EP300 - Anorectal Dilations for IBD and Beyond: Which Factors Impact Frequency?

Sunday, May 10, 2026

8:05 AM - 8:10 AM ET

ePoster Presenter(s)

CP

Casey K. Paterson, MD

Colorectal Surgery Fellow
Corewell Health/Michigan State University
Grand Rapids, Michigan, United States

Disclosure information not submitted.

Author(s)

Matt Morris, MD (he/him/his)

Resident Physician
Corewell Health West - Butterworth Hospital, Blodgett Hospital, and Lake Drive
Michigan State University College of Human Medicine
Grand Rapids, MI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
AS

Allison R. Swider-Ebels, MD

General Surgery Resident
Corewell Health West/MSU
Grand Rapids, Michigan, United States

Disclosure information not submitted.

Senior Author(s)

james Ogilvie, MD, MS

Staff Surgeon
Corewell Health
Michigan State University
Grand Rapids, MI, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Matt Morris, MD: This individual has no financial relationships with ineligible companies.

Purpose/Background: Anastomotic and inflammatory anorectal strictures in inflammatory bowel disease (IBD) remain a challenge to manage. Stricture dilation is a common temporizing procedure, but there is a paucity of data regarding outcomes and predictive factors. We aim to assess the efficacy of anorectal dilations for both IBD and non-IBD patients, with and without anorectal anastomosis.

Methods/Interventions: We reviewed 74 patients from 2018-2025 who underwent anorectal dilations requiring general anesthesia in the operating room at a single institution. Patients undergoing dilations under moderate sedation in the endoscopy suite were excluded. Patients were divided into 3 subgroups: 1) patients with IBD and an anorectal surgical anastomosis, 2) patients with IBD without an anorectal surgical anastomosis and 3) patients without IBD but with a stricture associated with a prior surgery. The primary outcome was percentage of patients in each group that required 2 or more dilations per year over the 8-year time frame. Demographic variables included age, gender, body mass index (BMI), history of inflammatory bowel disease, concurrent use of immunomodulators, existing anorectal anastomosis, and size diameter (mm) of largest dilator used intra-operatively.

Results/Outcomes: Of the 74 patients reviewed, 39% were male and 61% were female. Average BMI for group 1, group 2 and group 3 was 27, 26, and 29, respectively. The average maximum size of dilation amongst all groups was 20mm. While patients were distributed evenly among groups, their mean ages differed: group 1: n= 26 (35%), mean age 45, group 2: n=26 (35%), mean age 37, and group 3: n= 22 (30%), mean age 57. Of the IBD patients, 12% in group 1 were on concurrent immunomodulating medical therapy compared to 92% in group 2. 50% of patients in group 2 required 2 or more dilations within a year compared to only 42% of patients in group 1. Only 14% of patients in group 3 required 2 or more dilations within a year (Figure 1).

Conclusion/Discussion: Almost half of patients with IBD and an anorectal stricture (with or without an anastomosis) were likely to require 2 or more dilations in a single year from 2018-2025. Despite the high use of concurrent immunomodulators among those without an anastomosis, rates of repeat dilation were not appreciably different to those with a previous surgical anastomosis.

Percentage of patients with 2 or more dilations in a single year

Figure 1. Percentage of patients requiring 2 or more dilations in a single year from 2018-2025.
Percentage of patients by total dilations per group

Figure 2. Percentage of patients by total dilations per group.