Crohn’s Disease

Crohn's Disease
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Synonyms	Crohn syndrome, regional enteritis
Pronounce
Specialty	Gastroenterology
Symptoms	Abdominal pain, diarrhea, fever, weight loss
Complications	Inflammation, bowel obstruction, anemia, skin rashes, arthritis
Onset	Any age, often 15–30 years
Duration	Long term
Types
Causes	Unknown
Risks	Family history, smoking, certain medications
Diagnosis	Based on symptoms, medical imaging, endoscopy, biopsy
Differential diagnosis	Ulcerative colitis, irritable bowel syndrome, celiac disease
Prevention
Treatment	Lifestyle changes, medication, surgery
Medication	Anti-inflammatory, immune system suppressors, antibiotics
Prognosis	Variable
Frequency	3.2 per 1,000 people (developed world)
Deaths

Crohn's Disease is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, and weight loss. Other complications outside the gastrointestinal tract may include anemia, skin rashes, arthritis, inflammation of the eye, and tiredness. The skin rashes may be due to erythema nodosum or pyoderma gangrenosum. Arthritis may be due to spondyloarthropathy.

Causes and Risk Factors

The exact cause of Crohn's disease is unknown, but it is believed to be due to a combination of environmental, immune, and bacterial factors in genetically susceptible individuals. It results from an abnormal immune response that causes the immune system to attack the digestive tract. There is a higher risk in people who have family members with the disease, smokers, and those who have used certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).

Diagnosis

Diagnosis of Crohn's disease is based on a combination of symptoms, endoscopy, colonoscopy, biopsy, and medical imaging. Endoscopy is particularly useful as it allows direct visualization of the colon and the terminal ileum, where Crohn's is most commonly found, allowing for biopsy to confirm the diagnosis.

Treatment

Treatment options are geared towards controlling inflammation, maintaining nutritional status, and relieving symptoms, with the goal of inducing and maintaining remission. Lifestyle changes, such as diet modification and quitting smoking, are important. Medications used include anti-inflammatory drugs such as corticosteroids and aminosalicylates, immune system suppressors such as azathioprine and methotrexate, and biologics like infliximab. In severe cases, surgery may be required to remove damaged portions of the gastrointestinal tract.

Epidemiology

Crohn's disease affects about 3.2 per 1,000 people in the developed world. It occurs equally in men and women and can occur at any age, although it often begins in people between the ages of 15 and 30 years. The prevalence is increasing, particularly in the developed world.

See Also

• Inflammatory bowel disease
• Ulcerative colitis
• Gastrointestinal surgery