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==Differentiating Crohn's Disease from other Diseases==
==Differentiating Crohn's Disease from other Diseases==
The most common disease that mimics the symptoms of Crohn's disease is [[ulcerative colitis]], as both are inflammatory bowel diseases that can affect the [[colon (anatomy)|colon]] with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.<ref name="pmid28520586">{{cite journal| author=Fattahi MR, Malek-Hosseini SA, Sivandzadeh GR, Safarpour AR, Bagheri Lankarani K, Taghavi AR et al.| title=Clinical Course of Ulcerative Colitis After Liver Transplantation in Patients with Concomitant Primary Sclerosing Cholangitis and Ulcerative Colitis. | journal=Inflamm Bowel Dis | year= 2017 | volume=  | issue=  | pages=  | pmid=28520586 | doi=10.1097/MIB.0000000000001105 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28520586  }} </ref><ref name="pmid28486626">{{cite journal| author=Burisch J, Ungaro R, Vind I, Prosberg MV, Bendtsen F, Colombel JF et al.| title=Proximal disease extension in patients with limited ulcerative colitis: a Danish population-based inception cohort. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28486626 | doi=10.1093/ecco-jcc/jjx066 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28486626  }} </ref><ref name="pmid25964429">{{cite journal| author=Srivastava S, Kedia S, Kumar S, Pratap Mouli V, Dhingra R, Sachdev V et al.| title=Serum human trefoil factor 3 is a biomarker for mucosal healing in ulcerative colitis patients with minimal disease activity. | journal=J Crohns Colitis | year= 2015 | volume= 9 | issue= 7 | pages= 575-9 | pmid=25964429 | doi=10.1093/ecco-jcc/jjv075 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25964429  }} </ref><ref name="pmid28505293">{{cite journal| author=Karolewska-Bochenek K, Dziekiewicz M, Banaszkiewicz A| title=Budesonide MMX in pediatric patients with ulcerative colitis. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28505293 | doi=10.1093/ecco-jcc/jjx069 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28505293  }} </ref><ref name="pmid28486597">{{cite journal| author=Silva M, Cardoso H, Macedo G| title=Patency Capsule Safety in Crohn's Disease. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28486597 | doi=10.1093/ecco-jcc/jjx064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28486597  }} </ref><ref name="pmid28458507">{{cite journal| author=Stidham RW, Cross RK| title=Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity. | journal=Tech Gastrointest Endosc | year= 2016 | volume= 18 | issue= 3 | pages= 123-130 | pmid=28458507 | doi=10.1016/j.tgie.2016.08.001 | pmc=5405438 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28458507  }} </ref>
The most common disease that mimics the symptoms of Crohn's disease is [[ulcerative colitis]], as both are inflammatory bowel diseases that can affect the [[colon (anatomy)|colon]] with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.<ref name="pmid28520586">{{cite journal| author=Fattahi MR, Malek-Hosseini SA, Sivandzadeh GR, Safarpour AR, Bagheri Lankarani K, Taghavi AR et al.| title=Clinical Course of Ulcerative Colitis After Liver Transplantation in Patients with Concomitant Primary Sclerosing Cholangitis and Ulcerative Colitis. | journal=Inflamm Bowel Dis | year= 2017 | volume=  | issue=  | pages=  | pmid=28520586 | doi=10.1097/MIB.0000000000001105 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28520586  }} </ref><ref name="pmid28486626">{{cite journal| author=Burisch J, Ungaro R, Vind I, Prosberg MV, Bendtsen F, Colombel JF et al.| title=Proximal disease extension in patients with limited ulcerative colitis: a Danish population-based inception cohort. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28486626 | doi=10.1093/ecco-jcc/jjx066 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28486626  }} </ref><ref name="pmid25964429">{{cite journal| author=Srivastava S, Kedia S, Kumar S, Pratap Mouli V, Dhingra R, Sachdev V et al.| title=Serum human trefoil factor 3 is a biomarker for mucosal healing in ulcerative colitis patients with minimal disease activity. | journal=J Crohns Colitis | year= 2015 | volume= 9 | issue= 7 | pages= 575-9 | pmid=25964429 | doi=10.1093/ecco-jcc/jjv075 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25964429  }} </ref><ref name="pmid28505293">{{cite journal| author=Karolewska-Bochenek K, Dziekiewicz M, Banaszkiewicz A| title=Budesonide MMX in pediatric patients with ulcerative colitis. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28505293 | doi=10.1093/ecco-jcc/jjx069 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28505293  }} </ref><ref name="pmid28486597">{{cite journal| author=Silva M, Cardoso H, Macedo G| title=Patency Capsule Safety in Crohn's Disease. | journal=J Crohns Colitis | year= 2017 | volume=  | issue=  | pages=  | pmid=28486597 | doi=10.1093/ecco-jcc/jjx064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28486597  }} </ref><ref name="pmid28458507">{{cite journal| author=Stidham RW, Cross RK| title=Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity. | journal=Tech Gastrointest Endosc | year= 2016 | volume= 18 | issue= 3 | pages= 123-130 | pmid=28458507 | doi=10.1016/j.tgie.2016.08.001 | pmc=5405438 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28458507  }} </ref>


