Crohn’s disease

Crohn's disease is an unexplained intestinal inflammatory disease that can occur in any part of the gastrointestinal tract but mostly occurs in the terminal ileum and right colon. Both this disease and chronic nonspecific ulcerative colitis are collectively referred to as inflammatory bowel disease (IBD)

The clinical manifestations of this disease are abdominal pain, diarrhea, intestinal obstruction, and extraintestinal manifestations such as fever and nutritional disorders. The course of the disease is prolonged and recurrent, and it is not easy to cure. This disease is also known as localized enteritis, localized ileitis, segmental enteritis and granulomatous enteritis.


At present, there is no general method for a radical cure, and many patients need surgery when they have complications. The recurrence rate of this disease is related to the scope of the disease, the strength of the disease invasion, the prolongation of the disease course, and the increase of age.

Clinical manifestations

The clinical manifestations are abdominal pain, diarrhea, abdominal mass, fistula formation, and intestinal obstruction, which may be accompanied by fever, anemia, nutritional disorders, and extraintestinal damage such as joints, skin, eyes, oral mucosa, liver, etc. The disease can recur and will not heal.

1. Digestive system performance

(1) Abdominal pain is located in the right lower abdomen or around the umbilical cord. It presents cramping pain, with intermittent attacks, accompanied by bowel sounds, which aggravate after meals, and relieve after defecation. If the abdominal pain persists and the tenderness is obvious, it indicates that the inflammation spreads to the peritoneum or the abdominal cavity and forms an abscess. Severe abdominal pain and abdominal muscle tension may be caused by acute perforation of the diseased intestine.

(2) Diarrhea is caused by inflammation and exudation of the diseased intestine, increased peristalsis, and secondary malabsorption. Intermittent seizures started at the beginning, followed by persistent mushy stools, without pus, blood or mucus. If the lesion involves the lower part of the colon or rectum, there may be mucus, bloody stools and tenesmus.

(3) Abdominal masses are more common in the right lower abdomen and around the umbilical cord. They are caused by intestinal adhesions, thickening of the intestinal wall and mesentery, enlarged mesenteric lymph nodes, internal fistulas or local abscess formation.

(4) Fistula formation is one of the clinical features of Crohn's disease. Transmural inflammatory lesions penetrate the entire thickness of the intestinal wall to extraintestinal tissues or organs, forming a fistula. The internal fistula can lead to other intestinal segments, mesenteric, bladder, ureter, vagina and retroperitoneum. The external fistula leads to the abdominal wall or perianal skin.

(5) Perirectal lesions A few patients have lesions such as fistulas, abscess formation, anal fissures, etc. around the anus and rectum.

2. Whole-body performance

(1) Fever Fever is caused by intestinal inflammatory activity or secondary infection. It is usually intermittent low-grade or moderate-grade fever, and a few have a flaccid fever, which may be accompanied by toxemia.

(2) Nutritional disorders: Weight loss, anemia, hypoproteinemia, vitamin deficiency, calcium deficiency, osteoporosis, etc. caused by loss of appetite, chronic diarrhea and chronic wasting diseases.

(3) Water, electrolyte, and acid-base balance are disturbed during the acute attack.

3. Extraintestinal manifestations

Some patients have iridocyclitis, uveitis, clubbing, arthritis, erythema gangrenosum pyoderma, oral mucosal ulcer, chronic hepatitis, pericholangiitis, sclerosing cholangitis, etc., occasionally Amyloidosis or thromboembolic disease.

Reference:

Ran Zhihua. Consensus opinions on the diagnosis and treatment of inflammatory bowel disease (2012·Guangzhou)

Partial interpretation of the diagnosis of Crohn’s disease. "CNKI", 2012

Ouyang Qin, Miao Yinglei, Chen Daiyun, Pu Ping. The value of endoscopy and pathology in the differential diagnosis of Crohn's disease and intestinal tuberculosis. "WanFang", 2002

Shi Yin, Bao Chunhui, Wu Huangan, etc. The effect of medicine-separated moxibustion combined with acupuncture on the expression of TNF-α, TNFR1, TNFR2 and intestinal epithelial cell apoptosis in patients with Crohn's disease. "Vip", 2011

Zou Ning, Liu Xiaohong. Differential diagnosis of intestinal tuberculosis and Crohn's disease. "WanFang", 2003

Zheng Jiaju, Shi Xiaohua, Chu Xingqi, etc. The clinical diversity of Crohn's disease. "CNKI", 2002

克罗恩病 克羅恩病

克罗恩病是一种原因不明的肠道炎症性疾病，在胃肠道的任何部位均可发生，但多发于末端回肠和右半结肠。本病和慢性非特异性溃疡性结肠炎两者统称为炎症性肠病（IBD）