Presentation
Crypt abscesses may be present Granulomas are present in about 15-36% of biopsied cases Present in over half of colectomy specimens Compact aggregates of epithelioid histiocytes Non-necrotic Multinucleated giant cells may be present May be seen at all [surgpathcriteria.stanford.edu]
Patients typically present with chronic diarrhea and recurrent abdominal pain, although occasionally the presentation is with a complication or an extraintestinal manifestation. Anemia may be present and C-reactive protein may be elevated 29. [radiopaedia.org]
Although the disease most commonly presents at a young age, it can affect people of all ages. Patients often present with persistent diarrhoea, abdominal pain, and weight loss. [bmj.com]
Patients presenting with an acute abdomen (either initially or during a relapse) should have flat and upright abdominal x-rays and an abdominal CT scan. [msdmanuals.com]
The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient. [fascrs.org]
Entire Body System
- Weight Loss
Symptoms include: nausea vomiting loss of appetite weight loss Jejunoileitis Jejunoileitis causes patches of inflammation in the upper half of the small intestine, or jejunum. [medicalnewstoday.com]
It primarily causes abdominal pain, diarrhea, vomiting, low-grade fever and weight loss, but may also cause extraintestinal manifestations, usually involving the skin, joints, mouth, eyes, liver or bile ducts. [symptoma.com]
Intestinal symptoms Typically non-bloody, chronic diarrhea Abdominal pain, typically in the RLQ Signs of malabsorption Weight loss Failure to thrive and growth failure in children Anemia Intestinal blood loss can cause iron deficiency anemia Anemia of [amboss.com]
Symptoms include abdominal pain and diarrhea, sometimes bloody, and weight loss. [webmd.com]
- Fatigue
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]
The main symptoms are: diarrhoea stomach aches and cramps blood in your poo tiredness (fatigue) weight loss The symptoms may be constant or may come and go every few weeks or months. When they come back, it's called a flare-up. [nhs.uk]
Fatigue: Individuals often feel extremely tired. Fever is also possible during fatigue. Altered appetite: There may be time when the appetite is very low. Weight loss: This can result from a loss of appetite. [medicalnewstoday.com]
- Malnutrition
Signs and symptoms can include: pain in the abdomen weight loss diarrhoea (sometimes with blood and mucus) tiredness constipation malnutrition nausea delayed or impaired growth in children. [betterhealth.vic.gov.au]
The resulting malnutrition worsens the tiredness and fatigue and can eventually lead to weight loss. A well-balanced and nutritious diet is essential for anyone with Crohn’s disease to prevent malnutrition and maintain good health. [southerncross.co.nz]
Malnutrition. Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. [mayoclinic.org]
Other digestive complications may include tears in your anus, pockets of infection, malnutrition, and even colon cancer. [everydayhealth.com]
Skin complications of Crohn disease Secondary skin eruptions Crohn disease affecting the gut may lead to malnutrition. Iron deficiency and vitamin deficiencies may present as skin or oral ulceration, persistent infections or pellagra. [dermnetnz.org]
- Weight Gain
Weight loss is a common symptom of Crohn’s disease, and weight gain is a goal of treatment. Research supports the role of nutrition in treatment for Crohn’s disease. [chop.edu]
Growth failure and poor weight gain in children with inflammatory bowel disease. UpToDate, Inc. 2017 Nov 22. [rarediseases.org]
It is very important if your child is suffering from malnutrition or poor weight gain. Nutrition therapy can also be used for induction and maintenance of remission. [gikids.org]
Disabling them can cause bruising and weight gain. ‘There is a risk of infection, because steroids are immune-suppressants and work in a broad way, and they also affect so much of the body,’ adds Dr Pollok. [dailymail.co.uk]
Steroids are very effective (about eight out of ten patients have a good response) but some steroids can have side effects such as weight gain, insomnia, infection and acne. [gutscharity.org.uk]
- Pallor
Anemia is associated with fatigue, pale skin color (pallor), lightheadedness, and other symptoms. About 30% of children and adolescents develop perianal disease, which affects the area around the anus. [rarediseases.org]
