Course of disease
On average, Crohn’s disease presents between the age of 20 and 30. However, infants as well as elderly people can present with Crohn’s disease. Recent reports have shown that the disease has become more common among adolescent children. In Crohn’s disease, intestinal inflammation can involve the entire gastrointestinal tract, from the oral cavity to the anus. However for the individual patient the inflammation usually has a specific site. Generally speaking, Crohn’s patients can be divided into three equally sized groups. Those with small bowel inflammation, those with involvement of the last part of the small bowel (ileum) and the colon, and those with inflammation restricted solely to the colon. It is a misconception that the inflammation in Crohn’s disease tends to spread throughout the entire gastrointestinal tract over a period of time. It is rather that the inflammation has a predestined site of involvement for each patient. Crohn’s disease has a remitting and relapsing course. Interestingly, studies from US have shown that, on average, most time is spent in medically or surgically induced remission.
Symptoms
The clinical symptoms associated with Crohn’s disease depend on several factors. Diarrhoea is a typical feature in the majority of patients. Rectal bleeding occurs in approximately 30% of cases. Loss of appetite, weight loss and abdominal pain are common symptoms. In the more severe active state, fever and fatigue are often present.
Non-gastrointestinal Crohn’s disease
Approximately 10% of Crohn’s patients have disease manifestation outside of the gastrointestinal tract. The most common non-gastrointestinal manifestations are joint pain and inflammation. More rarely the skin, eyes or liver may be involved.
Investigation
Diagnosis of Crohn’s disease is based on a typical medical history in combination with endoscopical or radiological examination. Blood samples can reveal signs of ongoing inflammation and stool specimens may be needed in order to exclude an infectious origin.