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==Overview==
==Overview==
==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'''.
{| class="prettytable" cellpadding=1 style="text-align:center"
|+ '''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<ref name="Kornbluth-Sachar2004">{{cite journal | last = Kornbluth | first = Asher | coauthors = David B. Sachar | year = 2004 | month = July | title = Ulcerative Colitis Practice Guidelines in Adults | journal = American Journal of Gastroenterology | volume = 99 | issue = 7 | pages = 1371-1385 | doi = 10.1111/j.1572-0241.2004.40036.x | id = PMID 15233681 | url = http://www.acg.gi.org/physicians/guidelines/UlcerativeColitisUpdate.pdf | format = PDF | accessdate = 2006-11-08}}</ref>
|-
| Involvement around the [[anus]] || Common<ref name="HanauerCrohns">{{cite journal | last = Hanauer | first = Stephen B. | coauthors = William Sandborn |date=March 1 2001 | title = Management of Crohn's Disease in Adults | journal=American Journal of Gastroenterology | volume = 96 | issue = 3 | pages = 635-643 | doi = 10.1111/j.1572-0241.2001.03671.x | id = PMID 11280528 | url = http://www.acg.gi.org/physicians/guidelines/CrohnsDiseaseinAdults.pdf | format = PDF | accessdate = 2006-11-08}}</ref>
|| Seldom
|-
| Bile duct involvement || No increase in rate of [[primary sclerosing cholangitis]]  || Higher rate<ref>{{cite journal | last = Broomé | first = Ulrika | coauthors = Annika Bergquist | year = 2006 | month = February | title = Primary sclerosing cholangitis, inflammatory bowel disease, and colon cancer | journal = Seminars in Liver Disease | volume = 26 | issue = 1 | pages = 31-41 | doi =10.1055/s-2006-933561 | id = PMID 16496231 }}</ref>
|-
| Distribution of Disease || Patchy areas of inflammation (Skip lesions) || Continuous area of inflammation<ref name="Kornbluth-Sachar2004"/>
|-
| Endoscopy || Deep geographic and serpiginous (snake-like) [[ulcer]]s
|| Continuous ulcer
|-
| Depth of inflammation || May be transmural, deep into tissues<ref name="HanauerCrohns"/><ref name=Hanauer/>
|| Shallow, mucosal
|-
| [[Fistula]]e || Common<ref name="HanauerCrohns"/>
|| Seldom
|-
| [[Stenosis]] || Common || Seldom
|-
| [[Autoimmunity|Autoimmune disease]] || Widely regarded as an autoimmune disease || No consensus
|-
| [[Cytokine]] response || Associated with [[T helper cell#Th1.2FTh2 Model for helper T cells|T<sub>h</sub>1]] || Vaguely associated with T<sub>h</sub>2
|-
| [[Granuloma]]s on biopsy || Can have granulomas<ref name="HanauerCrohns"/>
|| Granulomas uncommon<ref name="Kornbluth-Sachar2004"/>
|-
| Surgical cure || Often returns following removal of affected part || Usually cured by removal of colon
|-
| [[Tobacco smoking|Smoking]] || Higher risk for smokers || Lower risk for smokers<ref name="Kornbluth-Sachar2004"/>
|}
==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Revision as of 03:42, 12 August 2012

Crohn's disease

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

Overview

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.

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[1]
Involvement around the anus Common[2] Seldom
Bile duct involvement No increase in rate of primary sclerosing cholangitis Higher rate[3]
Distribution of Disease Patchy areas of inflammation (Skip lesions) Continuous area of inflammation[1]
Endoscopy Deep geographic and serpiginous (snake-like) ulcers Continuous ulcer
Depth of inflammation May be transmural, deep into tissues[2][4] Shallow, mucosal
Fistulae Common[2] 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[2] Granulomas uncommon[1]
Surgical cure Often returns following removal of affected part Usually cured by removal of colon
Smoking Higher risk for smokers Lower risk for smokers[1]

References

  1. ↑ 1.0 1.1 1.2 1.3 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)
  2. ↑ 2.0 2.1 2.2 2.3 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)
  3. ↑ 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)
  4. ↑ Invalid <ref> tag; no text was provided for refs named Hanauer

Template:WH Template:WS

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