Crohn's Disease

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Sarah Bailey Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.

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Definition/Description

Crohn’s disease is a form of inflammatory bowel disease (IBD) that causes inflammation to the lining of the digestive or gastrointestinal (GI) tract and may be a result of an immune system malfunction. The immune system sees the bacteria and organisms that lie within the GI tract and intestines and mistakes them for outside invaders to the body. In response to this, the body produces extra white blood cells to the GI tract to fight off the invaders, which creates inflammation within the lining of the tract. Chronic inflammation may result in ulcerations within the layers of the tract . The inflammation can occur to any portion of the GI tract, from mouth to anus and can affect all layers of the intestinal tract while healthy bowel layers may be interspaced between the diseased portions of the bowel.

The most commonly affected portion of GI tract affected is the lower portion of the small intestine, or ileum .  Due to the inflammation, abdominal pain, diarrhea and malnutrition can be a result .  Crohn’s disease is also referred to as granulomatous enteritis or colitis, ileitis, regional enteritis, or terminal ileitis. This disease is similar in some aspects to ulcerative colitis, but the difference lies in the fact that ulcerative colitis produces inflammation only within the colon or rectum while Crohn’s disease produces inflammation within the colon, rectum, small intestine, stomach, mouth and esophagus. The inflammation caused by Crohn’s disease has the potential to affect the deeper layers more than ulcerative colitis .  While these two conditions are very similar, approximately 10 percent of individuals are unable to pinpoint whether the disease process is ulcerative colitis or Crohn’s disease. For these individuals, they are then diagnosed with indeterminate colitis .

Prevalence

Crohn’s disease affects approximately 500,000 to two million people in the United States, equally affecting men and women .  This disease may occur in individuals of all age, but has characteristically affected adolescents and young adults between 15-35 of age. It is estimated that 10 percent of individuals affected are under the age of 18. Crohn’s has been found to affect American Jews of European descent four to five times more than the general population. The prevalence among whites is 149 per 100,000 with a steady increase in incidence among African Americans. Hispanics and Asian have a lower prevalence than do African Americans and whites. There has been a potential link between living environment and the incidence of Crohn’s disease, where there are more reports amongst urban and northern climates than rural and southern climates. Similarly, this disease tends to be more predominant in the US and Europe .

Characteristics/Clinical Presentation

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Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

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Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports

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Resources

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Recent Related Research (from Pubmed)

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References

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