Crohn's+Disease

//Western Diagnosis// regional enteritis transmural inflammatory bowel disease usually affects distal ileum and proximal colon but can affect any part of GI tract

Etiology
1. unknown 2. genetics 3. immunological derangements 4. infectious agents 5. food sensitivities 6. lack of fiber in diet 7. stress 8. cigarette smoking

Epidemiology
1. equal among both genders 2. more in Jews 3. familial tendency 4. begins before age 30: peaks between 14 and 24

Pathology
1. segments of diseased bowel sharply demarcated from normal bowel a. segmental lesions may be separated by normal bowel 2. ulceration and inflammation of all layers of intestinal wall a. cobblestone appearance 3. edema - lymphocytic infiltration - fibrosis 4. ulceration, fibrosis, obstruction, fistulas, abscesses 5. malabsorption

Signs & Symptoms
1. chronic, possibly intermittent, diarrhea 2. fever 3. anorexia, weight loss, malaise 4. RLQ pain and fullness or mass 5. extraintestinal manifestations a. immunologic or infectious aspects i. peripheral arthritis ii. episcleritis iii. erythema nodosum iv. aphthous stomatitis b. 2x as common if disease also in LI

Diagnosis
1. clinical 2. lab: ---anemia, leukocytosis, inc ESR ---O&P, stool cultures 3. imaging ---x-ray: barium enema; UGI with SI follow-through 4. colonoscopy

Prognosis
1. lifelong exacerbations 2. CA

Treatment
1. corticosteroids, immunosuppressives 2. surgery