Mechanisms, Management, and Treatment of Fibrosis in Patients With Inflammatory Bowel Diseases

Gastroenterology. 2017 Feb;152(2):340-350.e6. doi: 10.1053/j.gastro.2016.09.047. Epub 2016 Oct 5.

Abstract

In the last 10 years, we have learned much about the pathogenesis, diagnosis, and management of intestinal fibrosis in patients with inflammatory bowel diseases. Just a decade ago, intestinal strictures were considered to be an inevitable consequence of long-term inflammation in patients who did not respond to anti-inflammatory therapies. Inflammatory bowel diseases-associated fibrosis was seen as an irreversible process that frequently led to intestinal obstructions requiring surgical intervention. This paradigm has changed rapidly, due to the antifibrotic approaches that may become available. We review the mechanisms and diagnosis of this serious complication of inflammatory bowel diseases, as well as factors that predict its progression and management strategies.

Keywords: Crohn’s Disease; Dilation; Treatment; Ulcerative Colitis.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / immunology
  • Constriction, Pathologic / physiopathology
  • Constriction, Pathologic / surgery
  • Cytokines / immunology
  • Dilatation / methods
  • Disease Progression
  • Endoscopy, Digestive System / methods
  • Fibroblasts*
  • Fibrosis
  • Humans
  • Inflammatory Bowel Diseases / immunology*
  • Intestinal Diseases / diagnostic imaging
  • Intestinal Diseases / immunology
  • Intestinal Diseases / physiopathology*
  • Intestinal Diseases / surgery
  • Intestines / pathology*
  • Magnetic Resonance Imaging
  • Myofibroblasts*
  • Tomography, X-Ray Computed

Substances

  • Cytokines