Crohn's disease (also known as regional enteritis) is a chronic, episodic, inflammatory bowel disease (IBD) and is generally classified as an autoimmune disease. Crohn's disease can affect any part of the gastrointestinal tract from mouth to anus; as a result, the symptoms of Crohn's disease vary among afflicted individuals. The disease is characterized by areas of inflammation with areas of normal lining between in a symptom known as skip lesions. The main gastrointestinal symptoms are abdominal pain, diarrhea (which may be bloody, though this may not be visible to the naked eye), constipation, vomiting, weight loss or weight gain. Crohn's disease can also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, and inflammation of the eye.^[1] Enteritis is the inflammation of the small intestine (inflammation of the large intestine is termed colitis). ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... In medicine, inflammatory bowel disease (IBD) is a group of inflammatory conditions of the large intestine and, in some cases, the small intestine. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Gut redirects here. ... For other uses, see Mouth (disambiguation). ... This article is about the bodily orifice. ... A lesion is a non-specific term referring to abnormal tissue in the body. ... Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Heaving redirects here. ... Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. ... This article or section should be merged with Birth control pill Weight Gain When Taking The Pill When starting to take the birth contol pill some people may expierence slight weight gain. ... For the manga by Tsukasa Hôjô, see Rash. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ...

The disease was independently described in 1904 by Polish surgeon Antoni Lesniowski and in 1932 by American gastroenterologist Burrill Bernard Crohn, for whom the disease was named. Crohn, along with two colleagues, described a series of patients with inflammation of the terminal ileum, the area most commonly affected by the illness.^[2] Crohn's disease affects between 400,000 and 600,000 people in North America.^[3] Prevalence estimates for Northern Europe have ranged from 27–48 per 100,000.^[4] Crohn's disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age.^[1][5] Antoni LeÅ›niowski (born January 28, 1867, died April 4, 1940), surgeon. ... Gastroenterology (MeSH heading[2] ) is the branch of medicine where the digestive system and its disorders are studied. ... Burrill Bernard Crohn (born June 13, 1884 in New York; died 1983 in Connecticut) was an American gastroenterologist and one of the first to describe the disease of which he is the namesake, Crohns disease. ... This page meets Wikipedias criteria for speedy deletion. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ...

Although the cause of Crohn's disease is not known, it is believed to be an autoimmune disease that is genetically linked. The highest relative risk occurs in siblings, affecting males and females equally. Smokers are three times more likely to get Crohn's disease. Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... This article is about the general scientific term. ...

Unlike the other major types of IBD, there is no known drug based or surgical cure for Crohn's disease.^[6] Treatment options are restricted to controlling symptoms, putting and keeping the disease in remission and preventing relapse. This article does not cite any references or sources. ... “Surgeon” redirects here. ... The treatment of Crohns disease is sequential: to treat acute disease, and then to maintain remission. ... A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... Remission is the state of absence of disease activity in patients with known chronic illness. ... A relapse (etymologically, who falls again) occurs when a person is affected again by a condition that affected them in the past. ...

Classification

Distribution of gastrointestinal Crohn's disease. More than likely the disease Ben Winsor has. Based on data from American Gastroenterological Association.

Crohn's disease is generally classified as an autoimmune disease. As it almost invariably affects the gastrointestinal tract, most gastroenterologists categorize the presenting disease by the affected areas. Ileocolic Crohn's disease, which affects both the ileum (the last part of the small intestine that connects to the large intestine) and the large intestine, accounts for fifty percent of cases. Crohn's ileitis, affecting the ileum only, accounts for thirty percent of cases, and Crohn's colitis, affecting the large intestine, accounts for the remaining twenty percent of cases, and may be particularly difficult to distinguish from ulcerative colitis. The disease can attack any part of the digestive tract, from mouth to anus. However, individuals affected by the disease rarely fall outside these three classifications, being affected in other parts of the gastrointestinal tract such as the stomach and esophagus.^[1] Crohn's disease may also be categorized by the behaviour of disease as it progresses. This was formalized in the Vienna classification of Crohn's disease.^[7] There are three categories of disease presentation in Crohn's disease: stricturing, penetrating, and inflammatory. Stricturing disease causes narrowing of the bowel which may lead to bowel obstruction or changes in the caliber of the feces. Penetrating disease creates abnormal passageways (fistulae) between the bowel and other structures such as the skin. Inflammatory disease (or non-stricturing, non-penetrating disease) causes inflammation without causing strictures or fistulae.^[7][8] Image File history File links Distribution_of_CD.svg‎ Other versions w:Image:Distribution of CD 2. ... Image File history File links Distribution_of_CD.svg‎ Other versions w:Image:Distribution of CD 2. ... Founded in 1897, the American Gastroenterological Association is the oldest medical-specialty society in the United States. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Grays Fig. ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. ... The large intestine, an organ which is now more commonly referred to by its Greek name, the colon, is the last part of the digestive system: the final stage of the alimentary canal in vertebrate animals. ... For other uses, see Mouth (disambiguation). ... This article is about the bodily orifice. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... The esophagus or oesophagus (see American and British English spelling differences), sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... Bowel obstruction is a mechanical blockage of the intestines, preventing the normal transit of the products of digestion. ... Horse feces Feces, faeces, or fæces (see spelling differences) is a waste product from an animals digestive tract expelled through the anus (or cloaca) during defecation. ... In medicine, a fistula (pl. ...