Clinical Examination of Crohn’s Disease (Inflammatory Bowel Disease) There are few physical signs of Crohn’s disease other than weight loss and general ill health, in particular pallor (pale skin) or cachexia (muscle wasting). [healthengine.com.au]
[…] skin tags, fistulae, ulcers, abscesses, and scarring in the perianal region; nephrolithiasis, hydronephrosis, and enterovesical fistulae Musculoskeletal: Possible arthritis and arthralgia, particularly of the large joints [6] Dermatologic: May show pallor [emedicine.medscape.com]
Gastrointestinal
- Diarrhea
Symptoms can include: abdominal pain or cramps after eating diarrhea Prolonged inflammation can lead to the formation of fistulas in the jejunum. [medicalnewstoday.com]
The goal of treatment is to control the swelling (inflammation), correct any nutritional deficiencies, and relieve symptoms such as abdominal pain, diarrhea and rectal bleeding. [genome.gov]
\ ˈkrōnz- \ variants: or less commonly Crohn disease \ ˈkrōn- \ or Crohn's Definition of Crohn's disease : chronic inflammation that typically involves the lower portion of the ileum, often spreads to the colon, and is characterized by diarrhea, cramping [merriam-webster.com]
Medicines may: Help stop diarrhea and belly pain Lessen inflammation in your intestine Change the way your immune system works Doctors may suggest special fluids that have extra nutrients in them, especially for children with slow growth. [msdmanuals.com]
- Abdominal Pain
This can be very painful and can cause diarrhea, abdominal pain, nausea and decreased appetite. The inflammatory process tends to be eccentric and segmental, often with skip areas (normal regions of bowel between inflamed areas). [genome.gov]
[…] location of abdominal pain can provide information about what may be causing the pain. [en.wikipedia.org]
It primarily causes abdominal pain, diarrhea, vomiting, low-grade fever and weight loss, but may also cause extraintestinal manifestations, usually involving the skin, joints, mouth, eyes, liver or bile ducts. [symptoma.com]
When the disease is active, signs and symptoms may include: Diarrhea Fever Fatigue Abdominal pain and cramping Blood in your stool Mouth sores Reduced appetite and weight loss Pain or drainage near or around the anus due to inflammation from a tunnel [mayoclinic.org]
Symptoms can include: abdominal pain or cramps after eating diarrhea Prolonged inflammation can lead to the formation of fistulas in the jejunum. [medicalnewstoday.com]
- Rectal Bleeding
Diarrhea Rectal bleeding Weight loss Arthritis Skin problems Fever Rectal bleeding may be serious and continuous enough to cause anemia (low red blood count). Children who have Crohn's disease may have delayed development and stunted growth. [genome.gov]
The disease may cause: abdominal pain and cramps diarrhea constipation rectal bleeding bloody stools weight loss fatigue Crohn's disease can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. [medicalnewstoday.com]
Other symptoms include rectal bleeding, weight loss, and fever. If you believe you have Crohn’s disease, you should speak with a healthcare provider who can confirm a diagnosis through laboratory tests, examination, imaging, and a colonoscopy. [celiac.org]
Unexplained abdominal pain, diarrhea, rectal bleeding, weight loss and fever are all symptoms of Crohn's disease and are very similar to those of ulcerative colitis. [radiologyinfo.org]
Symptoms may include abdominal pain, diarrhea, rectal bleeding, weight loss, fever, joint pain and rashes. In children, it can cause developmental delay and failure to grow. It is unclear what causes Crohn’s disease. [stanfordchildrens.org]
- Nausea
Common side effects of sulfasalazine include: headache nausea abdominal pain diarrhoea If side effects become particularly troublesome, you should tell your GP as the dose used may need to be adjusted. [hse.ie]
The most common side effects of azathioprine and mercaptopurine are nausea, vomiting, and a general feeling of illness (malaise). [msdmanuals.com]
On the other hand, people who have gastroduodenal Crohn's disease may experience more nausea and vomiting. [medicalnewstoday.com]
The most common symptoms of Crohn’s disease are diarrhea cramping and pain in your abdomen weight loss Other symptoms include anemia eye redness or pain feeling tired fever joint pain or soreness nausea or loss of appetite skin changes that involve red [niddk.nih.gov]
- Loss of Appetite
The most common symptoms of Crohn’s disease are diarrhea cramping and pain in your abdomen weight loss Other symptoms include anemia eye redness or pain feeling tired fever joint pain or soreness nausea or loss of appetite skin changes that involve red [niddk.nih.gov]
