Crohn's disease natural history, complications and prognosis: Difference between revisions

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{{Crohn's disease}}
{{Crohn's disease}}
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==Overview==
==Overview==
==Natural History , Complications and Prognosis==
If left untreated, patients with Crohn's disease can progress into colorectal cancer depending upon the region involved. The common complication of Crohn's disease include obstructions, abscesses, free perforation, and hemorrhage. With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.
===Complications===
==Natural History==
 
If left untreated, patients with Crohn's disease can progress into colorectal cancer depending upon the region involved. For example, individuals with Crohn's disease involving the [[small bowel]] are at higher risk for [[Small intestine cancer|small intestinal cancer]]. Similarly, people with Crohn's [[colitis]] have a [[relative risk]] of 5.6 for developing [[colon cancer]].<ref>{{cite journal |author=Ekbom A, Helmick C, Zack M, Adami H |title=Increased risk of large-bowel cancer in Crohn's disease with colonic involvement |journal=Lancet |volume=336 |issue=8711 |pages=357-9 |year=1990 |pmid=1975343}}</ref> Screening for colon cancer with [[colonoscopy]] is recommended for anyone who has had Crohn's colitis for eight years, or more.<ref>{{cite journal | author = Collins P, Mpofu C, Watson A, Rhodes J | title = Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease | journal = Cochrane Database Syst Rev | volume = | issue = | pages = CD000279 | year = | id = PMID 16625534}}</ref><ref>{{cite web|url=https://www.livingwithcrohnsdisease.com/livingwithcrohnsdisease/crohns_disease/complications_of_crohns.html|title=Complications of Crohn's Disease|accessdate=2008-01-16}}</ref><ref>{{cite journal |author=Ekbom A, Helmick C, Zack M, Adami H |title=Increased risk of large-bowel cancer in Crohn's disease with colonic involvement |journal=Lancet |volume=336 |issue=8711 |pages=357-9 |year=1990 |pmid=1975343}}</ref>
Crohn's disease can lead to several mechanical complications within the intestines, including obstruction, fistulae, and abscesses. Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents. Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. Abscesses are walled off collections of [[infection]], which can occur in the [[abdomen]] or in the [[wiktionary:perianal|perianal]] area in Crohn's disease sufferers.
==Complications==
 
Common complications of Crohn's disease include:<ref>{{cite web|url=https://www.livingwithcrohnsdisease.com/livingwithcrohnsdisease/crohns_disease/complications_of_crohns.html|title=Complications of Crohn's Disease|accessdate=2008-01-16}}</ref>
Crohn's disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohn's disease involving the [[small bowel]] are at higher risk for [[Small intestine cancer|small intestinal cancer]]. Similarly, people with Crohn's colitis have a [[relative risk]] of 5.6 for developing [[colon cancer]].<ref>{{cite journal |author=Ekbom A, Helmick C, Zack M, Adami H |title=Increased risk of large-bowel cancer in Crohn's disease with colonic involvement |journal=Lancet |volume=336 |issue=8711 |pages=357-9 |year=1990 |pmid=1975343}}</ref> Screening for colon cancer with [[colonoscopy]] is recommended for anyone who has had Crohn's colitis for eight years, or more.<ref>{{cite journal | author = Collins P, Mpofu C, Watson A, Rhodes J | title = Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease | journal = Cochrane Database Syst Rev | volume = | issue = | pages = CD000279 | year = | id = PMID 16625534}}</ref>
* [[Abscess]] - Abscesses are walled off collections of [[infection]], which can occur in the [[abdomen]] or in the [[wiktionary:perianal|perianal]] area in Crohn's disease sufferers.
 
* [[Bowel obstruction]]s - Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents.
Individuals with Crohn's disease are at risk of [[malnutrition]] for many reasons, including decreased food intake and [[malabsorption]]. The risk increases following resection of the [[small bowel]]. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, [[total parenteral nutrition]] (TPN). Most people with moderate or severe Crohn's disease are referred to a [[dietitian]] for assistance in nutrition.<ref>{{cite journal | author = Evans J, Steinhart A, Cohen Z, McLeod R | title = Home total parenteral nutrition: an alternative to early surgery for complicated inflammatory bowel disease | journal = J Gastrointest Surg | volume = 7 | issue = 4 | pages = 562–6 | year = 2003 | id = PMID 12763417}}</ref>
* [[Complication]]s of [[corticosteroid]] therapy
 
* [[Erythema nodosum]]
There are many complications that can come with Crohn's disease like: obstructions, abscesses, free perforation, and hemorrhage.<ref>{{cite web|url=https://www.livingwithcrohnsdisease.com/livingwithcrohnsdisease/crohns_disease/complications_of_crohns.html|title=Complications of Crohn's Disease|accessdate=2008-01-16}}</ref>
* Fistulae can develop between two loops of [[bowel]], between the bowel and [[bladder]], between the bowel and [[vagina]], and between the bowel and [[skin]].
 
