Crohn's disease

Crohn's disease (CD) is a disorder of unknown aetiology characterised by transmural inflammation of the gastrointestinal tract.

Common presenting symptoms include chronic diarrhoea, weight loss, and abdominal pain.

Diagnosis is confirmed by correlating imaging, endoscopic findings, and histology, with clinical symptoms consistent with inflammatory bowel disease.

Specialist input is required from the time of diagnosis, as treatment regimens require frequent monitoring of clinical response, knowledge of common adverse events, and expertise in managing potentially serious adverse events.

The overall treatment goals are to avoid surgery and to prevent long-term complications, including cancer.

Complications include extra-intestinal involvement, intestinal obstruction, abscess formation, sinuses, and fistulae.

Crohn's disease (CD) is a disorder of unknown aetiology characterised by transmural inflammation of the gastrointestinal (GI) tract. CD may involve any or all parts of the entire GI tract from the mouth to colon, with or without perianal involvement. CD is characterised by skip lesions (where normal bowel mucosa is found between diseased areas). The transmural inflammation often leads to fibrosis causing intestinal obstruction. The inflammation can also result in sinus tracts that burrow through and penetrate the serosa, thereafter giving rise to perforations and fistulae.[1]Dolinger M, Torres J, Vermeire S. Crohn's disease. Lancet. 2024 Mar 23;403(10432):1177-91. http://www.ncbi.nlm.nih.gov/pubmed/38437854?tool=bestpractice.com

This topic covers the diagnosis and management of CD in adults.

BMJ talk medicine podcast: Crohn's disease Opens in new window