Crohn's disease

Question 1

What is the definition of Crohn’s disease?

Answer 1

Characterised by transmural inflammation

Question 2

What are the risk factors for Crohn’s?

Answer 2

White ethnicity, family history, age 15-40 or 60-80

Question 3

What is the presentation of Crohn’s?

Answer 3

Abdominal pain, prolonged diarrhoea (non-bloody or bloody), perianal lesions, bowel obstruction, blood in stools, fever, fatigue, abdominal tenderness, weight loss, oral lesions
Arthropathy, erythema nodosum, uveitis

Question 4

What are the investigations for Crohn’s?

Answer 4

FBC (anaemia, leukocytosis), iron deficiency, B12 deficiency, CRP and ESR (raised), stool culture (-ve), AXR, CT, MRI, colonoscopy

Question 5

What are the findings on colonoscopy in Crohn’s?

Answer 5

Transmural inflammation, granulomatous, skip lesions, fissures and deep ulcers, fistula formation

Question 6

What is the management for Crohn’s?

Answer 6

Corticosteroids, azathioprine, infliximab
Smoking cessation
Surgery

Question 7

What are the complications of Crohn’s?

Answer 7

Fistula, stricture formation, recurrent perianal fistulas, GI malignancy
Malabsorption, growth delay in children, increased risk of gallstones and renal stones