Virginia Commonwealth University, Division of Gastroenterology and Hepatology, Richmond, Virginia, USA.
Virginia Commonwealth University, Division of Colorectal Surgery, Richmond, Virginia, USA.
Inflamm Bowel Dis. 2021 Oct 20;27(11):1839-1852. doi: 10.1093/ibd/izab038.
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.
胃肠道狭窄是克罗恩病的常见并发症，也是该人群发病率和死亡率的重要原因。炎症过程引发纤维化，导致异常的伤口愈合和细胞外基质蛋白的过度沉积。我们对这一过程的认识不断发展，包括细胞机制、表观遗传修饰以及纤维化的固有遗传倾向。尽管药物可以改善炎症，但仍没有药物可以减轻疤痕形成。因此，狭窄性疾病的治疗需要多学科和个体化的方法，包括药物治疗、治疗性内镜和手术。本文详细介绍了目前对狭窄性克罗恩病的发病机制、检测和治疗的理解。