Symptoms

Endoscopy image of colon showing serpiginous ulcer, a classic finding in Crohn's disease

Many people with Crohn's disease have symptoms for years prior to the diagnosis.^[9] The usual onset is between 15 and 30 years of age but can occur at any age.^[10] Because of the patchy nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more vague than with ulcerative colitis. People with Crohn's disease will go through periods of flare-ups and remission. Image File history File linksMetadata CD_serpiginous_ulcer. ... Image File history File linksMetadata CD_serpiginous_ulcer. ... It has been suggested that this article or section be merged with Large intestine. ... Serpiginous, often referring to some chronic medical affliction, signifies it as slowly progressive or creeping, such as ringworm. ... Remission is the state of absence of disease activity in patients with known chronic illness. ...

Gastrointestinal symptoms

Abdominal pain may be the initial symptom of Crohn's disease. The pain is commonly cramp-like and may be relieved by defecation. It is often accompanied by diarrhea, which may or may not be bloody, though diarrhea is not uncommon especially in those who have had surgery. People who have had surgery or multiple surgeries often end up with short bowel syndrome of the gastrointestinal tract. The nature of the diarrhea in Crohn's disease depends on the part of the small intestine or colon that is involved. Ileitis typically results in large-volume watery feces. Colitis may result in a smaller volume of feces of higher frequency. Fecal consistency may range from solid to watery. In severe cases, an individual may have more than 20 bowel movements per day and may need to awaken at night to defecate.^{[1][5][11][12]} Visible bleeding in the feces is less common in Crohn's disease than in ulcerative colitis, but may be seen in the setting of Crohn's colitis.^[1] Bloody bowel movements are typically intermittent, and may be bright or dark red in colour. In the setting of severe Crohn's colitis, bleeding may be copious.^[5] Flatus and bloating may also add to the intestinal discomfort.^[5] Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... This article is about muscular pain. ... Defecation or feceation (known colloquially as pooping or shitting) is the act of eliminating solid or semisolid waste material from the digestive tract. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... Short bowel syndrome is a malabsorption disorder caused by either the surgical removal of the small intestine or the loss of its absorptive function due to diseases. ... No joke intended. ... Flatus is a semi-retired webcomic featured on The Double S webpage (www. ...

Symptoms caused by intestinal stenosis are also common in Crohn's disease. Abdominal pain is often most severe in areas of the bowel with stenoses. In the setting of severe stenosis, vomiting and nausea may indicate the beginnings of small bowel obstruction.^[5] Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts. A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... Heaving redirects here. ... For other uses, see Nausea (disambiguation). ... Bowel obstruction is a mechanical blockage of the intestines, preventing the normal transit of the products of digestion. ... Primary sclerosing cholangitis (PSC) is a form of cholangitis due to an autoimmune reaction. ...

Perianal discomfort may also be prominent in Crohn's disease. Itchiness or pain around the anus may be suggestive of inflammation, fistulization or abscess around the anal area^[1] or anal fissure. Perianal skin tags are also common in Crohn's disease.^[13] Fecal incontinence may accompany peri-anal Crohn's disease. At the opposite end of the gastrointestinal tract, the mouth may be affected by non-healing sores (aphthous ulcers). Rarely, the esophagus, and stomach may be involved in Crohn's disease. These can cause symptoms including difficulty swallowing (odynophagia), upper abdominal pain, and vomiting.^[14] This article is about the bodily orifice. ... In medicine, a fistula (pl. ... For the death metal band, see Abscess (band). ... An anal fissure is an unnatural crack or tear in the anus skin. ... An acrochordon (a. ... Fecal incontinence is the loss of regular control of the bowels. ... An aphthous ulcer or canker sore is a type of mouth ulcer which presents as a painful open sore inside the mouth, caused by a break in the mucous membrane. ... The esophagus or oesophagus (see American and British English spelling differences), sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Odynophagia refers to a medical term that describes a painful swallowing experience. ...

Systemic symptoms

Crohn's disease, like many other chronic, inflammatory diseases, can cause a variety of systemic symptoms.^[1] Among children, growth failure is common. Many children are first diagnosed with Crohn's disease based on inability to maintain growth.^[15] As Crohn's disease may manifest at the time of the growth spurt in puberty, up to 30% of children with Crohn's disease may have retardation of growth.^[16] Fever may also be present, though fevers greater than 38.5 ˚C (101.3 ˚F) are uncommon unless there is a complication such as an abscess^[1] Among older individuals, Crohn's disease may manifest as weight loss. This is usually related to decreased food intake, since individuals with intestinal symptoms from Crohn's disease often feel better when they do not eat and might lose their appetite.^[15] People with extensive small intestine disease may also have malabsorption of carbohydrates or lipids, which can further exacerbate weight loss.^[17] B symptoms are a feature of both Hodgkins lymphoma and non-Hodgkins lymphoma, and include: Fever Drenching sweats, especially at night Weight loss. ... Growth failure is a medical term for a pattern of a childs growth which is poorer than normal for age, sex, stage of maturation, and genetic height expectation. ... Failure to thrive is a medical term which denotes poor weight gain and physical growth failure over an extended period of time in infancy. ... Puberty refers to the process of physical changes by which a childs body becomes an adult body capable of reproduction. ... For other uses, see Celsius (disambiguation). ... For other uses, see Fahrenheit (disambiguation). ... For the death metal band, see Abscess (band). ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Lactose is a disaccharide found in milk. ... Some common lipids. ...

