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Review
. 2021 Apr;15(4):401-411.
doi: 10.1080/17474124.2021.1854732. Epub 2020 Dec 28.

Prevention and Treatment of Stricturing Crohn's Disease - Perspectives and Challenges

Joseph Sleiman  1 , Sara El Ouali  1   2 , Taha Qazi  1 , Benjamin Cohen  1 , Scott R Steele  3 , Mark E Baker  4 , Florian Rieder  1   5
Affiliations
Review

Prevention and Treatment of Stricturing Crohn's Disease - Perspectives and Challenges

Joseph Sleiman et al. Expert Rev Gastroenterol Hepatol. 2021 Apr.

Abstract

Introduction: Fibrostenosis is a hallmark of Crohn's disease (CD), remains a challenge in today's clinical management of inflammatory bowel disease patients and represents a key event in the disease course necessitating improved preventative strategies and a multidisciplinary approach to diagnosis and management. With the advent of anti-fibrotic therapies and well-defined clinical endpoints for stricturing CD, there is promise to impact the natural history of disease.Areas covered: This review summarizes current evidence in the natural history of stricturing Crohn's disease, discusses management approaches as well as future perspectives on intestinal fibrosis.Expert opinion: Currently, there are no specific therapies to prevent progression to fibrosis or to treat it after it becomes clinically apparent. In addition to the international effort by the Stenosis Therapy and Anti-Fibrotic Research (STAR) consortium to standardize definitions and propose endpoints in the management of stricturing CD, further research to improve our understanding of mechanisms of intestinal fibrosis will help pave the way for the development of future anti-fibrotic therapies.

Keywords: Anti-fibrotic; Crohn’s disease; endoscopic balloon dilation; enterography; fibrosis; inflammatory bowel disease; stenosis; stricture; strictureplasty; surgery.

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Figures

Figure 1.
Figure 1.
Algorithm for the management of symptomatic small bowel strictures in Crohn’s disease. CD: Crohn’s disease. EBD: endoscopic balloon dilation. *abscess, fistula, malignancy
See this image and copyright information in PMC

References

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      **Thorough review of fibrosis in IBD, with a detailed section on pathophysiology

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