Skill Checkup: A 28-Year-Old Man With Diarrhea, Nausea, Vomiting, and Abdominal Cramping

Charles Bernstein, MD


February 01, 2022

The absence of symptoms does not always correlate with inflammation, and over time, chronic inflammation in Crohn disease can lead to intestinal complications such as fibrotic strictures, enteric fistulae, and intestinal neoplasia. The preferred outcome of treatment is complete remission, defined as both symptomatic (corticosteroid-free) and endoscopic or radiographic remission.

Of note, randomized controlled trials usually use symptomatic remission or symptomatic response as an outcome, though more recent trials have begun including endoscopic outcomes.

Meaningful improvement in symptoms as judged by both the patient and physician in absence of remission marks symptomatic response to therapy.


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