Resolution of multiple severe colonic strictures with prednisone therapy: DISCUSSION (Part 2)
Data are scarce on the management and follow-up of this condition. Publications on eight of the 33 previous cases provide no details on treatment or follow-up. Twelve cases were managed with surgical resection; four with endoscopic dilation and nine were managed conservatively by discontinuing NSAID therapy as the sole therapeutic maneuver.
Surgical resection has been a successful but dramatic method of dealing with these lesions. Of 12 cases, nine had no further complications after resection and discontinuation of NSAID therapy. The remaining three patients resumed NSAID use and experienced new stricture formation. One of these had partial improvement with endoscopic dilation of the new strictures but another failed treatment with endoscopic dilation and required further resection.
Of the four cases managed with endoscopic dilation of strictures, three had symptomatic improvement but no endoscopic follow-up. The remaining patient continued having abdominal pain for three months and at that time received repeat dilation and treatment with prednisone. In this case, prednisone was administered at an initial dose of 40 mg per day with a 5 mg taper each week, and complete endoscopic healing was documented following this eight-week therapy. You can find best pharmacy with finest quality medications available round the clock right now: all you need to do is buy antibiotics online only here discovering the amazing opportunities you are being offered.
Of the nine patients managed conservatively by discontinuing NSAID therapy, one had no follow-up, three became asymptomatic and had no further follow-up, four had endoscopic or radiological follow-up indicating no change to the lesions (after two weeks, five weeks, 18 months and two years, respectively) and one developed an obstruction relating to the lesion after three months of follow-up.