title: Fibrosis in ulcerative colitis: mechanisms, features, and consequences of a neglected problem.
abstract: Chronic intestinal inflammation and impaired tissue repair leading to intestinal fibrosis are a commonly observed complication in inflammatory bowel disease. This is particularly true for small bowel Crohn's disease. However, the development of fibrosis in ulcerative colitis has remained largely unexplored. This is surprising, given knowledge about its prevalence for decades, well described histopathologic features of fibrotic and stricturing ulcerative colitis, the relevance of the extracellular matrix for intestinal inflammation and fibrosis, and the clinical impact of fibrosis on stricture formation, motility, and the necessary discrimination from colonic malignancy. This systematic review summarizes the current knowledge of ulcerative colitis-related fibrosis, including epidemiology, basic mechanisms, histopathology, and clinical implications.
authors.affiliation: *Department of Anatomic Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio; †Department of Hospital Medicine, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio; ‡Department of Gastroenterology & Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio; and §Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Ilyssa O
authors.initials: IO
authors.lastname: Gordon
authors.forename: Neha
authors.initials: N
authors.lastname: Agrawal
authors.forename: John R
authors.initials: JR
authors.lastname: Goldblum
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiocchi
authors.forename: Florian
authors.initials: F
authors.lastname: Rieder
mesh_terms: D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D005355:Fibrosis / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D011379:Prognosis