The Pathogenesis and Clinical Management of Stricturing Crohn Disease

Abstract Stricturing of the gastrointestinal tract is a common complication in Crohn disease and is a significant cause of morbidity and mortality among this population. The inflammatory process initiates fibrosis, leading to aberrant wound healing and excess deposition of extracellular matrix prote...

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Published inInflammatory bowel diseases Vol. 27; no. 11; pp. 1839 - 1852
Main Authors Schmoyer, Christopher J, Saidman, Jakob, Bohl, Jaime L, Bierly, Claire L, Kuemmerle, John F, Bickston, Stephen J
Format Journal Article
LanguageEnglish
Published US Oxford University Press 20.10.2021
Subjects
Constriction, Pathologic
Crohn Disease - pathology
Crohn Disease - therapy
Endoscopy
Fibrosis
Humans
Montreal B2
pathogenesis
treatment
Crohn
biologic therapy
endoscopy
fibrosis
medical therapy
stricture
surgery
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Summary:Abstract Stricturing of the gastrointestinal tract is a common complication in Crohn disease and is a significant cause of morbidity and mortality among this population. The inflammatory process initiates fibrosis, leading to aberrant wound healing and excess deposition of extracellular matrix proteins. Our understanding of this process has grown and encompasses cellular mechanisms, epigenetic modifications, and inherent genetic predisposition toward fibrosis. Although medications can improve inflammation, there is still no drug to attenuate scar formation. As such, management of stricturing disease requires a multidisciplinary and individualized approach including medical management, therapeutic endoscopy, and surgery. This review details the current understanding regarding the pathogenesis, detection, and management of stricturing Crohn disease.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:1078-0998
1536-4844
DOI:10.1093/ibd/izab038