Extraintestinal symptoms

Erythema nodosum

In addition to systemic and gastrointestinal involvement, Crohn's disease can affect many other organ systems.^[18] Inflammation of the interior portion of the eye, known as uveitis, can cause eye pain, especially when exposed to light (photophobia). Inflammation may also involve the white part of the eye (sclera), a condition called episcleritis. Both episcleritis and uveitis can lead to loss of vision if untreated. Image File history File links Size of this preview: 450 × 600 pixelsFull resolution‎ (480 × 640 pixels, file size: 126 KB, MIME type: image/jpeg) {{ File historyClick on a date/time to view the file as it appeared at that time. ... Image File history File links Size of this preview: 450 × 600 pixelsFull resolution‎ (480 × 640 pixels, file size: 126 KB, MIME type: image/jpeg) {{ File historyClick on a date/time to view the file as it appeared at that time. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Photophobia (also light sensitivity) or fear of light, is a symptom of excessive sensitivity to light and the aversion to sunlight or well-lit places. ... Schematic diagram of the human eye. ... Scleritis is a serious inflammatory disease that affects the white outer coating of the eye, known as the sclera. ...

Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloarthropathy. This group of diseases is characterized by inflammation of one or more joints (arthritis) or muscle insertions (enthesitis). The arthritis can affect larger joints such as the knee or shoulder or may exclusively involve the small joints of the hand and feet. The arthritis may also involve the spine, leading to ankylosing spondylitis if the entire spine is involved or simply sacroiliitis if only the lower spine is involved. The symptoms of arthritis include painful, warm, swollen, stiff joints and loss of joint mobility or function. Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and therapy of rheumatic diseases. ... Spondyloarthropathies are a group of related inflammatory joint disease associated with the MHC class I molecule HLA-B27. ... For other uses, see Joint (disambiguation). ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... Enthesitis is an inflammation of the entheses. ... In medicine, sacroiliitis is an inflammation of the sacroiliac joint. ... This article does not cite any references or sources. ...

Crohn's disease may also involve the skin, blood, and endocrine system. One type of skin manifestation, erythema nodosum, presents as red nodules usually appearing on the shins. Erythema nodosum is due to inflammation of the underlying subcutaneous tissue and is characterized by septal panniculitis. Another skin lesion, pyoderma gangrenosum, is typically a painful ulcerating nodule. Crohn's disease also increases the risk of blood clots; painful swelling of the lower legs can be a sign of deep venous thrombosis, while difficulty breathing may be a result of pulmonary embolism. Autoimmune hemolytic anemia, a condition in which the immune system attacks the red blood cells, is also more common in Crohn's disease and may cause fatigue, pallor, and other symptoms common in anemia. Clubbing, a deformity of the ends of the fingers, may also be a result of Crohn's disease. Finally, Crohn's disease may cause osteoporosis, or thinning of the bones. Individuals with osteoporosis are at increased risk of bone fractures.^[4] The endocrine system is an integrated system of small organs that involve the release of extracellular signaling molecules known as hormones. ... Erythema nodosum is a form of inflammation of the subcutaneous fatty tissue. ... Panniculitis is a group of diseases whose hallmark is inflammation of subcutaneous fatty and muscle tissue. ... It has been suggested that Deep Vein Thrombosis be merged into this article or section. ... Autoimmune hemolytic anemia (AIHA) is one type of hemolytic anemias caused by excessive hemolyisis and it is identified by auto-antibodies that react with RBCs. ... Human red blood cells Red blood cells are the most common type of blood cell and are the vertebrate bodys principal means of delivering oxygen to body tissues via the blood. ... This article discusses the medical condition. ... For other uses, see Clubbing (disambiguation). ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Internal and external views of an arm with a compound fracture, both before and after surgery A bone fracture is a medical condition in which a bone has cracked or broken. ...

Crohn's disease can also cause neurological complications (reportedly in up to 15% of patients).^[19] The most common of these are seizures, stroke, myopathy, peripheral neuropathy, headache and depression.^[19]

Crohn's patients often also have issues with Small bowel bacterial overgrowth syndrome, which has similar symptoms.^{[citation needed]} Small bowel bacterial overgrowth syndrome (SBBOS), or small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth; is a disorder of excessive bacterial growth in the small intestine. ...

Complications

Endoscopic image of colon cancer identified in the sigmoid colon (anatomy) on screening colonoscopy for Crohn's disease.

Crohn's disease can lead to several mechanical complications within the intestines, including obstruction, fistulae, and abscesses. Obstruction typically occurs from strictures or adhesions which narrow the lumen, blocking the passage of the intestinal contents. Fistulae can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. Abscesses are walled off collections of infection, which can occur in the abdomen or in the perianal area in Crohn's disease sufferers. Image File history File linksMetadata Colorectal_cancer_endo_2. ... Image File history File linksMetadata Colorectal_cancer_endo_2. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... It has been suggested that this article or section be merged with Large intestine. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... An infection is the detrimental colonization of a host organism by a foreign species. ... The abdomen in a human and an ant. ...

Crohn's disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohn's disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohn's colitis have a relative risk of 5.6 for developing colon cancer.^[20] Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohn's colitis for eight years, or more.^[21] Diagram showing the small intestine In biology the small intestine is the part of the gastrointestinal tract between the stomach and the large intestine (colon). ... Endoscopic image of adenocarcinoma of duodenum seen in the post-bulbar duodenum. ... In statistics and mathematical epidemiology, relative risk (RR) of an event associated with the exposure is a ratio of probability of outcome of interest in exposed group versus treatment group. ... Diagram of the stomach, colon, and rectum Colorectal cancer includes cancerous growths in the colon, rectum and appendix. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ...

Individuals with Crohn's disease are at risk of malnutrition for many reasons, including decreased food intake and malabsorption. The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohn's disease are referred to a dietitian for assistance in nutrition.^[22] Percentage of population affected by malnutrition by country, according to United Nations statistics. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Diagram showing the small intestine In biology the small intestine is the part of the gastrointestinal tract between the stomach and the large intestine (colon). ... Total parenteral nutrition (TPN), is the practice of feeding a person intravenously, circumventing the gut. ... A dietitian (sometimes spelled dietician) is an expert in food and nutrition. ...

