One of the major complications of Crohn's disease is the development of
fibrosis, this causes the intestine to lose its mobility. The most frequent intestinal
“damage” occurrences are considered fibrosis, fistula, abscess, resected bowel. The
Lemann index has been developed to describe the entire gut damage score in CD. It is
summarizes the clinical, imaging, endoscopic, and surgical findings from all the
segments of the digestive tract into one global score and provides a superior
quantification of the severity of bowel, destruction. Chronic inflammation, hypertrophy
of MP (muscularis propria) and smooth muscle hyperplasia of SM (submucosa) were
the most valid histopathological features characterizing the intestinal stricture. Imaging
methods such as MRI, CT or IUS can detect penetrating disease and intra-abdominal
abscesses in different accuracy grades. Although the current imaging techniques were
not able to determine the degree of fibrosis, MRI was preferred in the US for pelvic
fistulae, abscesses or deep-seated fistulae. By decreasing MRTF and p38 MAPK
activation and increasing autophagy in fibroblasts, local ROCK inhibition prevents and
reverses intestinal fibrosis. Fibrosis is certainly reversible in animal models. The
duration of treatment and toxicity are challenging for the time being.
Keywords: Crohn Disease, Fibrosis, IL36A, Inflammatory bowel disease, Lemann index, MRFT, Penetrating disease, p38 MAPK, ROCK inhibition, Smooth muscle hyperplasia, Stricture.
