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- W2542702968 abstract "Crohn’s disease [CD] is characterised by a chronic progressive course leading to accumulation of structural intestinal damage. Up to 60% of CD patients eventually develop complications necessitating surgical intervention.1 Clearly, the need for surgery manifests the ‘tip of the iceberg’ of a continuous process of gradual accumulation of structural intestinal wall damage. Early and aggressive treatment of CD may be associated with a lower risk for change of phenotype, suggesting a possible ‘therapeutic window’ for disease course modification.2 The common paradigm of CD natural history suggests that stricturing and penetrating phenotype are usually absent at disease onset but rather develop as a consequence of a long-standing inflammatory process.1 A long diagnostic delay is common in CD, and the inflammatory process is frequently present many years before the actual diagnosis of the disease, further contributing to the risk of surgery.3 A thorough evaluation of the small bowel with optimal diagnostic tools such as capsule endoscopy and magnetic resonance enterography may lead to detection of a more aggressive phenotype in a significant proportion of the patients.4 It is plausible that early detection of progressing bowel damage may provide the benefits of early treatment, potentially resulting in a reduced risk of structural complications and need for surgery. The concept of progressive structural damage as a therapeutic target, although well established in rheumatology, is still relatively new in the IBD field. The first of … Corresponding author: Uri Kopylov, MD, Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Email: ukopylov{at}gmail.com" @default.
- W2542702968 created "2016-11-04" @default.
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- W2542702968 date "2016-10-26" @default.
- W2542702968 modified "2023-09-25" @default.
- W2542702968 title "The Lemann Index—A Glance Through the Window of Opportunity?" @default.
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- W2542702968 doi "https://doi.org/10.1093/ecco-jcc/jjw195" @default.
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