Crohn's disease can cause significant complications including bowel obstruction, abscesses, free perforation and hemorrhage.^[23] Bowel obstruction is a mechanical blockage of the intestines, preventing the normal transit of the products of digestion. ... A bowel perforation is a complete penetration of the intestinal wall resulting in the potential for bacterial contamination of the abdominal cavity (a condition known as peritonitis). ... To meet Wikipedias quality standards, this article or section may require cleanup. ...

Crohn's disease can be problematic during pregnancy, and some medications can cause adverse outcomes for the fetus or mother. Consultation with an obstetrician and gastroenterologist about Crohn's disease and all medications allows preventative measures to be taken. In some cases, remission can occur during pregnancy. Certain medications can also impact sperm count or may otherwise adversely affect a man's ability to conceive.^[24] This article is about human pregnancy in biological females. ... For other uses, see Fetus (disambiguation). ... The sperm count is a measure of fertility in a man. ... This article is about fertilisation in animals and plants. ...

Cause

Schematic of NOD2 CARD15 gene, which is associated with certain disease patterns in Crohn's disease

The exact cause of Crohn's disease is unknown. However, genetic and environmental factors have been invoked in the pathogenesis of the disease. Research has indicated that Crohn's disease has a strong genetic link.^[25] The disease runs in families and those with a sibling with the disease are 30 times more likely to develop it than the normal population. Ethnic background is also a risk factor. Until very recently, whites and European Jews accounted for the vast majority of the cases in the United States, and in most industrialized countries, this demographic is still true. Image File history File links NOD2_CARD15. ... Image File history File links NOD2_CARD15. ... Pathogenesis is the mechanism by which a certain etiological factor causes disease (pathos = disease, genesis = development). ...

Mutations in the CARD15 gene (also known as the NOD2 gene) are associated with Crohn's disease^[26] and with susceptibility to certain phenotypes of disease location and activity.^[27] In earlier studies, only two genes were linked to Crohn's, but scientists now believe there are over eight genes that show genetics play a crucial role in the disease. For linguistic mutation, see Apophony. ... Schematic of NOD2 CARD15 gene, which is associated with certain disease patterns in Crohns disease Also known as the NOD2 gene. ... For other uses, see Gene (disambiguation). ...

A handful of cases of Crohn's disease cases were reported at the turn of the 20th century, but since then, the disease has continued to increase in prevalence dramatically. Some argue that this increase has been the result of a genetic shift in the population caused by conditions favoring individuals carrying the genes linked with the disease. These conditions could be a lower infant mortality rate or better health care in the nations that have the highest incidence of disease (industrialized nations).

Others argue that Crohn's disease is caused by a combination of environmental and genetic factors. Many environmental factors have also been hypothesized as causes or risk factors for Crohn's disease. Proven environmental risk factors include living in an industrialized country, smoking, and living in an urban area. Diets high in sweet, fatty or refined foods may also play a role. A retrospective Japanese study found that those diagnosed with Crohn's disease had higher intakes of sugar, fat, fish and shellfish than controls prior to diagnosis.^[28] A similar study in Israel also found higher intakes of fats (especially chemically modified fats) and sucrose, with lower intakes of fructose and fruits, water, potassium, magnesium and vitamin C in the diets of Crohn's disease sufferers before diagnosis,^[29] and cites three large European studies in which sugar intake was significantly increased in people with Crohn's disease compared with controls. Certain chemicals in the diet, known as microparticles, are also hypothesized as a risk factor for the disease, as well as a poor imbalance of omega-6 to healthy omega-3 fatty acids that emerging research shows helps to improve all types of inflammatory disease. The most common forms of microparticles include titanium dioxide, aluminosilicates, anatase, calcium phosphate, and soil residue. These substances are ubiquitous in processed food and most toothpastes and lip glosses. Soil residue is found on fresh fruits and vegetables unless carefully removed. For other uses, see FAT. Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. ... Food processing is the set of methods and techniques used to transform raw ingredients into food for consumption by humans or animals. ... Flash point N/A Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Sucrose (common name: table sugar, also called saccharose) is a disaccharide (glucose + fructose) with the molecular formula C12H22O11. ... Fructose (also levulose or laevulose) is a simple reducing sugar (monosaccharide) found in many foods and is one of the three most important blood sugars along with glucose and galactose. ... General Name, symbol, number potassium, K, 19 Chemical series alkali metals Group, period, block 1, 4, s Appearance silvery white Standard atomic weight 39. ... General Name, symbol, number magnesium, Mg, 12 Chemical series alkaline earth metals Group, period, block 2, 3, s Appearance silvery white solid at room temp Standard atomic weight 24. ...

Smoking has been shown to increase the risk of the return of active disease, or "flares".^[30] The introduction of hormonal contraception in the United States in the 1960's is linked with a dramatic increase in the incidence rate of Crohn's disease. Although a causal linkage has not been effectively shown, there remain fears that these drugs work on the digestive system in similar ways to smoking.^[31] The cigarette is the most common method of smoking tobacco. ... Hormonal contraception refers to birth control methods that act on the hormonal system. ...

