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Crohn Disease

Reviewed 06/2020
 


BASICS

DESCRIPTION

A chronic, relapsing inflammatory gastrointestinal (GI) tract disorder, most commonly involving the terminal ileum (80%) 
  • Hallmark features of Crohn disease (CD)

    • Transmural inflammatio...

DIAGNOSIS

HISTORY

Hallmarks: fatigue, fever, weight loss, prolonged diarrhea, perianal disease, crampy abdominal pain (+/− bleeding). Children may present with failure to thrive. 
  • Factors exacerbating C...

TREATMENT

  • Disease activity: Crohn Disease Activity Index (CDAI)

    • Asymptomatic: spontaneous, after medical/surgical intervention, or while on steroids (CDAI <150)

    • Mild to moderate CD: ambulatory patien...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Vaccinations 
  • Check titers; avoid live vaccines (measles, mumps, and rubella, varicella, Zostavax) in patients on immunosuppressive therapy (ster...

REFERENCES

1
Lichtenstein GR, Loftus EV, Isaacs KL, et al. ACG clinical guideline: management of Crohn’s disease in adults. Am J Gastroenterol.  2018;113(4):481–517.
2
Baumgart DC, Sandborn WJ. Croh...

CODES

ICD10

  • K50.919 Crohn’s disease, unspecified, with unspecified complications

  • K50.00 Crohn’s disease of small intestine without complications

  • K50.10 Crohn’s disease of large intestine without complica...

CLINICAL PEARLS

  • Cigarette smoking doubles the risk of CD; tobacco cessation reduces flares and need for surgery.

  • MRE allows assessment of luminal and extraluminal CD without radiation exposure.

  • Assess f...

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