Crohn disease

Crohn disease (CD) is a disorder of unknown etiology characterized by transmural inflammation of the gastrointestinal tract.

Common presenting symptoms include chronic diarrhea, weight loss, and right lower quadrant abdominal pain mimicking acute appendicitis.

Diagnosis confirmed by colonoscopy with ileoscopy and tissue biopsy.

Specialist input is required from the time of diagnosis, as treatment regimens require frequent monitoring of clinical response, knowledge of common adverse events, and expertise in managing potentially serious adverse events.

The overall treatment goals are to induce and maintain remission, and to prevent relapse or recurrence.

Complications include extraintestinal involvement, intestinal obstruction, abscess formation, sinuses, and fistulae.

CD is a disorder of unknown etiology characterized by transmural inflammation of the gastrointestinal (GI) tract. CD may involve any or all parts of the entire GI tract from mouth to perianal area, although it is usually seen in the terminal ileal and perianal locations. Unlike ulcerative colitis, CD is characterized by skip lesions (where normal bowel mucosa is found between diseased areas). The transmural inflammation often leads to fibrosis, causing intestinal obstruction. The inflammation can also result in sinus tracts that burrow through and penetrate the serosa, thereafter giving rise to perforations and fistulae.[1]Podolsky DK. Inflammatory bowel disease. N Engl J Med. 2002 Aug 8;347(6):417-29. http://www.ncbi.nlm.nih.gov/pubmed/12167685?tool=bestpractice.com [2]Ekbom A, Helmick C, Zack M, et al. The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden. Gastroenterology. 1991 Feb;100(2):350-8. http://www.ncbi.nlm.nih.gov/pubmed/1985033?tool=bestpractice.com

BMJ talk medicine podcast: Crohn disease Opens in new window