Abstract
Fibrostenotic inflammatory bowel disease classically refers to Crohn’s disease, where stricture and submucosal fibrosis are frequent and defining histopathologic features. Descriptions of histologic fibrosis in ulcerative colitis have existed for over half a century, but are not currently part of the clinical diagnostic framework. Histologic scoring systems for fibrosis in inflammatory bowel disease are varied and highlight the need for improved histopathologic correlation, given recent advances in our understanding of the pathophysiology of intestinal fibrosis.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Koukoulis G, Ke Y, Henley JD, Cummings OW. Obliterative muscularization of the small bowel submucosa in Crohn disease: a possible mechanism of small bowel obstruction. Arch Pathol Lab Med. 2001;125(10):1331–4.
Zhang X, Ko H-BM, Cai Z, Zhu H, Polydorides AD, Torres J, et al. Fibromuscular strictures in Ileal Crohn’s disease: a detailed morphometric and Histopathologic analysis. Mod Pathol. 2017;30(S2):209A–10A.
Burke JP, Mulsow JJ, O’Keane C, Docherty NG, Watson RW, O’Connell PR. Fibrogenesis in Crohn’s disease. Am J Gastroenterol. 2007;102(2):439–48.
Rieder F, Brenmoehl J, Leeb S, Scholmerich J, Rogler G. Wound healing and fibrosis in intestinal disease. Gut. 2007;56(1):130–9.
Rieder F, Fiocchi C. Intestinal fibrosis in IBD—a dynamic, multifactorial process. Nature Rev. 2009;6(4):228–35.
Scales BS, Huffnagle GB. The microbiome in wound repair and tissue fibrosis. J Pathol. 2013;229(2):323–31.
Burke JP, Cunningham MF, Watson RW, Docherty NG, Coffey JC, O’Connell PR. Bacterial lipopolysaccharide promotes profibrotic activation of intestinal fibroblasts. Br J Surg. 2010;97(7):1126–34.
Gumaste V, Sachar DB, Greenstein AJ. Benign and malignant colorectal strictures in ulcerative colitis. Gut. 1992;33(7):938–41.
De Dombal FT, Watts JM, Watkinson G, Goligher JC. Local complications of ulcerative colitis: stricture, pseudopolyposis, and carcinoma of colon and rectum. Br Med J. 1966;1(5501):1442–7.
Hunt RH, Teague RH, Swarbrick ET, Williams CB. Colonoscopy in management of colonic strictures. Br Med J. 1975;3(5979):360–1.
Goulston SJ, McGovern VJ. The nature of benign strictures in ulcerative colitis. N Engl J Med. 1969;281(6):290–5.
Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut. 1964;5:1–22.
Gore RM. Colonic contour changes in chronic ulcerative colitis: reappraisal of some old concepts. AJR Am J Roentgenol. 1992;158(1):59–61.
Gordon IO, Agrawal N, Goldblum JR, Fiocchi C, Rieder F. Fibrosis in ulcerative colitis: mechanisms, features, and consequences of a neglected problem. Inflamm Bowel Dis. 2014;20(11):2198–206.
Mitomi H, Okayasu I, Bronner MP, Kanazawa H, Nishiyama Y, Otani Y, et al. Comparative histologic assessment of proctocolectomy specimens from Japanese and American patients with ulcerative colitis with or without dysplasia. Int J Surg Pathol. 2005;13(3):259–65.
Warren S, Sommers SC. Pathogenesis of ulcerative colitis. Am J Pathol. 1949;25(4):657–79.
Lumb G. Pathology of ulcerative colitis. Gastroenterology. 1961;40:290–8.
Lumb G, Protheroe RH. Ulcerative colitis; a pathologic study of 152 surgical specimens. Gastroenterology. 1958;34(3):381–407.
Jones MK, Tomikawa M, Mohajer B, Tarnawski AS. Gastrointestinal mucosal regeneration: role of growth factors. Front Biosci. 1999;4:D303–9.
