CROHN DISEASE(CD)

also called regional enteritis

 Inflammatory
Bowel
Disease
■ Inappropriate mucosal immune
responses to normal gut flora
■ it comprises two disorders:
Ulcerative colitis (UC) & Crohn
disease(CD)
■ also called regional enteritis
■ typically transmural inflammation
■ occurring anywhere in the GI tract!
 Epidemiology
■ IBD is more common in women
■ typically in their teens and 20s
■ More common in developed countries, leading to the hygiene
hypothesis.

Hygiene hypothesis:
■ reduced frequency of enteric infections results in inadequate
development of mucosal immune regulation.
■ CD involves
1. the small intestine alone
in 40% of cases
2. the small intestine and
colon in 30%
3. colon alone in 30%
4. other areas of the GI tract
are uncommonly involved.
 Clinical presentation
■ intermittent attacks of diarrhea, fever and abdominal pain
■ asymptomatic periods can last for weeks to months.

• Depending on the segment affected, extensive CD can lead to

1. malabsorption and malnutrition
2. loss of albumin (protein-losing enteropathy)
3. iron deficiency anemia
4. vitamin B12 deficiency

■ Fibrotic strictures or fistulas to adjacent viscera, abdominal and perineal skin,

bladder, or vagina typically require surgical resection; disease often recurs at the
anastomosis with 40% of patients requiring additional surgery within a decade.
 Extraintestinal
manifestations include
-migratory polyarthritis
-Sacroiliitis There is increased risk
-ankylosing spondylitis of colonic
adenocarcinoma in
-erythema nodosum
patients with long-
-Uveitis standing colon
-Cholangitis involvement.
-amyloidosis