Additionally, many in the scientific community believe that early childhood exposure to illness is necessary to the creation of a proper immune system for those with the genetic susceptibility for Crohn's Disease. Higher incidences of Crohn's Disease are associated with cleaner living conditions. Throughout the early and mid-20th century in the United States, the disease was strongly associated with upper-class populations, and today the disease does not yet exist in the many Third World countries, despite the fact that it occurs in all races. CD is also associated with first born and single children (because they would have less exposure to childhood illness from siblings) and in populations that have low incidences of gastric cancer. Gastric cancer is most often caused by the bacterium Helicobacter pylori that flourishes in cramped and unsanitary conditions.^[32]

Abnormalities in the immune system have often been invoked as being causes of Crohn's disease. It has been hypothesized that Crohn's disease involves augmentation of the T_h1 of cytokine response in inflammation.^[33] The most recent gene to be implicated in Crohn's disease is ATG16L1, which may reduce the effectiveness of autophagy, and hinder the body's ability to attack invasive bacteria.^[34] Antigen presentation stimulates T cells to become either cytotoxic CD8+ cells or helper CD4+ cells. ... Cytokines are a category of less-widely-known signalling proteins and glycoproteins that, like hormones and neurotransmitters, are used extensively in cellular communication. ... Autophagy is also a synonym for self-cannibalism Autophagy, or ocytosis, is a process of sequestering organelles and long-lived proteins in a double-membrane vesicle inside the cell, where the contents are subsequently delivered to the lysosome for degradation. ...

A variety of pathogenic bacteria were initially suspected of being causative agents of Crohn's disease. However, the current consensus is that a variety of microorganisms are simply taking advantage of their host's weakened mucosal layer and inability to clear bacteria from the intestinal walls, both symptoms of the disease.^[35] Some studies have linked Mycobacterium avium subsp. paratuberculosis to Crohn's disease, in part because it causes a very similar disease, Johne's disease, in cattle.^[36] The mannose bearing antigens, mannins, from yeast may also elicit pathogenic anti saccharomyces cerevisiae antibodies.^[37] Newer studies have linked specific strains of enteroadherent E. coli to the disease but failed to find evidence of contributions by other species.^[38] Trinomial name Mycobacterium avium paratuberculosis Mycobacterium avium subspecies paratuberculosis is a pathogenic bacteria in the genus Mycobacteria. ... distribution. ... D and L forms Haworth projection of mannose in its α-D-mannopyranose form. ... schematic representation of antibody. ... See also Entamoeba coli. ...

Pathophysiology

Section of colectomy showing transmural inflammation

At the time of colonoscopy, biopsies of the colon are often taken in order to confirm the diagnosis. There are certain characteristic features of the pathology seen that point toward Crohn's disease. Crohn's disease shows a transmural pattern of inflammation, meaning that the inflammation may span the entire depth of the intestinal wall.^[1] Grossly, ulceration is an outcome seen in highly active disease. There is usually an abrupt transition between unaffected tissue and the ulcer. Under a microscope, biopsies of the affected colon may show mucosal inflammation. This inflammation is characterized by focal infiltration of neutrophils, a type of inflammatory cell, into the epithelium. This typically occurs in the area overlying lymphoid aggregates. These neutrophils, along with mononuclear cells, may infiltrate into the crypts leading to inflammation (crypititis) or abscess (crypt abscess). Granulomas, aggregates of macrophage derivatives known as giant cells, are found in 50% of cases and are most specific for Crohn's disease. The granulomas of Crohn's disease do not show "caseation", a cheese-like appearance on microscopic examination that is characteristic of granulomas associated with infections such as tuberculosis. Biopsies may also show chronic mucosal damage as evidenced by blunting of the intestinal villi, atypical branching of the crypts, and change in the tissue type (metaplasia). One example of such metaplasia, Paneth cell metaplasia, involves development of Paneth cells (typically found in the small intestine) in other parts of the gastrointestinal system.^[39] Image File history File links Download high resolution version (253x728, 45 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ... Image File history File links Download high resolution version (253x728, 45 KB) Licensing I, the creator of this work, hereby grant the permission to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1. ... Colectomy is the surgical procedure by means of which part of the colon is removed. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Endoscopic images of a duodenal ulcer. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ... Neutrophil granulocytes (commonly referred to as neutrophils) are a class of white blood cells and are part of the immune system. ... This article is about the epithelium as it relates to animal anatomy. ... In mammals including humans, the lymphatic vessels (or lymphatics) are a network of thin tubes that branch, like blood vessels, into tissues throughout the body. ... A scanning electron microscope (SEM) image of a single human lymphocyte. ... The crypts of Lieberkühn are glands found in the epithelial lining of the small intestine. ... H&E section of non-caseasting granuloma seen in the colon of a patient with Crohns disease In medicine (anatomical pathology), a granuloma is a group of epithelioid macrophages surrounded by a lymphocyte cuff. ... A macrophage of a mouse stretching its arms to engulf two particles, possibly pathogens Macrophages (Greek: big eaters, from makros large + phagein eat) are cells within the tissues that originate from specific white blood cells called monocytes. ... Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ... Villus (Latin: shaggy hair[1], plural villi) can refer to: Intestinal villus. ... Metaplasia is the replacement of one differentiated cell type with another differentiated cell type. ...

Diagnosis

Endoscopic image of Crohn's colitis showing deep ulceration

CT scan showing Crohn's disease in the fundus of the stomach

Crohn's disease can mimic ulcerative colitis on endoscopy. This endoscopic image is of Crohn's colitis showing diffuse loss of mucosal architecture, friability of mucosa in sigmoid colon and exudate on wall, all of which can be found with ulcerative colitis.

The diagnosis of Crohn's disease can sometimes be challenging,^[9] and a number of tests are often required to assist the physician in making the diagnosis.^[5] Even with a full battery of tests it may not be possible to diagnose Crohn's with complete certainty; a colonoscopy is approximately 70% effective in diagnosing the disease with further being less effective. Disease in the small bowel is particularly difficult to diagnose as a traditional colonoscopy only allows access to the colon and lower portions of the small intestines; recent introduction of Capsule endoscopy aid in endoscopic diagnosis. Image File history File links CD_colitis. ... Image File history File links CD_colitis. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... Image File history File links Download high resolution version (844x702, 71 KB) Summary CT scan of patient shown Crohns disease in the fundus of the stomach. ... Image File history File links Download high resolution version (844x702, 71 KB) Summary CT scan of patient shown Crohns disease in the fundus of the stomach. ... CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Image File history File links CD_colitis_2. ... Image File history File links CD_colitis_2. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ... Easily crumbled, pulverized, or reduced to powder. ...

