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Crohn Disease

Samir A. Shah, MD, AGAF, FACG, FASGE and Eric J. Mao, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A chronic, progressive inflammatory GI tract disorder, most commonly involving the terminal ileum (80%)

  • Hallmark features of Crohn disease (CD)

    • Transmural inflammation that can result ...

DIAGNOSIS

HISTORY

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

TREATMENT

  • Disease activity: Harvey Bradshaw Index or Crohn Disease Activity Index (CDAI)

  • Disease severity: risk stratification for rapidly progressive disease

    • Risk factors for high-risk disease: age at ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Monitor CBC, BMP, LFTs every 3-4 months.

  • Actively monitor disease with CRP and/or calprotectin every 6 months.

  • With azathioprine or 6-mercaptopurine therapy, check ...

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. [Vi...

ADDITIONAL READING

Miglioretto C, Beck E, Lambert K. A scoping review of the dietary information needs of people with inflammatory bowel disease. Nutr Diet. 2023. doi: 10.1111/174...

CODES

ICD10

  • K50.0 Crohn's disease of small intestine

  • K50.113 Crohn's disease of large intestine with fistula

  • K50.011 Crohn's disease of small intestine with rectal bleeding

  • K50.01 Crohn's disease of small...

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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