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Revision as of 16:13, 19 May 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Crohn's disease should be differentiated from other causes of diarrhea. It is very important to differentiate it from ulcerative colitis as the management of both conditions is different though the initial presentation may be confused for any of these disorders.[1][2]

Differentiating Crohn's Disease from other Diseases

The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.[1][2][3][4][5][6]

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[7]
Involvement around the anus Common[8] Seldom
Bile duct involvement No increase in rate of primary sclerosing cholangitis Higher rate[9]
Distribution of Disease Patchy areas of inflammation (Skip lesions) Continuous area of inflammation[7]
Endoscopy Deep geographic and serpiginous (snake-like) ulcers Continuous ulcer
Depth of inflammation May be transmural, deep into tissues[8] Shallow, mucosal
Fistulae Common[8] Seldom
Stenosis Common Seldom
Autoimmune disease Widely regarded as an autoimmune disease No consensus
Cytokine response Associated with Th1 Vaguely associated with Th2
Granulomas on biopsy Can have granulomas[8] Granulomas uncommon[7]
Surgical cure Often returns following removal of affected part Usually cured by removal of colon
Smoking Higher risk for smokers Lower risk for smokers[7]
Risk of Cancer Lower than UC Higher

References

  1. ↑ 1.0 1.1 Fattahi MR, Malek-Hosseini SA, Sivandzadeh GR, Safarpour AR, Bagheri Lankarani K, Taghavi AR; et al. (2017). "Clinical Course of Ulcerative Colitis After Liver Transplantation in Patients with Concomitant Primary Sclerosing Cholangitis and Ulcerative Colitis". Inflamm Bowel Dis. doi:10.1097/MIB.0000000000001105. PMID 28520586.
  2. ↑ 2.0 2.1 Burisch J, Ungaro R, Vind I, Prosberg MV, Bendtsen F, Colombel JF; et al. (2017). "Proximal disease extension in patients with limited ulcerative colitis: a Danish population-based inception cohort". J Crohns Colitis. doi:10.1093/ecco-jcc/jjx066. PMID 28486626.
  3. ↑ Srivastava S, Kedia S, Kumar S, Pratap Mouli V, Dhingra R, Sachdev V; et al. (2015). "Serum human trefoil factor 3 is a biomarker for mucosal healing in ulcerative colitis patients with minimal disease activity". J Crohns Colitis. 9 (7): 575–9. doi:10.1093/ecco-jcc/jjv075. PMID 25964429.
  4. ↑ Karolewska-Bochenek K, Dziekiewicz M, Banaszkiewicz A (2017). "Budesonide MMX in pediatric patients with ulcerative colitis". J Crohns Colitis. doi:10.1093/ecco-jcc/jjx069. PMID 28505293.
  5. ↑ Silva M, Cardoso H, Macedo G (2017). "Patency Capsule Safety in Crohn's Disease". J Crohns Colitis. doi:10.1093/ecco-jcc/jjx064. PMID 28486597.
  6. ↑ Stidham RW, Cross RK (2016). "Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity". Tech Gastrointest Endosc. 18 (3): 123–130. doi:10.1016/j.tgie.2016.08.001. PMC 5405438. PMID 28458507.
  7. ↑ 7.0 7.1 7.2 7.3 Kornbluth, Asher (2004). "Ulcerative Colitis Practice Guidelines in Adults" (PDF). American Journal of Gastroenterology. 99 (7): 1371–1385. doi:10.1111/j.1572-0241.2004.40036.x. PMID 15233681. Retrieved 2006-11-08. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)
  8. ↑ 8.0 8.1 8.2 8.3 Hanauer, Stephen B. (March 1 2001). "Management of Crohn's Disease in Adults" (PDF). American Journal of Gastroenterology. 96 (3): 635–643. doi:10.1111/j.1572-0241.2001.03671.x. PMID 11280528. Retrieved 2006-11-08. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)
  9. ↑ Broomé, Ulrika (2006). "Primary sclerosing cholangitis, inflammatory bowel disease, and colon cancer". Seminars in Liver Disease. 26 (1): 31–41. doi:10.1055/s-2006-933561. PMID 16496231. Unknown parameter |coauthors= ignored (help); Unknown parameter |month= ignored (help)

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