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Crohn's disease
What's new
The American Gastroenterological Association (AGA) has published an expert review update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease (IBD). Annual total body skin examination is advised for patients on immunomodulators or anti-TNF therapy, and for those previously on thiopurines, continued even after cessation. Live vaccines should be avoided in patients receiving immune-modifying agents. A recombinant herpes zoster vaccine series is advised before starting immune-modifying therapies. .
Background
Overview
Definition
CD is a chronic relapsing IBD characterized by a transmural granulomatous inflammation most commonly affecting the ileum, colon, or both.
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Pathophysiology
The exact cause of CD is unknown; however, a complex interplay of genetic factors, environmental factors, immune dysregulation to intestinal microbiota have been implicated.
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Disease course
The complex interplay of genetic, environmental factors and immune dysregulation to intestinal microbiota result in CD, which causes clinical manifestations of chronic diarrhea, fatigue, abdominal pain, weight loss, bloody stools, mucinous stools, peripheral arthritis, aphthous stomatitis, uveitis, erythema nodosum, ankylosing spondylitis, pyoderma, gangrenosum, psoriasis, PSC. Disease progression may lead to fistulae and decreased QoL.
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Prognosis and risk of recurrence
The annual mortality rate in CD is 1.6%.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of Crohn's disease are prepared by our editorial team based on guidelines from the American Gastroenterological Association (AGA 2025,2024,2023,2021,2020,2018,2017,2013), the European Crohn's and Colitis Organisation (ECCO 2024,2015), the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES 2024), the European Society for Clinical Nutrition and Metabolism (ESPEN 2023), the European Society for ...
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