2017
DOI: 10.1053/j.gastro.2016.09.047
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Mechanisms, Management, and Treatment of Fibrosis in Patients With Inflammatory Bowel Diseases

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 (IBD). 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. IBD-associated fibrosis was seen as an irreversible process that frequently led to intestinal obstructions requiring surgical intervention. This paradigm has changed ra… Show more

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Cited by 384 publications
(438 citation statements)
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References 221 publications
(181 reference statements)
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“…Furthermore, IBD progression is associated with the development of a number of common complications. For example, inflammation associated with CD often leads to fibrosis 90 . Other complications such as anemia also are associated with IBD.…”
Section: Inflammatory Bowel Disease: the Involvement Of Barrier Dysfumentioning
confidence: 99%
See 1 more Smart Citation
“…Furthermore, IBD progression is associated with the development of a number of common complications. For example, inflammation associated with CD often leads to fibrosis 90 . Other complications such as anemia also are associated with IBD.…”
Section: Inflammatory Bowel Disease: the Involvement Of Barrier Dysfumentioning
confidence: 99%
“…Anti-TNF therapy can lead to immune-compromised states and is related to a higher risk of infectious disease as well as a higher risk of malignancy 93 . Moreover, complications such as fibrosis still can appear and represent major indication for surgical interventions owing to the lack of pharmacologic options 90 . This emphasizes the need for new therapeutic approaches that can prolong remission and control the development of complications.…”
Section: Inflammatory Bowel Disease: the Involvement Of Barrier Dysfumentioning
confidence: 99%
“…CD-associated strictures are frequently unresponsive to any of the current anti-inflammatory drugs for CD and require alternative therapeutic approaches like endoscopic balloon dilation (3•), strictureplasty or bowel resection, and often recur after resection (2, 4, 5). Clinically, the CD fibrostenotic stricture needs to be distinguished from inflammation-related bowel wall thickening which may respond to anti-inflammatory therapy; the two often coexist, and their distinction is difficult since intestinal fibrosis follows the distribution and location of inflammation (6).…”
Section: Morphology and Mechanisms Of Intestinal Fibrosismentioning
confidence: 99%
“…Of these enteropathies, IBD is the main cause of intestinal fibrosis since this disease is characterized by a persistent immuno-mediated intestinal inflammation (1, 2). It becomes clinically apparent in >30% of patients with Crohn’s disease (CD) and in about 5% with ulcerative colitis (UC).…”
Section: Introductionmentioning
confidence: 99%
“…As known, intestinal fibrosis is a consequence of local chronic inflammation and is characterized by excessive ECM protein deposition [22]. The transforming growth factor-β1 (TGF-β1) isoform was considered to be closely involved in fibrosis and ECM synthesis.…”
Section: Introductionmentioning
confidence: 99%