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Indications include: Medically refractory disease not responding to optimized biologic therapy Bowel obstruction from fibrostenotic stricture Intra-abdominal abscess not amenable to percutaneous drainage Complex perianal fistula (seton placement, diversion) Enterocutaneous or enterovesical fistula Dysplasia or cancer in Crohns colitis Free perforation (rare) Nutritional Therapy Exclusive enteral nutrition (EEN) effective for induction in pediatric Crohns

They're not a last resort

Multiple sessions are usually needed for optimal results

Circulating prolactin associates with diabetes and impaired glucose regulation: A population-based study

Abraham 2005)

Extracellular vesicle-guided in situ reprogramming of synovial macrophages for the treatment of rheumatoid arthritis