Fast Five Quiz: Signs and Symptoms of Crohn Disease

Jaime Shalkow, MD

Disclosures

January 12, 2022

Crohn disease manifests in different gastrointestinal segments, but the location of the disorder usually remains stable over time. A relatively small proportion of patients (up to 14%) will have a change in disease location.

The majority of patients with Crohn disease have inflammatory disease behavior at diagnosis, whereas a smaller population presents with stricturing or penetrating disease.

Crohn disease is chronic, and symptoms usually progress with an intermittent course. A population-based study modeled the lifetime course of Crohn disease, in which a representative patient spent 24% of their disease in remission, 27% in mild disease, 1% in severe drug-responsive disease, 4% in severe drug-dependent disease, 2% in severe drug-refractory disease, 1% in surgery, and 41% in postsurgical remission.

Crohn disease is characterized by transmural inflammation. Approximately one third of patients have small bowel involvement, and 50% of patients have ileocolitis, which refers to involvement of both the ileum and colon. Further, 20% have disease limited to the colon. Approximately 20%-30% of patients have perianal disease, and 4% have involvement of the mouth or gastroduodenal area (but studies suggest that this percentage may be underestimated).

Fewer patients have involvement of the esophagus and proximal small bowel.

Learn more about Crohn disease.

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