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日期: 113年 01月 19日   地點:B1 第一演講廳

主題: Crohn's disease with intestinal fibrosis

講者: 胃腸科  張肇丰  醫師

大綱: 

Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract. 70% of diagnosed patients encountered fibrosis-associated intestinal stricture after 10 years of disease course. Intestinal stricture may lead to intestinal obstruction, which impacts the patient’s life quality. The etiology of fibrosis remained uncertain. Extracellular matrix remodeling, aberrant immune response, intestinal microbiome imbalance and creeping fat might involve on the multiple physiological and pathophysiological processes.

While patients had inflammatory bowel disease, monitor disease course and activity is very important. Many modalities including enteroscopy, capsule endoscopy and Magnetic resonance enterography are helpful in confirming intestinal stricture. In terms of drug treatment, TNF antibody drugs are mainly adalimumab, infliximab can be considered for patients with vasculitis-related diseases, and ustekinumab can be considered for patients with refractory or Crohn's disease stenosis. However, anti-fibrotic therapy is limited in preventing or reversing the process of fibrosis. Hence, endoscopic balloon dilatation is still a concern in therapeutic strategy and it is a bridging therapy between drug therapy and surgical intervention in treating stricture.