Intestinal
fibrosis, which is usually the consequence of chronic
inflammation, is a common complication of
inflammatory bowel disease (IBD), including
Crohn's disease and
ulcerative colitis. In the past few years, substantial advances have been made in the areas of pathogenesis, diagnosis and management of intestinal
fibrosis. Of particular interest have been
inflammation-independent mechanisms behind the gut fibrotic process, genetic and environmental risk factors (such as the role of the microbiota), and the generation of new in vitro and in vivo systems to study fibrogenesis in the gut. A huge amount of work has also been done in the area of
biomarkers to predict or detect intestinal
fibrosis, including novel cross-sectional imaging techniques. In parallel, researchers are embarking on developing and validating clinical trial end points and protocols to test novel
antifibrotic agents, although no antifibrotic
therapies are currently available. This Review presents the state of the art on the most recently identified pathogenic mechanisms of this serious IBD-related complication, focusing on possible targets of antifibrotic
therapies, management strategies, and factors that might predict
fibrosis progression or response to treatment.