Crohn's Disease

Question 1

Aetiologies?

Answer 1

Genetic vs Environmental triggers

Largely unknown

Question 2

Epidemiology?

Answer 2

Males = Females

Peak ages 20-40 and 60+

Question 3

Pathology?

Answer 3

Chronic inflammation of anywhere in the GI tract due to prolonged activation of the mucosal immune system vs normal gut flora

Question 4

Signs and Symptoms?

Answer 4

Depend on location, e.g. diarrhoea, abdominal pain, weight loss, malaise, anorexia, N+V, fever
Malabsorption, mouth ulceration, perianal symptoms, clubbing, erythema nodosum

Question 5

Investigations and Findings?

Answer 5

Colonoscopy + biopsy - Skip lesions, non-caseating granulomas
FBC - decreased Hb
Biochem - increased ESR, decreased albumin

Question 6

Management?

Answer 6

Mild: steroids, progressively lowering dose
Severe: hospital –> IV fluids, high dose steroids, biologics

Question 7

Complications?

Answer 7

Haemorrhage
Perforation
Toxic dilation
Colonic cancer