisory Committee/Board Member, Consultant. Gilead – Advisory Committee/Board Member, Consultant. Janssen – Advisory Committee/Board Member, Consultant. Organon – Advisory Committee/Board Member, Consultant. Pfizer – Advisory Committee/Board Member, Consultant. Prometheus – Advisory Committee/Board Member, Consultant. Salix – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant. UCB – Advisory Committee/Board Member, Consultant.

Thabet Qapaja, MD¹, Yazan Al Jabiri, MD¹, Mohammad Aldiabat, MD¹, Benjamin L. Cohen, MD², Florian Rieder, MD², Miguel Regueiro, MD³. P1182 - Endoscopic Balloon Dilation Within 2 Years of Ileocolonic Resection in Crohn’s Disease Is Associated With Increased Corticosteroid Use, Hospitalizations, and Repeat Surgery, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.