Crohn's disease is a chronic inflammatory condition affecting the GI tract at any point from the mouth to the rectum.Symptoms and signs may consist of:
- diarrhea
- abdominal pain
- fever
- weight loss
- abdominal masses
- anemia
Extraintestinal manifestations of Crohn's disease include:
- osteoporosis
- inflammatory arthropathies
- scleritis
- nephrolithiasis
- cholelithiasis
- erythema nodosum
Laboratory findings
Acute phase reactants, such as CRP and ESR, are often increased with inflammation and may correlate with disease activity.
Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status.
Procedures often used to diagnose Crohn's disease:
- colonoscopy with ileoscopy
- capsule endoscopy
- computed tomography (CT) enterography
- small bowel follow-through
Diagnostic tools for extraintestinal manifestations or complications (e.g., abscess, perforation):
- ultrasonography
- computed axial tomography (CT)
- scintigraphy
- MRI
Medical management
Mesalamine products are used for mild to moderate colonic disease. Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment.
Patients with moderate to severe Crohn's disease are treated with:
- corticosteroids
- azathioprine
- 6-mercaptopurine
- anti-tumor necrosis factor agents (e.g., infliximab, adalimumab)
References
Diagnosis and management of Crohn's disease. Wilkins T, Jarvis K, Patel J. Am Fam Physician. 2011 Dec 15;84(12):1365-75.
Image source: Colon (anatomy), Wikipedia, public domain.
