Crohn’S Disease

Last Updated on

(Regional enteritis, granulomatous ileitis or granulomatous ileocolitis)

Crohn’s disease is defined as a chronic transmural Darmntzündung that usually affects the distal ileum and colon but may also occur in any part of the gastrointestinal tract. Symptoms include diarrhea and abdominal Schhmerzen. Abscesses, internal and external fistulas and intestinal obstruction may occur. Extra-intestinal symptoms, v. a. Arthritis, also occur. Diagnosis is colonoscopy and imaging techniques. The therapy consists of 5-aminosalicylic acid, corticosteroids, immunomodulators, Antizytokinen, antibiotics and often surgical approaches.

(See also the American College of Gastroenterology’s practice guidelines for management of Crohn’s disease in adults.)

Crohn’s disease is defined as a chronic transmural Darmntzündung that usually affects the distal ileum and colon but may also occur in any part of the gastrointestinal tract. Symptoms include diarrhea and abdominal Schhmerzen. Abscesses, internal and external fistulas and intestinal obstruction may occur. Extra-intestinal symptoms, v. a. Arthritis, also occur. Diagnosis is colonoscopy and imaging techniques. The therapy consists of 5-aminosalicylic acid, corticosteroids, immunomodulators, Antizytokinen, antibiotics and often surgical approaches. (See also the American College of Gastroenterology’s practice guidelines for management of Crohn’s disease in adults.) Pathophysiology Crohn’s disease starts with an inflammatory reaction of the crypts and crypt abscesses, which progress to tiny focal aphthoid ulcers. This mucosal damage can be deep longitudinal and transverse develop ulcers with intervening mucosal edema and cause in this way the characteristic picture of a paving stone reliefs. The transmural spread of inflammation leads to lymphedema and a thickening of the bowel wall and the mesentery. The mesenteric fat widens typically from the serosal surface of the intestine. The mesenteric lymph nodes are enlarged frequently. The pronounced inflammatory reaction can mucosae hypertrophy of the muscular branches, fibrosis and lead to Strikturbildungen and bowel obstruction. Abscesses occur frequently, fistulas often penetrate into the adjacent structures, incl. Other loops of bowel, bladder or the psoas muscle. Fistulas may also into the skin on the front or abdomen extend into the flanks. Regardless of the intra-abdominal disease activity occur perianal fistulas and abscesses in 25-33% of cases and are often the most troublesome complications of Crohn’s disease. Non-caseating granulomas may occur in the lymph nodes in the peritoneum, liver and all layers of the intestinal wall. Although their presence is pathognomonic, they are not found in about half of patients with Crohn’s disease. The presence of granulomas does not seem to be related to the clinical course of the disease in conjunction. The segments of the diseased intestine are sharply demarcated from adjacent normal bowel (so-called. Skip areas), hence the name regional enteritis. Approximately 35% of Crohn’s disease cases involve the ileum alone (ileitis). About 45% comprise ileum and colon (ileocolitis), with a preference for the right side of the colon. About 20% are in the intestine alone (granulomatous colitis), most of which, unlike ulcerative colitis (UC) avoiding the rectum. Occasionally, the entire small intestine affected (Jejunoileitis). Stomach, duodenum, or esophagus are clinically rarely affected, although often a microscopic detection of the disease in the gastric antrum succeed, especially in younger patients. If no surgical procedures are performed, the disease never spread almost made to regions of the small intestine that were not infected at initial diagnosis. Terminal ileitis image provided by David M. Martin, M.D. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/crohns_ileitis_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/crohns_ileitis_high_de.jpg?la = en & thn = 0 ‘, title:’ terminal ileitis ‘description:’ u003Ca id = “v38395180 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eIn about 80% of cases of Crohn’s disease ileum is inflamed u003c / p u003e u003c / div u003e ‘credits’. picture courtesy of David M. Martin

Health Life Media Team

Leave a Reply