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Background and Aim: Resection for Crohn's disease (CD) related strictures is definitive but carries risk of morbidity, recurrence, and short bowel syndrome. On the contrary, the durability of endotherapy (ET) for CD‐related strictures is questionable. Prospective comparative studies are limited. We aimed to prospectively compare the outcomes of ET in CD strictures with a case‐matched surgical therapy (ST) cohort. Methods: Patients undergoing ET or resection for primary CD strictures (symptomatic, non‐traversable, < 5 cm length, n ≤ 3) between January 2021 and March 2022 in a high‐volume tertiary center were compared with regard to recurrent symptoms, escalation of therapy, re‐intervention, and re‐operation based on propensity matched analysis. Results: Fifty‐nine patients [49% ET, 57.6% male, median (years): 34 (15–74)] had ≥ 12 months of follow up. Before propensity matching, cumulative re‐intervention rate was significantly higher with ET [34.5% (10/29) vs 3.3% (1/30) ST, P = 0.002]. Recurrent symptoms (34.5% vs 26.7%, P = 0.42), escalation of medical therapy (27.5% vs 23.3%, P = 0.64), and re‐operation (7.4% vs 3.1%, P = 0.55) were comparable. In propensity matched analysis adjusted for demographics, disease, and stricture characteristics [n = 42, 21 each, 62% male, median (years): 32 (15–60)], cumulative probability of re‐intervention rates was higher in ET (28.6% vs 4.8%, P = 0.042). The cumulative probability of recurrent symptoms (ET: 33.3% vs surgery 33.3%, P = 0.93), therapy escalation (ET: 23.8% vs surgery 28.6%, P = 0.75), and re‐operation (ET: 9.5% vs surgery 4.8%, P = 0.57) was similar. Conclusions: ET for CD strictures require higher re‐interventions compared with resection although re‐operation could be avoided in the majority with comparable symptom free survival at 1 year. [ABSTRACT FROM AUTHOR]

B I Conclusion: i b In adult patients willing to undertake dietary therapy for management of their Crohn's disease, CDED is a well-tolerated approach and is associated with clinical remission at 6 weeks, based on this small cohort of prospective patients. B 36 b B Postpartum dietary therapy for Crohn's disease following Hartmann's procedure: A case report b R Davis SP 1 sp , E Young SP 1 sp , A Day SP 2 sp and D Sathananthan SP 1 sp SP 1 sp I Lyell McEwin Hospital, Adelaide; i SP 2 sp I The Queen Elizabeth Hospital, Adelaide, South Australia, Australia i B I Introduction: i b Medical and surgical management of Crohn's disease (CD) during pregnancy and lactation is complex. Dietary therapy is effective for inducing remission, offering a safe and effective treatment alternative when medical management is contraindicated or when patients opt for non-pharmacological therapies. Dietary therapy can therefore be a suitable option for patients with CD during pregnancy and lactation, with the potential to yield clinical benefit while optimizing nutritional intake and mitigating potential treatment-related side effects. [Extracted from the article]

Background and Aim: Despite widespread recommendations and use of intravenous corticosteroids (IVCS) for the treatment of acute flares of ulcerative colitis and Crohn's disease, limited evidence exists comparing outcomes of the two most common regimens, intravenous methylprednisolone (IVMP) and intravenous hydrocortisone (IVHC). IVHC has stronger mineralocorticoid effects compared with IVMP and may cause higher rates of hypokalemia. We aimed to determine differences in clinical outcomes including requirement for inpatient rescue therapy, bowel resection, and rates of hypokalemia. Methods: We conducted a multicenter cohort study of all adult patients admitted with an acute flare of inflammatory bowel disease (IBD) to the three tertiary hospitals in Auckland, New Zealand, where the protocol at each institution is either IVMP 60 mg daily or IVHC 100 mg four times daily. All patients requiring IVCS between 20 June 2016 and 30 June 2018 were included. The IVCS protocol was then changed at one hospital, where further data were collected for a further 12 months from 30 January 2019 until 30 December 2019. Results: There were 359 patients, including 129 (35.9%) patients receiving IVMP and 230 (64.1%) patients receiving IVHC. IVMP treatment was associated with a greater requirement for rescue therapy than IVHC (36.4% vs 19.6%, P = 0.001; odds ratio [OR] = 2.79; 95% confidence interval [CI], 1.64–4.75, P < 0.001), but also reduced rates of hypokalemia (55.8% vs 67.0%, P = 0.04; OR = 0.49; 95% CI, 0.30–0.81, P = 0.005). There was no difference between treatment groups for the median length of admission (5 days, interquartile range [IQR] 3–8), median duration of IVCS treatment (3 days, IQR 2–5), or bowel resection within 30 days of admission (12.4% vs 11.7%; OR = 1.04). Conclusion: For the treatment of an acute flare of IBD, treatment with IVMP results in significantly more requirement for inpatient rescue biologic or cyclosporin. In addition, it causes statistically significant less hypokalemia than IVHC, although in practice differences are negligible. [ABSTRACT FROM AUTHOR]