Fibrostenosis of the small bowel is common in patients with Crohn’s disease. No consensus recommendations on definition, diagnosis and management in clinical practice are currently available. In this Consensus Statement, we present a clinical practice RAND/UCLA appropriateness study on the definition, diagnosis and clinical management of fibrostenosing Crohn’s disease. It was conducted by a panel of 28 global experts and one patient representative. Following a systematic literature review, 526 candidate items grouped into 136 questions were generated and subsequently evaluated for appropriateness. Strictures are best defined as wall thickening, luminal narrowing and prestenotic dilation. Cross-sectional imaging is required for accurate diagnosis of fibrostenosing Crohn’s disease, and it is recommended before making treatment decisions. It should also assess the degree of inflammation in the bowel wall. Multiple options for medical anti-inflammatory, endoscopic and surgical therapies were suggested, including follow-up strategies following therapy. This Consensus Statement supports clinical practice through providing guidance on definitions, diagnosis and therapeutic management of patients with fibrostenosing small bowel Crohn’s disease.

小肠纤维狭窄在克罗恩病患者中很常见。目前尚无关于临床实践中的定义、诊断和管理的共识建议。在本共识声明中，我们提出了一项关于纤维狭窄性克罗恩病的定义、诊断和临床管理的兰德/加州大学洛杉矶分校临床实践适当性研究。该研究由 28 名全球专家和一名患者代表组成的小组进行。经过系统的文献综述后，生成了 526 个候选项目，分为 136 个问题，并随后评估了其适当性。狭窄最好定义为壁增厚、管腔变窄和狭窄前扩张。需要进行横断面成像才能准确诊断纤维狭窄性克罗恩病，建议在做出治疗决定之前进行横断面成像。它还应该评估肠壁的炎症程度。建议采取多种药物抗炎、内窥镜和手术治疗方案，包括治疗后的后续策略。本共识声明通过为纤维狭窄性小肠克罗恩病患者的定义、诊断和治疗管理提供指导来支持临床实践。