Summary
Definition
History and exam
Other diagnostic factors
- bowel obstruction
- blood in stools
- fever
- fatigue
- abdominal tenderness
- weight loss
- oral lesions
- abdominal mass
- extraintestinal manifestations (e.g., erythema nodosum or pyoderma gangrenosum)
Risk factors
- white ancestry
- age 15-40 or 60-80 years
- family history of CD
- cigarette smoking
- diet high in refined sugar
- oral contraceptives
- not breastfed
- NSAIDS
Diagnostic investigations
1st investigations to order
- CBC
- iron studies (serum iron, serum ferritin, total iron binding capacity [TIBC], transferrin saturation)
- serum vitamin B12
- serum folate
- comprehensive metabolic panel (CMP)
- C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)
- stool testing
- Yersinia enterocolitica serology
- plain abdominal films
- CT abdomen
- MRI abdomen/pelvis
Investigations to consider
- upper gastrointestinal and small bowel series
- abdominal and pelvic ultrasonography
- colonoscopy
- tissue biopsy
- technetium-99 labeled white blood cell scanning
- esophagogastroduodenoscopy
- wireless capsule endoscopy
- autoantibodies
- fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)
Treatment algorithm
Contributors
Authors VIEW ALL
Consultant Colorectal Surgeon
Imperial College Healthcare NHS Trust
London
UK
Disclosures
GR is an author of a number of references cited in this topic.
SpR in Gastroenterology and General Medicine
Imperial College Healthcare NHS Trust
Research Fellow
Imperial College London
London
UK
Disclosures
GW declares that she has no competing interests.
SpR in General Surgery
Imperial College Healthcare
Research Fellow
Imperial College London
London
UK
Disclosures
PHP declares that he has no competing interests.
Mr George Reese, Dr Georgia Woodfield, and Mr Pranav H. Patel would like to gratefully acknowledge Dr Philip J. Smith, Dr Charlotte Ford, Dr Wissam Bleibel, Dr Bishal Mainali, Dr Chandrashekhar Thukral, and Dr Mark A. Peppercorn, the previous contributors to this topic. PJS, CF, WB, BM, CT, and MAP declare that they have no competing interests.
Peer reviewers VIEW ALL
Chief of Gastroenterology & Hepatology
Professor of Medicine
Director of Crohn's & Colitis Center of New Jersey
New Brunswick
NJ
Disclosures
KMD declares that he has no competing interests.
Consultant Gastroenterologist and Senior Lecturer
Royal Victoria Infirmary
Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University
Newcastle upon Tyne
UK
Disclosures
JM declares that he has no competing interests.
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