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Inflammatory bowel disease - Crohn's disease

Constipation in children

Inflammatory bowel disease - Crohn's disease

<< Inflammatory bowel disease < Ulcerative colitis Crohn's disease

On the other hand, in noting Crohn's disease, always remember that it occurs in patches (unlike ulcerative colitis which is continuous). It was once thought to be limited only to the ileum (the distal or the last portion of the small intestine) so it was once known as “terminal ileitis”. However, upon recognition that it can affect other segments of the bowel, including the colon, with areas that are relatively unaffected (called as “skip areas”), this was given the name as it is now.

Again, smoking is another strong exogenous factor, and females have a greater tendency to develop Crohn's disease than do the males. Its clinical manifestations are very much varied, and generally more understated than that of ulcerative colitis. Most often, attacks are also precipitated by periods of emotional and even physical stress, contributing to fulminant attacks of the disease. It often begins with symptoms that are nonspecific – fever, mild diarrhea, and abdominal pain – with periods that show almost zero manifestations of the underlying condition. There are also manifestations that sound relatively far-off from the site of abnormality, such as migratory polyarthritis, clubbing of the fingertips (such as those with cardiac disease), and even erythema nodosum (presence of tender red nodules on the skin; a sign of inflammation).

Due to its chronic nature, Crohn's disease is most prone to result to complications. Among these are the development of strictures (narrowing of blood vessels), fistulas (formation of abnormal passages from one organ to another, as in the case of an anal fistula wherein the anus is connected to the skin than the rectum) that could result into perianal abscesses. There is also a large risk for developing colon cancer, but this is relatively low compared to that of ulcerative colitis.

Comparisons of various factors in Crohn's disease and ulcerative colitis

Crohn's disease Ulcerative colitis
Terminal ileum involvement Commonly Seldom
Colon involvement Usually Always
Rectum involvement Seldom Usually[80]
Involvement around the anus Common[81] Seldom
Bile duct involvement No increase in rate of primary sclerosing cholangitis Higher rate[82]
Distribution of Disease Patchy areas of inflammation (Skip lesions) Continuous area of inflammation[80]
Endoscopy Deep geographic and serpiginous (snake-like) ulcers Continuous ulcer
Depth of inflammation May be transmural, deep into tissues[1][81] Shallow, mucosal
Fistulae Common[81] Seldom
Stenosis Common Seldom
Autoimmune disease Widely regarded as an autoimmune disease No consensus
Cytokine response Associated with Th17 [43] Vaguely associated with Th2
Granulomas on biopsy May have non-necrotizing non-peri-intestinal crypt granulomas[81][83][84] Non-peri-intestinal crypt granulomas not seen[80]
Surgical cure Often returns following removal of affected part Usually cured by removal of colon
Smoking Higher risk for smokers Lower risk for smokers[80]



<< Inflammatory bowel disease < Ulcerative colitis Crohn's disease

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