* Impaired growth and sexual development in children
Women with Inflammatory bowel disease shows that they "face a higher risk of adverse outcomes related to pregnancy, according to a report in the October issue of Gastroenterology" [http://www.ccfa.org/reuters/pregnancyoutcomes].
* [[Arthritis|Inflammation of the joints]]
* Lesions in the [[eye]]
* Nutritional deficiencies (particularly [[vitamin B12 deficiency]])
* [[Pyoderma gangrenosum]]
* Development of [[cancer]]
* [[Malnutrition]]<ref>{{cite journal | author = Evans J, Steinhart A, Cohen Z, McLeod R | title = Home total parenteral nutrition: an alternative to early surgery for complicated inflammatory bowel disease | journal = J Gastrointest Surg | volume = 7 | issue = 4 | pages = 562–6 | year = 2003 | id = PMID 12763417}}</ref>


===Prognosis===
==Prognosis==
 
*Crohn's disease is a [[Chronic (medicine)|chronic]] condition for which there is currently no cure. It is characterized by periods of improvement followed by episodes when symptoms flare up.  
Crohn's disease is a [[Chronic (medicine)|chronic]] condition for which there is currently no cure. It is characterized by periods of improvement followed by episodes when symptoms flare up. With treatment, most people achieve a healthy height and weight, and the mortality rate for the disease is low. Crohn's disease is associated with an increased risk of small bowel and colorectal carcinoma.<ref name=Canavan>{{cite journal | last = Canavan | first = C. | coauthors = K. R. Abrams, J. Mayberry | year = 2006 | month = August? | title = Meta-analysis : colorectal and small bowel cancer risk in patients with Crohn's disease | journal = Alimentary pharmacology & therapeutics  | volume = 23 | issue = 8 | pages = 1097-1104 | id = ISSN 0269-2813 | url = http://cat.inist.fr/?aModele=afficheN&cpsidt=17660183 | accessdate = 2007-05-23 }}</ref>
*With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.
 
*Crohn's disease is associated with an increased risk of small bowel and colorectal carcinoma.<ref name=Canavan>{{cite journal | last = Canavan | first = C.| year = 2006 | title = Meta-analysis : colorectal and small bowel cancer risk in patients with Crohn's disease | journal = Alimentary pharmacology & therapeutics  | volume = 23 | issue = 8 | pages = 1097-1104 | id = ISSN 0269-2813 | url = http://cat.inist.fr/?aModele=afficheN&cpsidt=17660183 | accessdate = 2007-05-23 }}</ref>
Crohn's cannot be cured by surgery, though surgery does happen with blockages, whether partial or a full blockage occurs.  After the first surgery, the Crohn's usually shows up at the site of the resection though it can appear in other locations.  After a resection, scar tissue builds up which causes strictures.  A stricture is when the intestines becomes too small to allow excrement to pass through easily which can lead to a blockage. After the first resection, another resection may be necessary within five years of the first surgery.  [http://ibdcrohns.about.com/od/surgeryprocedures/a/resectioncrohns.htm]
*Many patients will have temporary stoma formations together with possible associated complications.<ref>http://www.answers.com/topic/crohn-s-disease?cat=health</ref>
 
Many patients will have temporary stoma formations together with possible associated complications. [http://www.answers.com/topic/crohn-s-disease?cat=health]


==References==
==References==
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{{WH}}
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[[Category:Disease]]
[[Category:Autoimmune diseases]]
[[Category:Digestive diseases]]
[[Category:Gastroenterology]]
[[Category:Genetic disorders]]
[[Category:Inflammations]]
[[Category:Conditions diagnosed by stool test]]
[[Category:Abdominal pain]]
[[Category:Needs overview]]

Latest revision as of 21:10, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

If left untreated, patients with Crohn's disease can progress into colorectal cancer depending upon the region involved. The common complication of Crohn's disease include obstructions, abscesses, free perforation, and hemorrhage. With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.

Natural History

If left untreated, patients with Crohn's disease can progress into colorectal cancer depending upon the region involved. For example, individuals with Crohn's disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn's colitis have a relative risk of 5.6 for developing colon cancer.[1] Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn's colitis for eight years, or more.[2][3][4]

Complications

Common complications of Crohn's disease include:[5]

Prognosis

  • Crohn's disease is a chronic condition for which there is currently no cure. It is characterized by periods of improvement followed by episodes when symptoms flare up.
  • With treatment, most people achieve a healthy life, and the mortality rate for the disease is low.
  • Crohn's disease is associated with an increased risk of small bowel and colorectal carcinoma.[7]
  • Many patients will have temporary stoma formations together with possible associated complications.[8]

References

  1. ↑ Ekbom A, Helmick C, Zack M, Adami H (1990). "Increased risk of large-bowel cancer in Crohn's disease with colonic involvement". Lancet. 336 (8711): 357–9. PMID 1975343.
  2. ↑ Collins P, Mpofu C, Watson A, Rhodes J. "Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease". Cochrane Database Syst Rev: CD000279. PMID 16625534.
  3. ↑ "Complications of Crohn's Disease". Retrieved 2008-01-16.
  4. ↑ Ekbom A, Helmick C, Zack M, Adami H (1990). "Increased risk of large-bowel cancer in Crohn's disease with colonic involvement". Lancet. 336 (8711): 357–9. PMID 1975343.
  5. ↑ "Complications of Crohn's Disease". Retrieved 2008-01-16.
  6. ↑ Evans J, Steinhart A, Cohen Z, McLeod R (2003). "Home total parenteral nutrition: an alternative to early surgery for complicated inflammatory bowel disease". J Gastrointest Surg. 7 (4): 562–6. PMID 12763417.
  7. ↑ Canavan, C. (2006). "Meta-analysis : colorectal and small bowel cancer risk in patients with Crohn's disease". Alimentary pharmacology & therapeutics. 23 (8): 1097–1104. ISSN 0269-2813. Retrieved 2007-05-23.
  8. ↑ http://www.answers.com/topic/crohn-s-disease?cat=health

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