Fibrostenosis occurs in both Crohn’s disease (CD) and ulcerative colitis (UC). Up to 21% of CD patients presented with stricturing behavior at diagnosis while rate of stenosis varies from 1-11% in UC. Despite increasing use of immunomodulators and biologics, there has been no decrease in the rate of progression from inflammatory phenotype to complicated disease phenotype (stricturing or penetrating). Presence of stenosis is an independent risk factor for surgery in patients with CD and patients are at risk of post-operative recurrence with rate up to 55% at 10 years after operation. IBD patients with strictures are at risk of malignant transformation. Thus, surveillance colonoscopy should be offered to this group of patients. Several risk factors for stricture development have been identified. In CD, patients less than 40 years old, presence of perianal disease at diagnosis, need of steroid at first flare and ileal disease are at risk of developing strictures; while in UC, patients with extensive colitis and long-standing disease are risk factors for stricture development. Recently, microbiota signatures have also been identified as marker for stricture development. Presence of Ruminococcus is associated with development of stricture in pediatric Crohn’s disease. In this review, we highlight the epidemiology, risk factors and natural history of fibrostenosing IBD. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.