Endoscopy

A colonoscopy is the best test for making the diagnosis of Crohn's disease as it allows direct visualization of the colon and the terminal ileum, identifying the pattern of disease involvement. Occasionally, the colonoscope can travel past the terminal ileum but it varies from patient to patient. During the procedure, the gastroenterologist can also perform a biopsy, taking small samples of tissue for laboratory analysis which may help confirm a diagnosis. As 30% of Crohn's disease involves only the ileum,^[1] cannulation of the terminal ileum is required in making the diagnosis. Finding a patchy distribution of disease, with involvement of the colon or ileum but not the rectum, is suggestive of Crohn's disease, as are other endoscopic stigmata.^[40]The utility of capsule endoscopy for this, however, is still uncertain.^[41] Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... This page meets Wikipedias criteria for speedy deletion. ... Gastroenterology or Gastrology might be better described as the field of digestive diseases, which are traditionally separated by anatomic or functional category. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... A cannula (pl. ... The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ...

Radiologic tests

A small bowel follow-through may suggest the diagnosis of Crohn's disease and is useful when the disease involves only the small intestine. Because colonoscopy and gastroscopy allow direct visualization of only the terminal ileum and beginning of the duodenum, they cannot be used to evaluate the remainder of the small intestine. As a result, a barium follow-through x-ray, wherein barium sulfate suspension is ingested and fluoroscopic images of the bowel are taken over time, is useful for looking for inflammation and narrowing of the small bowel.^[40][42] Barium enemas, in which barium is inserted into the rectum and fluoroscopy used to image the bowel, are rarely used in the work-up of Crohn's disease due to the advent of colonoscopy. They remain useful for identifying anatomical abnormalities when strictures of the colon are too small for a colonoscope to pass through, or in the detection of colonic fistulae.^[43] A barium follow-through procedure is a type of medical imaging technique. ... Endoscopic still of esophageal ulcers seen after banding of esophageal varices, at time of esophagogastroduodenosocopy In medicine (gastroenterology), esophagogastroduodenoscopy is a diagnostic endoscopic procedure that visualises the upper part of the gastrointestinal tract up to the duodenum. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube about 25-30 cm long connecting the stomach to the jejunum. ... A barium follow-through procedure is a type of medical imaging technique. ... Granulated Barium Sulfate Barium sulfate (or barium sulphate) is the white crystalline solid with the formula BaSO4. ... A modern fluoroscope. ...

CT and MRI scans are useful for evaluating the small bowel with enteroclysis protocols.^[44]They are additionally useful for looking for intra-abdominal complications of Crohn's disease such as abscesses, small bowel obstruction, or fistulae.^[45] Magnetic resonance imaging (MRI) are another option for imaging the small bowel as well as looking for complications, though it is more expensive and less readily available^[46] negron305 Cat scan redirects here. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ... Enteroclysis is a fluoroscopic X-ray of the small intestine. ... For the death metal band, see Abscess (band). ... MRI redirects here. ... Diagram showing the small intestine In biology the small intestine is the part of the gastrointestinal tract between the stomach and the large intestine (colon). ...

Blood tests

A complete blood count may reveal anemia, which may be caused either by blood loss or vitamin B₁₂ deficiency. The latter may be seen with ileitis because vitamin B₁₂ is absorbed in the ileum.^[47] Erythrocyte sedimentation rate, or ESR, and C-reactive protein measurements can also be useful to gauge the degree of inflammation.^[48] It is also true in patient with ilectomy done in response to the complication. Another cause of anaemia is anaemia of chronic disease, characterized by its microcytic and hypochromic anaemia. There are reasons in anaemia, including medication in treatment of inflammatory bowel disease like azathioprine can lead to cytopenia and sulfasalazine can also result in folate malabsorption, etc. Testing for anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) has been evaluated to identify inflammatory diseases of the intestine^[49] and to differentiate Crohn's disease from ulcerative colitis.^[50] Schematics of shorthand for complete blood count commonly used by physicians. ... This article discusses the medical condition. ... Cyanocobalamin is a compound that is metabolized to a vitamin in the B complex commonly known as vitamin B12 (or B12 for short). ... Grays Fig. ... The erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ... C-reactive protein (CRP) is a plasma protein, an acute phase protein produced by the liver. ... Binomial name Meyen ex E.C. Hansen Saccharomyces cerevisiae is a species of budding yeast. ... For other uses of ANCA, including the Australian company, ANCA Pty Ltd, see ANCA (disambiguation). ...

Comparison with ulcerative colitis

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.^[11][1][5] It has been suggested that this article or section be merged with Large intestine. ...

This page meets Wikipedias criteria for speedy deletion. ... This article is about the bodily orifice. ... Primary sclerosing cholangitis (PSC) is a form of cholangitis due to an autoimmune reaction. ... Endoscopic images of a duodenal ulcer. ... In medicine, a fistula (pl. ... A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure. ... Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ... Cytokines are a category of less-widely-known signalling proteins and glycoproteins that, like hormones and neurotransmitters, are used extensively in cellular communication. ... Antigen presentation stimulates T cells to become either cytotoxic CD8+ cells or helper CD4+ cells. ... H&E section of non-caseasting granuloma seen in the colon of a patient with Crohns disease In medicine (anatomical pathology), a granuloma is a group of epithelioid macrophages surrounded by a lymphocyte cuff. ... The cigarette is the most common method of smoking tobacco. ...

