Crohn's Disease:

characterised by focal, asymmetrical, transmural and occasionally granulomatous inflammation
It may affect any part of the gastrointestinal tract but particularly the terminal ileum and proximal colon.
Disease is restricted to the small bowel in 30% of patients and the large bowel in 30% of patients. 40% of patients have involvement of the small and large bowel.
Fistulae and strictures may occur.
Unlike ulcerative colitis, there may be unaffected bowel between areas of active disease (skip lesions).
The clinical course is characterised by exacerbations and remission.
peak age: 15-30, and 60-80 y/o
female:male ratio in adults is 1.8:1 (reversed in kids)
smoking increases risk

Symptoms:

diarrhoea (which may be bloody and become chronic - ie present for more than six weeks),
abdominal pain and/or weight loss.
periods of acute exacerbation, interspersed with remissions or less active disease.
Systemic symptoms of malaise, anorexia, or fever are common.

Extra-intestinal manifestations:

Clubbing, erythema nodosum, pyoderma gangrenosum.
mouth ulcers, perianal (abscess, skin tags, fistulaes) or anal fissure.
Conjunctivitis, episcleritis, iritis.
Large joint arthritis, sacroiliitis (10-12%), ankylosing spondylitis.
Fatty liver, primary sclerosing cholangitis (rare), cholangiocarcinoma (rare).
Granulomata may occur (in 50-70% of patients) in the skin, epiglottis, mouth, vocal cords, liver, nodes, mesentery, peritoneum, bones, joints, muscle or kidney.

Children may present with poor growth, delayed puberty, malnutrition and bone demineralisation.

	Created by bessimajamal almost 10 years ago

Note on Bowels: obstruction, IBS and IBD, created by bessimajamal on 12/06/2014.

Bowels: obstruction, IBS and IBD