Mucosal Healing in Crohn’s Disease: Bull’s Eye or Bust? The “Relative” Con Position

Inflammatory Intestinal Diseases

Mahmoud Mosli¹  Turki Alameel²  Ala I. Sharara³ 

[1] Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia;Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia;Division of Gastroenterology, Department of Medicine, American University of Beirut Medical Center, Beirut, Lebanon;

关键词: crohn’s disease;    mucosal healing;    treatment;    partial healing;   

DOI  :  10.1159/000519731

来源: DOAJ

【 摘 要 】

Background: Crohn’s disease is a progressive inflammatory bowel disease. Persistent untreated inflammation can cumulatively result in bowel damage in the form of strictures, fistulas, and fibrosis, which can ultimately result in the need for major abdominal surgery. Mucosal healing has emerged as an attractive, yet ambitious goal in the hope of preventing long-term complications. Summary: Clinical remission is an inadequate measure of disease activity. Noninvasive markers such as fecal calprotectin, CRP, or small bowel ultrasound are useful adjunct tools. However, endoscopic assessment remains the cornerstone in building a treatment plan. Achieving complete mucosal healing has proved to be an elusive goal even in the ideal setting of a clinical trial. Key Messages: Aiming for complete mucosal healing in all patients may result in overuse of medications, higher costs, and potential side effects of aggressive immunosuppressive treatment. More practical goals such as relative or partial healing, for example, 50% improvement in inflammation and reduction in size of ulcers, ought to be considered, particularly in difficult-to-treat populations.

【 授权许可】

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