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Colonic Crohn Disease

Crohn Disease of the Colon


Presentation

  • We report the presentation, investigations and subsequent improvement of our patient and speculate on possible causes.[ncbi.nlm.nih.gov]
  • Changes were observed in both diseases and when ulceration was present these consisted of both cellular and humoral immune reactivity.[ncbi.nlm.nih.gov]
  • We report herein a case in which a liver abscess was the initial clinical manifestation of Crohn's disease in a 36 year old man who presented with high fever and weakness.[ncbi.nlm.nih.gov]
  • The clinical features, outcome after surgery, and pathological features of colonic resection specimens of 73 patients who presented initially with isolated colonic Crohn's disease were evaluated and compared with 45 Crohn's disease patients who presented[ncbi.nlm.nih.gov]
  • Key findings include a higher incidence in females (65%) and older average age at presentation than Crohn's disease at other sites, a mucosa-associated microbiota between that found in ileal Crohn's disease and UC, no response to mesalazine, but possibly[ncbi.nlm.nih.gov]
Weight Loss
  • After controlling these infections, she continued to complain of diarrhea ( 10 bowel movements per day) with further weight loss.[acgcasereports.gi.org]
  • Symptoms : You might have: Considerable weight loss Diarrhea Cramping Pain in the middle or lower right part of your abdomen Ileitis: This type of Crohn's disease just affects the ileum.[webmd.com]
  • It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Inflammation caused by Crohn's disease can involve different areas of the digestive tract in different people.[mayoclinic.org]
  • Those with ileocolitis may experience symptoms such as: diarrhea significant weight loss pain or cramping in the middle or lower-right region of the abdomen Ileitis Like ileocolitis, ileitis causes inflammation and irritation of the ileum.[healthline.com]
  • The disease may also be associated with weight loss, persistent canker sores, joint pain and soreness, eye pain when looking at a bright light, anemia or skin lesions.[digestive.vcu.edu]
Chills
  • Symptoms of infusion reactions may include fever, chills, chest pain, low blood pressure ( hypotension ) or high blood pressure ( hypertension ), shortness of breath, rash and itching.[medicinenet.com]
Diarrhea
  • After controlling these infections, she continued to complain of diarrhea ( 10 bowel movements per day) with further weight loss.[acgcasereports.gi.org]
  • One year later he was still well except for some episodes of diarrhea. Figure 3 Histological examination of the specimen revealing adenocarcinoma of the colon sigmoid.[jmedicalcasereports.biomedcentral.com]
  • Diarrhea: Bloody vs. Non-Bloody Bloody diarrhea : Ulcerative colitis. Think of bleeding ulcer. Nonbloody diarrhea : Crohn’s disease affects the small bowel directly so malabsorption with non bloody diarrhea is a prominent feature.[medicalmediareview.com]
  • However, no improvement was noticed and the diarrhea and fever rather deteriorated in the next days. A CT-scan examination was performed to rule out an abdominal or pelvic abscess.[bmcgastroenterol.biomedcentral.com]
  • Tiny ulcers and small abscesses in the colon and rectum flare up and cause bloody stools and diarrhea.[digestive.vcu.edu]
Abdominal Pain
  • Nonetheless, as with our patient, they may be more predisposed to have inflammatory manifestations associated with CGD. 2 GI manifestations of CGD include abdominal pain, diarrhea, colitis, proctitis, strictures, fistulae, and obstruction.[acgcasereports.gi.org]
  • Symptoms include diarrhea, abdominal pain, intestinal bleeding and, in cases of childhood onset, growth retardation. IBD occurs frequently in young people, with a peak age of onset between ages 15 and 30.[digestive.vcu.edu]
  • It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Inflammation caused by Crohn's disease can involve different areas of the digestive tract in different people.[mayoclinic.org]
  • Symptoms include bloody diarrhea with mucus; cramping abdominal pain; and an urgent need to have a bowel movement. Perianal disease.[healthywomen.org]
  • For example, primary symptoms of ulcerative colitis include: Bloody diarrhea Abdominal pain Poor appetite Weight loss Lack of bowel control Chronic fatigue Symptoms of Crohn’s disease include: Diarrhea Abdominal pain and cramps Fever Fatigue Bloody stools[lacolon.com]
Chronic Diarrhea
  • diarrhea for 3 years associated with significant weight loss.[acgcasereports.gi.org]
  • Evaluation of chronic diarrhea. Am Fam Physician. 2011;84:1119-1126. Crohn’s and Colitis Foundation of America. Types of Crohn’s disease and associated symptoms. Accessed 6/4/15 at: Burakoff RS. Gastroduodenal Crohn’s disease.[crohnsdisease.com]
  • Colonoscopy performed for chronic diarrhea in an HIV-infected child Rectal Polyp Rectal Polyp Rectal Polyp Rectal Polyp Foreign Body Foreign Body Foreign Body Foreign Body Removal with snare Juvenile Polyp Stalk Juvenile Polyp Stalk Juvenile Polyp Juvenile[naspghan.org]
