Crohn's Disease

Question 1

What is Crohn’s?

Answer 1

A chronic inflammatory disease characterised by transmural granulomatous inflammation affecting any part of the gut from the mouth to the anus

Question 2

What layers are affected in Crohn’s?

Answer 2

Transmural

Question 3

What part of the GI tract is affected?

Answer 3

Any part from the mouth to the anus. Especially the terminal ileum in ~70%

Question 4

Skip lesions are seen in Crohn’s. True or false?

Answer 4

True

Question 5

What is the cause of Crohn’s?

Answer 5

Inappropriate immune response against the (?abnormal) gut flora in a genetically susceptible individual

Question 6

What is the prevalence of Crohn’s?

Answer 6

100-200/ 100 000/yr; typically presents ~20-40yrs

Question 7

What is the incidence of Crohn’s?

Answer 7

10-20/100 000/yr

Question 8

What age does Crohn’s typically present at?

Answer 8

~20-40yrs

Question 9

What are the associated risk factors/things that make the disease worse?

Answer 9

Smoking increases the risk x3-4 and NSAIDs may exacerbate disease

Question 10

What are the symptoms that present in Crohn’s?

Answer 10

D- diarrhoea 
W- weight loss 
A- abdominal pain
R 
F - failure to thrive

Question 11

What are the systemic symptoms associated with Crohn’s?

Answer 11

F- Fatigue,
F - Fever,
A - Anorexia
M -Malaise

Question 12

What are the signs relating to Crohn’s?

Answer 12

Bowel ulceration
Abdominal tenderness/mass
Perianal abscess/fistulae/skin tags
Anal structures

Question 13

What are the signs relating to Crohn’s? (Not Gut related signs)

Answer 13

Clubbing

Skin, joints and eye problems

Question 14

What are the potential complications associated with Crohn’s?

Answer 14

SBO, toxic dilatation, abscess formation, fistulae, perforation, colon cancer, malnutrition

Question 15

Which condition is colonic toxic dilatation more common in?

Answer 15

Ulcerative colitis

Question 16

Where are abscesses most likely to form in Crohn’s?

Answer 16

Abdominal, pelvic or perianal

Question 17

What percentage of people with Crohn’s are fistulae seen in?

Answer 17

~10%

Question 18

Where are fistulae in Crohn’s most likely to develop?

Answer 18

Entering-enteric, colovesicke (bladder), colovaginal, perianal, enterocutaneous

Question 19

What tests should be done if Crohn’s is suspected?

Answer 19

Bloods
Stool sample
Colonoscopy
Small bowel