Crohn's Disease

Etiology

  • Automimmune
  • Genetic
  • Other
  • Environmentally triggered
  • Transmural involvement--> strictures, fistulae
  • Can affect anywhere in GI tract mouth-to-anus

Risk Factors

  • Smoking and appendectomy increase risk
  • Northern Europeans and North Americans
  • Peak onset 15-30

Symptoms

  • Sub-acute
  • Mucous
  • Cramps
  • Constipation
  • Fever
  • And pain
  • Fatigue
  • Wt loss
  • Fistulas
  • Peri-rectal dz
  • Diarrhea→ though can be less prominent than w/UC
  • Nocturnal diarrhea
  • Sometimes bloody stools
  • Feeling poorly overall
  • Bowel obstruction
  • Spectrum of sx and findings
  • DVT: risk markedly increased w/IBD flair, immobility and/or hospitalization

Physical Exam Findings

  • Aphtous ulcers
  • Sometimes abd mass
  • Peri-rectal disease
  • Erythema nodosum
  • Pyoderma gangrenosa
  • Peripheral arthritis
  • Ankylosing spond/sacroiliitis
  • Primary sclerosing cholangitis
  • Eye sx→ episcleritis/scleritis/uveitis

Links