Treatment

Main articles: Treatment of Crohn's disease and Biological therapy for inflammatory bowel disease

Currently there is no cure for Crohn's disease and remission may not be possible or prolonged if achieved;^[54] in cases where remission is possible, relapse can be prevented and symptoms controlled with medication, lifestyle changes and in some cases, surgery. Adequately controlled, Crohn's disease may not significantly restrict daily living.^[55] Treatment for Crohn's disease is only when symptoms are active and involve first treating the acute problem, then maintaining remission. The treatment of Crohns disease is sequential: to treat acute disease, and then to maintain remission. ... The anti-tumor necrosis factor α monoclonal antibody infliximab is a mainstay of the biological therapy for inflammatory bowel disease Biological therapy refers to the use of medication that is tailored to specifically target an immune or genetic mediator of disease. ... Remission is the state of absence of disease activity in patients with known chronic illness. ... A relapse (etymologically, who falls again) occurs when a person is affected again by a condition that affected them in the past. ... A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... In medicine, an acute disease is a disease with either or both of: a rapid onset; a short course (as opposed to a chronic course). ... Remission is the state of absence of disease activity in patients with known chronic illness. ...

Medication

Acute treatment uses medications to treat any infection (normally antibiotics) and to reduce inflammation (normally aminosalicylate anti-inflammatory drugs and corticosteroids). When symptoms are in remission, treatment enters maintenance with a goal of avoiding the recurrence of symptoms. Prolonged use of corticosteroids has significant side-effects; as a result they are generally not used for long-term treatment. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs.^[52] Staphylococcus aureus - Antibiotics test plate. ... Aminosalicylic acid (C7H7NO3) is also known as para-aminosalicylic acid, p-aminosalicylic acid or 4-aminosalicylic acid; abbreviated 4-ASA, PAS or P. It is sold in the US by Jacobus Pharmaceutical as Paser®. 5-aminosalicylic acid is a closely related compound that also has medical uses. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ...

Medications used to treat the symptoms of Crohn's disease include 5-aminosalicylic acid (5-ASA) formulations , prednisone, cannabis, immunomodulators such as azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab^[11] and natalizumab.^[56][57] Mesalazine (INN, BAN), also known as Mesalamine (USAN) or 5-aminosalicylic acid (5-ASA), is an anti-inflammatory drug used to treat inflammation of the digestive tract (Crohns disease) and mild to moderate ulcerative colitis. ... Prednisone is a synthetic corticosteroid drug which is usually taken orally but can be delivered by intramuscular injection and can be used for a great number of different conditions. ... This article is about the plant genus Cannabis. ... Azathioprine is a chemotherapy drug, now rarely used for chemotherapy but more for immunosuppression in organ transplantation, autoimmune disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohns disease. ... Mercaptopurine: chemical structure Mercaptopurine (also called 6-MP or by its brand name Purinethol®) is an immunosuppressive drug used to treat leukemia. ... Amethopterin redirects here. ... Infliximab (brand name Remicade®) is a drug used to treat auto-immune disorders. ... Adalimumab (Humira®) is the third TNF antagonist (after infliximab and etanercept) to be approved in the US. Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors; adalimumab was constructed from a fully human monoclonal antibody, while infliximab is a mouse-human chimeric antibody and etanercept... Natalizumab is a drug co-marketed by Biogen Idec and Élan as Tysabri. ...

Lifestyle changes

Certain lifestyle changes can reduce symptoms, including dietary adjustments, proper hydration and smoking cessation.^[55] In nutrition, the diet is the sum of food consumed by a person or other organism. ... In chemistry, hydration is the condition of being combined with water. ... A No Smoking sign Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. ...

Surgery

Crohn's cannot be cured by surgery, though it is used when partial or a full blockage of the intestine occurs. Surgery may also be required for complications such as obstructions, fistulas and/or abscesses, or if the disease does not respond to drugs within a reasonable time. After the first surgery, Crohn's usually shows up at the site of the resection though it can appear in other locations. After a resection, scar tissue builds up which causes strictures. A stricture is when the intestines becomes too small to allow excrement to pass through easily which can lead to a blockage. After the first resection, another resection may be necessary within five years.^[58] For patients with an obstruction due to a stricture, two options for treatment are strictureplasty and resection of that portion of bowel. There is no statistical significance between strictureplasty alone versus strictureplasty and resection in cases of duodenal involvement. In these cases, re-operation rates were 31% and 27%, respectively, indicating that strictureplasty is a safe and effective treatment for selected patients with duodenal involvement.^[59] “Surgeon” redirects here. ... In statistics, a result is significant if it is unlikely to have occurred by chance, given that a presumed null hypothesis is true. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube about 25-30 cm long connecting the stomach to the jejunum. ...

Prospective treatments

Researchers at University College London have questioned the wisdom of suppressing the immune system in Crohn's, as the problem may be an under-active rather than an over-active immune system: their study found that Crohn's patients showed an abnormally low response to an introduced infection, marked by a poor flow of blood to the wound, and the response improved when the patients were given sildenafil.^[60] Affiliations University of London Russell Group LERU EUA ACU Golden Triangle G5 Website http://www. ... Sildenafil citrate, sold under the names Viagra, Revatio and generically under various other names, is a drug used to treat male erectile dysfunction (impotence) and pulmonary arterial hypertension (PAH), developed by the pharmaceutical company Pfizer. ...

Recent studies using helminthic therapy or hookworms to treat Crohn's Disease and other (non-viral) auto-immune diseases seem to yield promising results.^[61] Helminthic therapy is currently considered one of the most promising alternative treatments for Crohns disease, Multiple Sclerosis, Asthma and Ulcerative colitis. ... The hookworm is a parasite that lives in the small intestine of its host, which may be a mammal such as a dog, cat, or human. ...