Dammeier J, Brauchle M, Falk W, Grotendorst GR, Werner S. Connective tissue growth factor: a novel regulator of mucosal repair and fibrosis in inflammatory bowel disease? Int J Biochem Cell Biol. 1998;30(8):909–22.
Willis E, Lopez R, Agrawal N, Rieder F, Gordon I. Alterations in lamina propria and muscularis mucosa in ulcerative colitis are associated with prior medication and degree of histologic inflammatory activity. Mod Pathol. 2017;30(S2):206A.
Gordon IO, Agrawal N, Willis E, Goldblum JR, Lopez R, Allende D, Liu X, Patil DY, Yerian L, El-Khider F, Fiocchi C, Rieder F. Fibrosis in ulcerative colitis is directly linked to severity and chronicity of mucosal inflammation. Aliment Pharmacol Ther. 2018;47(7):922–39.
Higgins PD. Measurement of fibrosis in Crohn’s disease strictures with imaging and blood biomarkers to inform clinical decisions. Dig Dis. 2017;35(1–2):32–7.
Theiss AL, Fuller CR, Simmons JG, Liu B, Sartor RB, Lund PK. Growth hormone reduces the severity of fibrosis associated with chronic intestinal inflammation. Gastroenterology. 2005;129(1):204–19.
Higgins PD, Johnson LA, Sauder K, Moons D, Blanco L, Taube S, et al. Transient or persistent norovirus infection does not alter the pathology of salmonella typhimurium induced intestinal inflammation and fibrosis in mice. Comp Immunol Microbiol Infect Dis. 2011;34(3):247–57.
Adler J, Punglia DR, Dillman JR, Polydorides AD, Dave M, Al-Hawary MM, et al. Computed tomography enterography findings correlate with tissue inflammation, not fibrosis in resected small bowel Crohn’s disease. Inflamm Bowel Dis. 2012;18(5):849–56.
Maconi G, Carsana L, Fociani P, Sampietro GM, Ardizzone S, Cristaldi M, et al. Small bowel stenosis in Crohn’s disease: clinical, biochemical and ultrasonographic evaluation of histological features. Aliment Pharmacol Ther. 2003;18(7):749–56.
Chiorean MV, Sandrasegaran K, Saxena R, Maglinte DD, Nakeeb A, Johnson CS. Correlation of CT enteroclysis with surgical pathology in Crohn’s disease. Am J Gastroenterol. 2007;102(11):2541–50.
Dillman JR, Stidham RW, Higgins PD, Moons DS, Johnson LA, Keshavarzi NR, et al. Ultrasound shear wave elastography helps discriminate low-grade from high-grade bowel wall fibrosis in ex vivo human intestinal specimens. J Ultrasound Med. 2014;33(12):2115–23.
Fazio VW, Marchetti F, Church M, Goldblum JR, Lavery C, Hull TL, et al. Effect of resection margins on the recurrence of Crohn’s disease in the small bowel. A randomized controlled trial. Ann Surg. 1996;224(4):563–71. Discussion 71–3.
Kotanagi H, Kramer K, Fazio VW, Petras RE. Do microscopic abnormalities at resection margins correlate with increased anastomotic recurrence in Crohn’s disease? Retrospective analysis of 100 cases. Dis Colon Rectum. 1991;34(10):909–16.
de Bruyn JR, Meijer SL, Wildenberg ME, Bemelman WA, van den Brink GR, D’Haens GR. Development of fibrosis in acute and longstanding ulcerative colitis. J Crohns Colitis. 2015;9(11):966–72.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Gordon, I.O. (2018). Histopathology of Intestinal Fibrosis. In: Rieder, F. (eds) Fibrostenotic Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-90578-5_11
Download citation
DOI: https://doi.org/10.1007/978-3-319-90578-5_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-90577-8
Online ISBN: 978-3-319-90578-5
eBook Packages: MedicineMedicine (R0)