Crohn's disease

Question 1

Crohn’s disease?

Answer 1

• Crohn’s disease is a form of inflammatory bowel disease.
• It commonly affects the terminal ileum and colon but may be seen anywhere from the mouth to anus.

Question 2

Pathology?

Answer 2

• cause is unknown but there is a strong genetic susceptibility
• inflammation occurs in all layers, down to the serosa. This is why patients with Crohn’s are prone to strictures, fistulas and adhesions

Question 3

Crohn’s disease typically presents in late adolescence or early adulthood. Features include:

Answer 3

• presentation may be non-specific symptoms such as weight loss and lethargy
• diarrhoea: the most prominent symptom in adults. Crohn’s colitis may cause bloody diarrhoea
• abdominal pain: the most prominent symptom in children
• perianal disease: e.g. Skin tags or ulcers
• extra-intestinal features are more common in patients with colitis or perianal disease

Question 4

Venn diagram showing shared features and differences between ulcerative colitis and Crohn’s disease. Note that whilst some features are present in both, some are much more common in one of the conditions, for example colorectal canceAttach Imagesr in ulcerative colitis

Answer 4

Common to both Crohn’s disease (CD) and Ulcerative colitis (UC):

Related to disease activityArthritis:

• pauciarticular, asymmetric
• Erythema nodosum
• Episcleritis
• Osteoporosis

Notes:

• Arthritis is the most common extra-intestinal feature in both CD and UC
• Episcleritis is more common in CD

Question 5

Key differences between Crohn’s and Ulcerative Colitis?

Answer 5