  • Symptoms may include chronic diarrhea, rectal bleeding, weight loss, fever, abdominal pain and tenderness, feeling of mass or fullness in the lower-right abdomen, and delayed development and stunted growth in children.[digestive.vcu.edu]
  • Ryan Stevens was only 36, but a diagnosis of Crohn's disease left him with overwhelming lethargy and chronic diarrhea every time he ate a morsel of food. The former college swimmer lost 65 pounds and spent most of his days on the couch.[abcnews.go.com]
Loss of Appetite
  • Symptoms : Nausea Weight loss Loss of appetite Vomiting (if narrow segments of bowel are obstructed) Jejunoileitis : This type of the disease causes areas of inflammation in the jejunum, which is the middle part of your small intestine.[webmd.com]
  • Symptoms of Crohn’s Disease Symptoms specific to GI tract inflammation: Abdominal cramps Urgent bowel movements Persistent diarrhea Rectal bleeding Other symptoms of Crohn’s Disease and most IBD conditions: Fever Fatigue Weight loss Loss of appetite Night[rochestercolon.com]
  • Some of the common symptoms of Crohn’s disease include: Diarrhoea which may be mixed with mucus, blood or pus Urgency to go to the toilet Abdominal cramps and pain Constipation Tiredness and fatigue Feeling generally unwell Loss of appetite Unintended[ibdrelief.com]
  • Common symptoms of Crohn’s disease include : Diarrhea Loss of appetite Weight loss Low energy and fatigue Abdominal cramps and pain Rectal bleeding or blood in the stool Anemia Fatigue Constipation Night sweats Fever Nausea/ vomiting Joint pain Inflammation[nwgastro.net]
  • Weight loss : This can result from a loss of appetite. Anemia : A loss of blood can lead to anemia. Rectal bleeding and anal fissures : The skin of the anus becomes cracked, leading to pain and bleeding.[medicalnewstoday.com]
Abdominal Cramps
  • Symptoms of Crohn’s Disease Symptoms specific to GI tract inflammation: Abdominal cramps Urgent bowel movements Persistent diarrhea Rectal bleeding Other symptoms of Crohn’s Disease and most IBD conditions: Fever Fatigue Weight loss Loss of appetite Night[rochestercolon.com]
  • Some of the common symptoms of Crohn’s disease include: Diarrhoea which may be mixed with mucus, blood or pus Urgency to go to the toilet Abdominal cramps and pain Constipation Tiredness and fatigue Feeling generally unwell Loss of appetite Unintended[ibdrelief.com]
  • Common symptoms of Crohn’s disease include : Diarrhea Loss of appetite Weight loss Low energy and fatigue Abdominal cramps and pain Rectal bleeding or blood in the stool Anemia Fatigue Constipation Night sweats Fever Nausea/ vomiting Joint pain Inflammation[nwgastro.net]
  • These include: Abdominal cramping Abdominal pain Ongoing diarrhea Chronic constipation Bleeding with bowel movements Fever Extreme tiredness Weight loss Drainage from the skin around the anus Abscesses (infections) around the anus that come back Anal[fascrs.org]
  • Symptoms include rectal bleeding, diarrhea, abdominal cramps, weight loss, and fevers. In addition, patients who have had extensive ulcerative colitis for many years are at an increased risk to develop large bowel cancer.[ccrcfw.com]
Night Sweats
  • sweats Sometimes, people with Crohn’s Disease may not experience many symptoms, but they can be triggered by specific foods.[rochestercolon.com]
  • Common symptoms of Crohn’s disease include : Diarrhea Loss of appetite Weight loss Low energy and fatigue Abdominal cramps and pain Rectal bleeding or blood in the stool Anemia Fatigue Constipation Night sweats Fever Nausea/ vomiting Joint pain Inflammation[nwgastro.net]
  • Symptoms of Crohn's include diarrhea, abdominal pain; bowel obstruction (when something partially or fully blocks the intestines), weight loss, fever, night sweats and fatigue.[healthywomen.org]
  • "I kept feeling horrible and I had daily fevers up to 102, 103, 104, and night sweats. None worked." Meanwhile, Stevens had four trips to the emergency room, and surgery to repair his fistula and drain the abscess.[abcnews.go.com]
  • Cortisone or corticosteroids can be very effective by reducing inflammation within the body, but their side effects are vast including night sweats, high blood pressure, osteoporosis, bone fractures, excessive facial hair, increased susceptibility for[physio-pedia.com]
Arthritis
  • BACKGROUND: Recent studies demonstrated an association of STAT4 variants with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), indicating that multiple autoimmune diseases share common susceptibility genes.[ncbi.nlm.nih.gov]
  • Other complications associated with Crohn’s disease include arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, or liver disease.[colonhealthatoz.org]
  • Crohn's disease can result in external problems, like arthritis, skin rashes, eye inflammations and a feeling of tiredness. You may also experience bowel obstruction and you are at greater risk of bowel cancer if you have Crohn's Disease.[ct-colorectal.com]
  • Treat ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis.[medicinenet.com]