Symptoms include loss of appetite, weight loss, nausea, and vomiting. Jejunoileitis This less common type of Crohn's disease affects the upper half of the small intestine, called the jejunum. [medicalnewstoday.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]
[…] of appetite, weight loss Bloody diarrhea, mild fever, abdominal pain and cramps, anemia, fatigue, loss of appetite, weight loss Terminal ileum involvement Common Never Colon involvement Common Always Rectum involvement Common Always Peri-anal disease [crohnsandcolitis.ca]
Musculoskeletal
- Arthralgia
Crohn’s patient 4 and is often chronic or nocturnal); Abdominal pain; Weight lossor anorexia; Blood or mucus in stools (faeces); Rectal bleeding ; Perineal pain (pain in the area between the anus and the genitals); Nausea; Malaise (feeling unwell); Arthralgia [healthengine.com.au]
The examiner should ask about any history of arthritis/arthralgia, back pain, rashes, pruritus, dyspnea, jaundice, right upper quadrant pain, mouth ulcerations, and eyesight changes. [cancertherapyadvisor.com]
Some affected individuals develop joint pain (arthralgia) or joint inflammation (arthritis). Causes The exact cause of pediatric Crohn’s disease is not fully understood. [rarediseases.org]
[…] abnormalities, presence of hematochezia Genitourinary: May include presence of skin tags, fistulae, ulcers, abscesses, and scarring in the perianal region; nephrolithiasis, hydronephrosis, and enterovesical fistulae Musculoskeletal: Possible arthritis and arthralgia [emedicine.medscape.com]
Skin
- Eczema
[…] trophoblastic neoplasms.[1] Autoimmune disorders[edit] It is used as a disease-modifying treatment for some autoimmune diseases, including rheumatoid arthritis, juvenile dermatomyositis, psoriasis, psoriatic arthritis, lupus, sarcoidosis, Crohn's disease,[13] eczema [en.wikipedia.org]
Urogenital
- Flank Pain
(RUQ), right rib pain, right flank pain, right shoulder pain Clinical (history & physical exam) Imaging: FAST examination, CT of abdomen and pelvis Diagnostic peritoneal aspiration and lavage Resuscitation (Advanced Trauma Life Support) with IV fluids [en.wikipedia.org]
Workup
[…] complete blood count, urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is unstable: IV fluid resuscitation, urgent obstetrics and gynecology consultation If patient is stable: continue diagnostic workup [en.wikipedia.org]
Clinical Testing and Workup Children and adolescents suspected to have pediatric Crohn’s disease will receive a complete blood count. A complete blood count is a test that evaluates the cells in a person’s blood. [rarediseases.org]
[…] accuracy, but their overall sensitivity and specificity are reported to be 75–85% and 85–98%, respectively. 24,40,79–85 It is not infrequent to find intraoperatively more locations [mainly short skip lesions] than there were identified in the preoperative workup [academic.oup.com]
X-Ray
- Nephrolithiasis
complicated urinary tract infection Left low back pain Spleen Kidney: kidney stone (nephrolithiasis), complicated urinary tract infection Low back pain kidney pain (kidney stone, kidney cancer, hydronephrosis) Ureteral stone pain Pathophysiology[edit [en.wikipedia.org]
[…] ducts connecting to the liver); and Fatty liver or the excessive build-up of fat in liver cells, which may lead to further liver disorders such as chronic hepatitis (inflammation of the liver) and liver failure ; Urogenital complications, including: Nephrolithiasis [healthengine.com.au]
[…] from normal to those of an acute abdomen; assess for rectal sphincter tone, gross rectal mucosal abnormalities, presence of hematochezia Genitourinary: May include presence of skin tags, fistulae, ulcers, abscesses, and scarring in the perianal region; nephrolithiasis [emedicine.medscape.com]
Colonoscopy
- Colonic Ulcer
Ulcerative colitis, on the other hand, is continuous inflammation of the colon Ulcerative colitis only affects the inner most lining of the colon while Crohn's disease can occur in all the layers of the bowel walls Indeterminate Colitis Approximately [uclahealth.org]
Treatment
The authors conclude that a further trial is required to confirm that genetic testing prior to treatment will reduce the rate of treatment failure by facilitating the most effective choice of therapy for individual patients. [eurekalert.org]
Maintaining remission Your doctor should discuss all the treatment options with you, including treatment, no treatment and treatment side-effects. [patient.info]
