Crohn disease in Adult
See also in: Anogenital,Oral Mucosal LesionAlerts and Notices
Synopsis
Symptoms from Crohn disease can vary considerably, due to location but also to the severity of disease involvement. Patients may present with abdominal pain, bloody or nonbloody diarrhea, weight loss or malnutrition, fistulas, abscesses (often perianal), dysphagia, or oral ulcerations. Additionally, Crohn disease has many extraintestinal manifestations that can at times be the presenting symptoms. These manifestations can involve joints, skin, eyes, vasculature, the lungs, or the kidneys.
Chronic inflammation from Crohn disease can lead to fistula and stricture formation, which predispose to small and large bowel obstructions, infections secondary to fistula tracts, and malnutrition as a result of longstanding intestinal inflammation. These complications result in much of the morbidity from Crohn disease, highlighting the importance of achieving and sustaining deep remission as a primary goal of treatment.
Crohn disease presents most typically in the second to fourth decades of life, with a slight female predominance. While no clear genetic mutation is linked to the development of Crohn disease, there are many genetic mutations that are associated with Crohn disease. For unclear reasons, Crohn disease is more prevalent at higher latitudes and in certain patient populations, namely individuals of Ashkenazi Jewish descent and individuals of Northern European descent in the United States.
Crohn disease is a chronic disease with many pharmacologic options that can be used depending on the severity of symptoms and on radiographic and endoscopic findings. Many patients are able to achieve remission, although the disease is progressive in nature and characterized by disease flares.
Codes
ICD10CM:K50.918 – Crohn's disease, unspecified, with other complication
SNOMEDCT:
34000006 – Crohn's disease
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Differential Diagnosis & Pitfalls
- Ulcerative colitis
- Behçet disease
- Irritable bowel syndrome
- Infectious colitis
- Lactose intolerance
- Celiac disease
- Tuberculous enteritis
- Severe aphthous disease
- Amebiasis
- Actinomycosis
- Sexual abuse
- Granuloma inguinale
- Granulomatous cheilitis / Melkersson-Rosenthal syndrome
- Bile acid diarrhea
- Hidradenitis suppurativa
- Pyoderma gangrenosum
- Cutaneous sarcoidosis
- Granulomatosis with polyangiitis
- Whipple disease
- Acute appendicitis
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
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Last Reviewed:11/01/2017
Last Updated:05/03/2022
Last Updated:05/03/2022
Crohn disease in Adult
See also in: Anogenital,Oral Mucosal Lesion