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By ULY CLINIC

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Chrohn’s Disease

 

Introduction

 

Crohn disease is an idiopathic, chronic, transmural inflammatory process of the bowel that often leads to fibrosis and obstructive symptoms and can affect any part of the gastrointestinal tract from the mouth to the anus. 

 

Diagnostic Criteria 

 

  • Abdominal pain, diarrhea, weight loss, anorexia and fever

  • Gross rectal bleeding or acute hemorrhage is uncommon

  • Anemia due to illeal disease involvement

  • Small bowel obstruction, due to stricturing

  • Perianal disease associated with fistulization

  • Gastroduodenal ulceration PLUS

  • Endoscopic evidence of rectal sparing skip lesions, cobble stoning with linear ulceration appearance with,

  • Histological evidence of transmural disease, apthous ulcers, and non caseating granulomas 

 

Pharmacological Treatment

 

  • Methotrexate (PO) 7.5–15mg weekly   

OR

  • Azathioprine (PO) 50mg once daily for maintenance of remission.

PLUS 

  • Prednisolone (PO) 1–2mg/kg for induction of remission only. 

PLUS 

  • Metronidazole (PO) 400mg 8hourly for 7–10 days  

OR

  • Ciprofloxacin (PO) 500mg 12 hourly for 7–10 days – can be added in presence of perianal disease or evident septic complications. 

 

Note: 

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  • Resuscitative and supportive management should be instituted as for UC section note above

  • Refer to next level of care with adequate expertise and facilities for all suspected cases for initial evaluation and management and cases presenting with acute complications.

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Updated on, 2.11.2020

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References

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1. STG

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