Crohn’s Disease

Classification of inflammatory bowel disease (IBD)

Type

Clinical Features

Ulcerative colitis 

  • Chronic inflammatory condition with relapsing and remitting episodes of inflammation in colonic mucosal layer
  • Involves colon in continuous manner without skip lesions
    • Rectum (proctitis)
    • Rectum and sigmoid colon (proctosigmoiditis)
    • Colon to splenic flexure (left sided colitis)
    • Extension beyond splenic flexure (extensive colitis)

Crohn’s Disease 

  • Transmural inflammation of entire GI tract with skip lesions
    • Segments of normal appearing areas interrupted by diseased areas
  • Possible findings in GI tract
    • Fibrosis
    • Obstruction
    • Sinus tracts (micro-perforation and fistulas)
  • Typical distribution 
    • 80% of patients with small bowel involvement
    • 50% of patients with involvement of ileum and colon
    • 20% of patients with only colonic disease
    • 33% of patients with perianal disease
    • 5-15% have involvement of mouth or gastroduodenal area
(Next Lesson) Possible pathogenesis of IBD
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