Tracking the Natural Course of Silent Small Bowel Narrowing in Adults With Crohn's Disease

Crohn's disease is a long-term condition that causes inflammation in the digestive tract. Over time, some people develop narrowings in the small intestine, called "strictures." These strictures can block food and cause symptoms like abdominal pain, bloating, nausea, or vomiting. However, strictures are sometimes found by chance in people who have no symptoms. These are called "asymptomatic" or "silent" strictures. Doctors do not know how often silent strictures become a problem or whether it is better to treat them early or simply monitor them. Current treatments for Crohn's disease are not very effective at reversing scar tissue once it forms, and there are no clear guidelines for what to do when a silent stricture is found. The SILENCE study will look at the natural course of silent small bowel strictures in adults with Crohn's disease. Researchers will review the medical records of people aged 18 and older who were diagnosed with a silent small bowel stricture between 2015 and 2023. All participants must have at least one year of follow-up information available. The study will record: How often strictures become symptomatic (cause abdominal pain, nausea, vomiting, bloating, or other symptoms) Whether patients require treatments such as changes in medication, endoscopic dilation, or surgery Any changes in the size or severity of the stricture seen on imaging or endoscopy The study will also compare two groups: People whose silent stricture was found at the same time as their Crohn's diagnosis People with Crohn's in remission for at least two years before developing a silent stricture Researchers will examine possible risk factors for progression, such as age, smoking status, prior treatment, and results from blood or stool tests. By understanding how silent strictures behave over time, this study aims to help doctors decide when it is safe to observe and when intervention might be needed. The findings could improve patient care and inform future treatme