Phenotypic Heterogeneity in Crohn's Disease-Associated Intestinal Strictures: An Exploratory Retrospective Cohort...

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Heterogeneity Studies

Background:

• Crohn's disease-associated intestinal strictures are a significant cause of morbidity, often necessitating intervention.
• Patients with stricturing Crohn's disease exhibit considerable clinical variability in disease location, complications, and treatment history.

Purpose of the Study:

• To explore the phenotypic heterogeneity within the patient population experiencing Crohn's disease-associated intestinal strictures.
• To identify distinct clinical patterns and associations among various disease manifestations in stricturing Crohn's disease.

Main Methods:

• Retrospective analysis of 96 patients with Crohn's disease-associated intestinal strictures (2014-2024).
• Analysis of clinical, structural, metabolic, and treatment variables.
• Exploratory univariate and multivariable logistic regression models were employed.

Main Results:

• The cohort presented with high rates of perianal disease, penetrating complications, and prior surgeries/biologic therapies.
• Female sex, autoimmune disease, rectal stenosis, and multiple biologic exposures were associated with extraintestinal manifestations (EIMs).
• Smoking was linked to anastomotic stenosis; hepatic steatosis showed associations with fistulas and resections.

Conclusions:

• Substantial clinical heterogeneity exists among patients with Crohn's disease-associated intestinal strictures.
• Overlapping phenotypic patterns involving structural, systemic, penetrating, behavioral, and metabolic factors are suggested.
• Findings require validation in larger prospective studies due to the exploratory nature and limitations.