Abstract

The Pathogenesis and Clinical Management of Stricturing Crohn Disease

Inflamm Bowel Dis. 2021 Mar 9;izab038. doi: 10.1093/ibd/izab038. Online ahead of print.

Christopher J Schmoyer 1, Jakob Saidman 1, Jaime L Bohl 2, Claire L Bierly 1, John F Kuemmerle 1 3, Stephen J Bickston 1

 
     

Author information

  • 1Virginia Commonwealth University, Division of Gastroenterology and Hepatology, Richmond, Virginia, USA.
  • 2Virginia Commonwealth University, Division of Colorectal Surgery, Richmond, Virginia, USA.
  • 3Virginia Commonwealth University, Department of Physiology and Biophysics, Richmond, Virginia, USA.

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.

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