Intestinal stricture in Crohn's disease: an update in 2020.

Crohn's disease (CD) is a chronic and relapsing-remitting inflammatory disorder of the gastrointestinal tract. Approximately 70% of patients will inevitably develop fibrosis associated intestinal stricture after 10 years of diagnosis of CD, which seriously affects their quality of life. Current therapies play limited role in preventing or reversing the process of fibrosis and no specific anti-fibrotic therapy is yet available. Nearly half of patients thus have no alternative but to receive at least one surgery within 10 years of diagnosis. The potential mechanisms of intestinal fibrosis remain poorly understood, extracellular matrix remodeling, aberrant immune response, intestinal microbiome imbalance and creeping fat might exert fundamental influences on the multiple physiological and pathophysiological processes. Recently, the emerging new diagnostic techniques have markedly promoted the accurate assessment of intestinal stricture by distinguishing fibrosis from inflammation, which is crucial for guiding treatment and prognosis. In this review, we concisely summarized the key studies published in the year 2020 covering pathogenesis, diagnostic modalities, and therapeutic strategy of intestinal stricture. A comprehensive and timely review of the updated researches in intestinal stricture could provide insight for further elucidating its pathogenesis and identifying novel drug targets with anti-fibrotic potentiality. This article is protected by copyright. All rights reserved.