Our approach
Treatment depends on the cause, length, and number of strictures.
We assess the activity of inflammation, the functional state of the bowel, and the risk of obstruction. Whenever possible, a bowel-preserving approach is used. If conservative treatment is ineffective or the risk of complications is high, surgery is performed.
What is a small bowel stricture?
A stricture is a persistent narrowing of the small bowel lumen that makes it difficult or impossible for food and intestinal contents to pass.
Strictures may be:
- inflammatory
- scar-related (fibrotic)
- postoperative
- radiation-induced
- tumor-related
Why do strictures develop?
The most common causes are:
- Crohn's disease
- postoperative scarring
- intestinal ischemia
- radiation therapy
- small bowel tumors
- previous inflammatory processes
Symptoms
Depending on the degree of narrowing, the following may occur:
- cramping abdominal pain
- bloating
- nausea
- vomiting
- constipation or inability to pass gas
- weight loss
- repeated episodes of bowel obstruction
When to see a doctor
A consultation is recommended if:
- a small bowel stricture has been diagnosed
- episodes of bowel obstruction keep recurring
- medication is ineffective
- a tumor is suspected as the cause of the narrowing
- the indications for surgery need to be determined
How is the diagnosis made?
The following are used to establish the cause of the stricture:
- consultation with a surgeon
- laboratory tests
- contrast-enhanced computed tomography
- MR enterography
- endoscopic methods when indicated
- histological examination after surgery or biopsy
How is it treated?
The treatment strategy is determined individually.
Options may include:
- medication for inflammatory strictures
- endoscopic dilation of certain short strictures when indicated
- strictureplasty
- segmental resection of the small bowel
- laparoscopic or open operations
Surgical treatment
At MSI we perform:
- strictureplasty when appropriately indicated
- segmental resection of the small bowel
- reconstruction of bowel continuity
- laparoscopic operations
- open procedures for multiple or complex strictures
The goal of surgery is to eliminate the narrowing, restore normal bowel passage, and preserve as much small bowel length as possible.
Recovery after treatment
After surgery, modern ERAS protocols, early mobilization, and a gradual return to eating are used.
Further treatment depends on the cause of the stricture. Patients with Crohn's disease continue therapy under the supervision of a gastroenterologist.
Why choose MSI
- Experience in treating complex small bowel conditions
- An organ-preserving approach
- Strictureplasty and reconstructive operations
- Modern laparoscopic surgery
- Multidisciplinary treatment planning
- Enhanced recovery protocols (ERAS)
Frequently Asked Questions
No. If the narrowing is inflammatory, medication may be effective. Surgery is indicated for fibrotic strictures, repeated episodes of obstruction, or when conservative treatment is ineffective.
In many cases, yes. For certain short fibrotic strictures, strictureplasty can be performed, which preserves the length of the small bowel.
Yes. In many patients a laparoscopic approach is possible and allows faster postoperative recovery.
Yes. This depends on the cause of the disease. For example, in Crohn's disease new strictures can form, so regular follow-up and medication are needed after surgery.
For most patients, well-chosen treatment completely eliminates the symptoms of bowel obstruction and significantly improves quality of life. The long-term outlook depends on the underlying disease that caused the stricture.