A single, small, uncontrolled trial of patients with mild Crohn's on stable medications suggested improvement with low dose naltrexone therapy.^[62] Low dose naltrexone (LDN), where naltrexone is used in doses approximately one-tenth those used for drug/alcohol rehabilitation purposes, is being used as an off-label treatment for certain immunologically-related disorders. ...

Prognosis

Crohn's disease is a chronic condition for which there is currently no cure. It is characterised by periods of improvement followed by episodes when symptoms flare up. With treatment, most people achieve a healthy height and weight, and the mortality rate for the disease is low. Crohn's disease is associated with an increased risk of small bowel and colorectal carcinoma.^[63] In medicine, a chronic disease is a disease that is long-lasting or recurrent. ...

Epidemiology

The incidence of Crohn's disease has been ascertained from population studies in Norway and the United States and is similar at 6 to 7.1:100,000.^[64][65] Crohn's disease is more common in northern countries, and shows a higher preponderance in northern areas of the same country.^[66] The incidence of Crohn's disease is thought to be similar in Europe but lower in Asia and Africa.^[64] It also has a higher incidence in Ashkenazi Jews.^[11] For other uses, see Europe (disambiguation). ... For other uses, see Asia (disambiguation). ... A world map showing the continent of Africa Africa is the worlds second-largest and second most-populous continent, after Asia. ... Language(s) Yiddish, Hebrew, Russian, English Religion(s) Judaism Related ethnic groups Sephardi Jews, Mizrahi Jews, and other Jewish ethnic divisions Ashkenazi Jews, also known as Ashkenazic Jews or Ashkenazim (Standard Hebrew: sing. ...

Crohn's disease has a bimodal distribution in incidence as a function of age: the disease tends to strike people in their teens and 20s, and people in their 50s through to their 70s, and ages in between due to not being diagnosed with Crohn's and being diagnosed instead with irritable bowel syndrome IBS .^[1][5] It is rarely diagnosed in early childhood. It strikes females more than males.[1] Parents, siblings or children of people with Crohn's disease are 3 to 20 times more likely to develop the disease.^[67] Twin studies show a concordance of greater than 55% for Crohn's disease.^[68] In statistics, a bimodal distribution is a distribution with two different peaks — that is, there are two distinct values that measurements tend to center around. ... Incidence is a measure of the risk of developing some new condition within a specified period of time. ... IBS is an abbreviation with several meanings: Irritable bowel syndrome, a disorder of the bowel IBS Software services, an IT provider to the global Travel, Transportation and Logistics (TTL) industry IBS, a satirical news channel on the BBCs programme Broken News ICFAI Business School, an MBA School in India...

History

Inflammatory bowel diseases were described by Giovanni Battista Morgagni (1682-1771), by Polish surgeon Antoni Leśniowski in 1904 (leading to the use of the eponym "Leśniowski-Crohn disease" in Poland) and by Scottish physician T. Kennedy Dalziel in 1913.^[69] Giovanni Battista Morgagni (February 25, 1682 - December 6, 1771), Italian anatomist, was born on at ForIi. ... This article is about the country. ...

Burrill Bernard Crohn, an American gastroenterologist at New York City's Mount Sinai Hospital, described fourteen cases in 1932, and submitted them to the American Medical Association under the rubric of "Terminal ileitis: A new clinical entity". Later that year, he, along with colleagues Leon Ginzburg and Gordon Oppenheimer published the case series as "Regional ileitis: a pathologic and clinical entity".^[2] Burrill Bernard Crohn (born June 13, 1884 in New York; died 1983 in Connecticut) was an American gastroenterologist and one of the first to describe the disease of which he is the namesake, Crohns disease. ... New York, New York and NYC redirect here. ... The Mount Sinai Hospital is a hospital in New York City, New York, serving Manhattans Upper East Side and Harlem. ... The American Medical Association (AMA) is the largest association of medical doctors in the United States. ...

See also

• Crohn's and Colitis Foundation of America
• List of Crohn's disease organizations worldwide

The Crohns and Colitis Foundation of America is a United States medical research charity dedicated to the curing of Crohns disease and Ulcerative colitis. ...

References

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 314th day of the year (315th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 143rd day of the year (144th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 277th day of the year (278th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... is the 194th day of the year (195th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 16th day of the year in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 294th day of the year (295th in leap years) in the Gregorian calendar. ... The Crohns and Colitis Foundation of America is a United States medical research charity dedicated to the curing of Crohns disease and Ulcerative colitis. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 45th day of the year in the Gregorian calendar. ... The Crohns and Colitis Foundation of America is a United States medical research charity dedicated to the curing of Crohns disease and Ulcerative colitis. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 106th day of the year (107th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 110th day of the year (111th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 16th day of the year in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 312th day of the year (313th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 312th day of the year (313th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... The Crohns and Colitis Foundation of America is a United States medical research charity dedicated to the curing of Crohns disease and Ulcerative colitis. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 121st day of the year (122nd in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 45th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 136th day of the year (137th in leap years) in the Gregorian calendar. ... WebMD is available to both consumers and physicians, and contains several different health sites owned and run by WebMD, including WebMD Health, Medscape, MedicineNet, eMedicine, eMedicine Health, RxList and theheart. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 45th day of the year in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 46th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 12th day of the year in the Gregorian calendar. ... Screenshot of About. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 45th day of the year in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 143rd day of the year (144th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 183rd day of the year (184th in leap years) in the Gregorian calendar. ...

External links

• Crohn's disease at the Open Directory Project