Endoscopic balloon dilatation (EBD) is a minimally invasive therapy for intestinal strictures that can eliminate the need for surgery and improve the quality of life. EBD is regarded as a safe and effective procedure mainly for the management of benign intestinal strictures. In recent years, the development of balloon-assisted enteroscopy (double-balloon endoscopy and single-balloon endoscopy) has enabled the use of EBD for small intestinal strictures as well as for esophageal, gastric, duodenal and colonic strictures. Through-the-scope (TTS) balloon is now frequently used for EBD because the technique is easier than that using the over-the-wire (OTW) balloon. In this article, indications, therapeutic techniques and complications of EBD for intestinal strictures using the TTS balloon are described. In order to perform EBD successfully, it is important to carefully assess whether the patient's stricture meets the inclusion criteria before the balloon dilatation therapy. It is also important to perform multi-step inflation with a gradually increasing diameter under minimal conscious sedation. This technique can reduce complications such as massive bleeding and perforation. In this paper, the effectiveness of EBD for Crohn's strictures is also discussed. In recent years, a few reports have described the usefulness and efficacy of EBD for small intestinal strictures in Crohn's disease patients. This procedure may be of significant benefit and should be considered as a useful and effective alternative to surgery. Further investigation will be necessary to confirm the benefit of this procedure.
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|Published - 2013 Nov