Treatment is self-administered by subcutaneous injection. [frontiersin.org]
The aim of treatment is to control inflammation and to have no symptoms (reach ‘remission’) and then to keep having no symptoms with regular treatment to keep the disease under control (‘maintenance treatment’). [3, 6] As the main cause of symptoms in [ensayosclinicosroche.es]
These treatments include everything from prescription medications to natural treatments, diet, exercise, as well as stress control techniques. [bioplushealth.com]
Prognosis
Left untreated, Crohn's spreads throughout the intestinal tract, causing more severe symptoms and a bleaker prognosis. [edition.cnn.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]
What is the prognosis? The outlook (prognosis) is variable. It depends on which part or parts of the gut (gastrointestinal tract) are affected and how often and how severe the flare-ups are. [patient.info]
The outlook, or prognosis, for Crohn’s disease is different for different people and depends on which part or parts of the gut are affected and how often and how severe the flare-ups are. [healthnavigator.org.nz]
Etiology
The exact etiology is unknown. Symptoms depend on what part of the gastrointestinal tract is affected. [symptoma.com]
Etiology Cause : Unknown factors lead to an imbalance between proinflammatory and anti-inflammatory mediators. [amboss.com]
The etiology for Crohn’s disease is likely multifactorial as genetic, microbial, environmental, and host factors have been associated with disease. [cancertherapyadvisor.com]
Disease and Ulcerative Colitis Written by a sufferer of inflammatory bowel disease (IBD), the guide shares common tales and insights while also covering symptoms, medications, and procedures, from a uniquely entertaining viewpoint. 8 Crohn's Disease: Etiology [educalingo.com]
Obstruction due to uncomplicated Crohn disease should resolve within a few days and therefore does not require either specific anti-inflammatory therapy or parenteral nutrition; absence of prompt response, however, indicates a complication or another etiology [msdmanuals.com]
Epidemiology
[Epidemiological characteristics and trend of incidence of human brucellosis in Razavi Khorasan province.]. Med J Mashhad. 2016;9:531-8. 22. Falah R, Alipoor M. [mcs.ajaums.ac.ir]
Structural damage; Keywords: بیماری کرون; Crohn's disease; Magnetic resonance imaging; Anti-tumor necrosis factor agents; Keywords: بیماری کرون; Crohn's disease; Ulcerative colitis; MRE; SBFT; Colectomy; Keywords: بیماری کرون; Inflammatory bowel diseases; Epidemiology [daneshyari.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]
More common in white populations and people of Jewish descent (especially Ashkenazi Jews, middle European Jews) References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Pathophysiology
References: [1] [4] Pathophysiology Clinical features Typically, CD occurs episodically and there is a 30% risk of recurring inflammation over the span of one year. If symptoms persist for six months, the disease is considered chronic. [amboss.com]
The pathophysiology of Crohn’s has been extensively studied, yet there still exists much uncertainty about the underlying cause and reason for certain populations being affected more than others. [cancertherapyadvisor.com]
[…] iStockPhoto / iStockPhoto / BigStock / Medscape iStockPhoto iStockPhoto Medscape MedicineNet iStockPhoto iStockPhoto iStockPhoto Thinkstock iStock Getty Images MedicineNet iStockPhoto REFERENCES: Sleisenger and Fordtran's Gastrointestinal and Liver Disease – Pathophysiology [onhealth.com]
Risk Factors of Crohn’s Disease (Ileitis) and Ulcerative Colitis (UC) The exact pathophysiology of inflammatory bowel disease (IBD) is unclear, but a number of risk factors are associated with their development. [lecturio.com]
Prevention
These prevent the onset of acute episodes and prolong remission phases, while allowing gastrointestinal tract lesions time to heal. [inserm.fr]
This will enable further efforts to prevent onset, recurrence, or progression, as well as development of complications from the disease. [helmsleytrust.org]
The goal of treatment is to relieve symptoms, prevent other problems, and prevent future flare-ups. [kidshealth.org]
High quality multidisciplinary care, of which primary care is a key aspect, can attenuate relapse, prevent long term complications, and improve quality of life. [bmj.com]
A well-balanced and nutritious diet is essential for anyone with Crohn’s disease to prevent malnutrition and maintain good health. [southerncross.co.nz]