Workup

  • Case presentation Here, we report a case of isolated colonic tuberculosis where the initial diagnostic workup was suggestive of Crohn's disease.[bmcgastroenterol.biomedcentral.com]
  • […] considered a standard diagnostic procedure Upper endoscopy, or esophagogastroduodenoscopy (EGD), should be part of the first-line investigation Video capsule endoscopy is increasingly being used to evaluate for small-bowel Crohn disease in children [4] See Workup[emedicine.medscape.com]
Colonic Stricture
  • The lesions arose from the muscularis propria proximal to colonic strictures and possibly due to diverticular outpouching of the colonic wall associated with increased intraluminal pressure, although the exact mechanism of their formation appears unclear[ncbi.nlm.nih.gov]
Colitis
  • colitis, 2 radiation colitis, and 18 colonic Crohn's disease; p 1 x 10(-8); odds ratio 199 [25.5-2294]).[ncbi.nlm.nih.gov]
  • […] patients with ulcerative colitis.[ncbi.nlm.nih.gov]
  • Bridging pseudopolyps are seen in ulcerative colitis and rarely in Crohn's disease but do not contain substantial amounts of smooth muscle and/or nerve fibers.[ncbi.nlm.nih.gov]
  • These data support the suggestion made previously that oral contraceptives may predispose to a colitis that resembles colonic Crohn's disease.[ncbi.nlm.nih.gov]
  • Abstract The mesenteric lymph nodes in total colectomy specimens from patients with ulcerative colitis or Crohn's colitis were assessed for immunological reactivity.[ncbi.nlm.nih.gov]

Treatment

  • Typical steroid-related side effects were observed during the acute-phase treatment in only 18% of the patients.[ncbi.nlm.nih.gov]
  • All patients received exclusive polymeric feed as treatment, with a repeat endoscopy at completion of treatment. At enrollment the ileal group had significantly less severe disease (P 0.05) compared to the colonic and ileocolonic groups.[ncbi.nlm.nih.gov]
  • Currently all but 14 patients are well and symptom-free and only 16 are receiving specific medical treatment.[ncbi.nlm.nih.gov]
  • Dr Tung and Dr Warner discuss the use of these and more traditional drugs in patients with colonic Crohn's disease and ulcerative colitis, stressing the need for individualized treatment.[ncbi.nlm.nih.gov]
  • Abstract Reversion of radiographic signs has been observed in 11 patients with colonic Crohn's disease during treatment. The commonest radiographic change has been healing of ulcers which are often of a collar-stud type or appear as fissures.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract The long-term prognosis including operation rates, the incidences of recurrent disease, morbidity and mortality and current status has been analysed in a group of 360 patients with Crohn's colitis grouped according to the primary site of macroscopic[ncbi.nlm.nih.gov]
  • More colonic carcinomas in Crohn's disease are poorly differentiated and mucinous compared with sporadic colon malignancies and, overall, the prognosis is much poorer [ 8 – 10 ].[jmedicalcasereports.biomedcentral.com]
  • Am J Surg 140: 462–463 PubMed CrossRef Google Scholar Cooke WT, Mallas E, Prior P, Allan RN (1980) Crohn’s disease: course, treatment and long term prognosis.[link.springer.com]
  • POST-TREATMENT PROGNOSIS It is important to follow up with your physicians so they can devise an ongoing management plan to control your symptoms. When you have Crohn’s disease, you must stay on medication throughout your entire life.[fascrs.org]
  • Once colon cancer is confirmed, the next step is to determine which stage the cancer is at, as this can help in treatment and prognosis. The stages of colon cancer are as follows. Stage I : The cancer has not spread beyond the colon wall or rectum.[belmarrahealth.com]

