Crohn Disease

Gastroenterology

Transmural granulomatous inflammation that can affect any part of the GI tract, skip lesions common.

Clinical features

  • Diarrhoea (often non-bloody)
  • Abdominal pain
  • Weight loss, fatigue
  • Perianal disease, fistulae

Investigations

  • FBC, CRP, ferritin, B12, folate, vitamin D
  • Faecal calprotectin
  • Ileocolonoscopy + biopsy
  • MR enterography for small bowel

Management

  • Induction: budesonide (ileocaecal), prednisolone, exclusive enteral nutrition (paeds)
  • Maintenance: azathioprine, methotrexate, biologics (anti-TNF, ustekinumab, vedolizumab)
  • Surgery for stricture / fistula / abscess

Complications

  • Strictures, fistulae, abscess
  • Malabsorption, B12 deficiency
  • Cancer risk

References

  • ECCO Crohn 2020

Educational — verify locally.

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