Fibrosis in ulcerative colitis is directly linked to severity and chronicity of mucosal inflammation

• DOI: 10.1111/apt.14526
• Publication Date: 2018-02-07T03:56:40Z
• Authors: I. O. Gordon; N. Agrawal; E. Willis; J. R. Goldblum; R. Lopez; D. Allende; X. Liu; D. Y. Patil; L. Yerian; F. El‐Khider; C. Fiocchi; F. Rieder
• Keywords: Muscularis mucosae; Submucosa

Summary Background Fibrosis in ulcerative colitis has remained largely unexplored despite its clinical implications. Aims This cross‐sectional study was aimed at characterising the presence, anatomical location and degree of colitis‐associated fibrosis possible link to parameters. Methods Seven hundred six individual tissue cross‐sections derived every 10 cm along length 89 consecutive Ulcerative colectomy specimens were examined compared Crohn's disease colitis, diverticular uninvolved areas from colorectal cancer patients. Degree inflammation, morphometric measurements all layers intestinal wall evaluated. Three gastrointestinal pathologists independently assessed colon sections stained with haematoxylin eosin, Masson trichrome Sirius red. Clinical data collected prospectively. Results Submucosal detected 100% specimens, but only affected by inflammation. associated severity inflammation (Spearman correlations rho (95% confidence interval): 0.58 ( P < 0.001) histopathological changes chronic mucosal injury, not active Colectomy for refractory rather than presence dysplasia increased a thicker muscularis mucosae, whereas thinner mucosae anti‐tumour necrosis factor therapy. No feature on endoscopic biopsies could predict underlying amount or thickness mucosae. Conclusions A significant thickening should be considered as common complications progressive colitis. These features may have consequences such motility abnormalities stiffness.