Etiology

  • Tumor necrosis factor-alpha, a proinflammatory cytokine, might have an important role(s) in initiating, modifying, and/or sustaining chronic inflammatory processes such as those that characterize Crohn's disease, an inflammatory bowel disease of unknown etiology[ncbi.nlm.nih.gov]
  • We have determined a common profile of "late" CD, and also demonstrated the potential variability, suggesting possible differences in etiology, triggers, and the need for more individualized management.[ncbi.nlm.nih.gov]
  • Several studies have revealed a possible etiologic link between intestinal microorganisms and inflammatory bowel disease.[ncbi.nlm.nih.gov]
  • Sections of the book are based on the most current, evidenced-based resources and have been structured to review the etiology and diagnosis of Crohn’s disease, discuss advances in medical and surgical treatment, illustrate emerging technologies impacting[books.google.com]

Epidemiology

  • We have therefore systematically reviewed its epidemiology, pathophysiology and treatment.[ncbi.nlm.nih.gov]
  • Little is known about the epidemiology and natural history of isolated CD of the colon (Montreal Classification L2) because most studies have not accurately distinguished it from ileocolonic disease.[ncbi.nlm.nih.gov]
  • The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16 (1) 51-60 2 Mills S, Stamos MJ. Colonic Crohn's disease.[thieme-connect.com]
  • Mazaz 1 and Khalid Ait Taleb 1 Journal of Medical Case Reports 2010 4 :167 Ankouz et al; licensee BioMed Central Ltd. 2010 Received: 16 September 2008 Accepted: 1 June 2010 Published: 1 June 2010 Abstract Introduction There is growing evidence from epidemiological[jmedicalcasereports.biomedcentral.com]
  • Epidemiology of pediatric inflammatory bowel disease: A systematic review of international trends”. Inflammatory Bowel Disease 2011; 17 (1), 423–439. Castro M., Papadatou B., Baldassare M., Balli F. et al.[ragazzicoraggiosi.it]
Sex distribution
Age distribution

Pathophysiology

  • We have therefore systematically reviewed its epidemiology, pathophysiology and treatment.[ncbi.nlm.nih.gov]
  • Thus, our data indicate differences in IEL populations between CD, UC, and controls, which support the pathophysiologic differences between CD and UC. The different phenotypes suggest a role for these cells in the diagnosis of IBD.[jimmunol.org]
  • While the research and contemporary understanding of the pathophysiology of both conditions is often confusing, a layperson naturally focuses only on symptoms.[lacolon.com]
  • […] iStockPhoto Medscape iStockPhoto / iStockPhoto / BigStock / Medscape iStockPhoto iStockPhoto Medscape MedicineNet iStockPhoto iStockPhoto iStockPhoto MedicineNet iStockPhoto REFERENCES: Sleisenger and Fordtran's Gastrointestinal and Liver Disease – Pathophysiology[onhealth.com]
  • Pathophysiology: Implications for the Physical Therapist. 3rd ed. St. Louis, MO: Saunders-Elsevier; 2009. Susman E.. SONIC gives boost to infliximab for Crohn's. Medical Post [serial online]. November 2008;44:14. Available from: Health Module.[physio-pedia.com]

Prevention

  • Treatment includes prevention of infectious complications and immunomodulation. However, a standard strategy is not yet defined.[acgcasereports.gi.org]
  • Similarity of colorectal cancer in Crohn's disease and ulcerative colitis: implications for carcinogenesis and prevention. Gut 1994; 35 (7) 950-954 6 Richards ME, Rickert RR, Nance FC. Crohn's disease-associated carcinoma.[thieme-connect.com]
  • Prevention There is no way to prevent Crohn's because the cause is not known, but there are treatments to prevent acute flares and maintain remission of Crohn's.[healthywomen.org]
  • […] cancer prevention and colon cancer prevention.[uchospitals.edu]
  • For others, medication to prevent flare-ups can make a big difference to quality of life.[patient.info]

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