Fast Five Quiz: Test Yourself on Crohn Disease

Jamie Shalkow, MD

Disclosures

January 12, 2022

Colonic Crohn disease may be difficult to distinguish from ulcerative colitis clinically, with symptoms of bloody mucopurulent diarrhea, cramping abdominal pain, and urgency to defecate. Of note, however, are signs that point to Crohn disease: sparing of the rectum, discontinuous involvement with skip areas, deep/linear/serpiginous ulcers of the colon, strictures, fistulas, or granulomatous inflammation.

Patients with Crohn disease usually report low-grade fever, prolonged diarrhea with abdominal pain, weight loss, and generalized fatigue. Crampy or steady right lower quadrant or periumbilical pain may develop; the pain precedes and may be partially relieved by defecation. Diarrhea is usually not grossly bloody and is often intermittent. If the colon is involved, patients may report diffuse abdominal pain accompanied by mucus, blood, and pus in the stool.

Crohn disease of the small intestine usually presents with evidence of malabsorption, including diarrhea, abdominal pain, weight loss, and anorexia. Initially, these symptoms may be quite subtle. Although fewer than 5% of patients with Crohn disease have gastroduodenal involvement, these patients more commonly present with anorexia, nausea, and vomiting. Those with perianal disease may have debilitating perirectal pain, malodorous discharge from the fistula, and disfiguring scars from active disease or previous surgery.

Learn more about the presentation of Crohn disease.

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