Crohn’s Disease Diagnosis Details to Know

A Crohn's disease diagnosis is a chronic inflammatory pathology that affects the gastrointestinal tract and presents intermittently over the person's life.

A Crohn’s disease diagnosis is due to an illness that consists of chronic inflammation of the intestinal walls and other parts of the digestive tract. It leads to symptoms such as diarrhea, abdominal pain, fever, etc.

Inflammatory bowel diseases

Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the intestinal wall that has nonspecific origins. And, they present in recurring fashion. Two of the big ones include ulcerative colitis and Crohn’s disease.

Illustration of the colon

First, ulcerative colitis affects only the mucous membrane of the intestinal wall. On the other hand, a Crohn’s disease diagnosis applies to the entire thickness of the intestinal wall and all of the bowel segments. However, it often does so in a segmented and asymmetric way.

Additionally, the cause of the illness is not known for certain. And, the most widely accepted theory is that it has many factors. Or, in other words, a Crohn’s disease diagnosis is the result of genetic, environmental, microbiological, and immunological factors.

Symptoms that lead to a Crohn’s disease diagnosis

  • Diarrhea, normally bloody
  • Abdominal pain
  • Increase in size of the abdomen
  • Weight loss
  • Tiredness
  • Tenesmus
  • Fever

Crohn’s disease can give way to complications such as:

  • Abcesses
  • Fistulas
  • Intestinal obstructions
  • Stenosis
  • Perianal disease
  • Toxic megacolon

Crohn’s disease diagnosis has also been linked to a predisposition to colon cancer. However, studies are not conclusive due to the unknown origin of the disease.

Extraintestinal manifestations

Related to the degree of activity:

  • Peripheral arteriopathy
  • Erythema nodosum
  • Episcleritis
  • Ulcerative stomatitis
  • Fatty liver

Independent of the degree of activity:

  • Pyoderma gangrene
  • Psoriasis
  • Ankylosing spondylitis
  • Uveitis and sacroileitis

Diagnosing Crohn’s disease

A diagnosis of Chrohn’s disease relies on clinical and histologic data, laboratory tests, and endoscopic and radiological tests. However, there is no one specific test that will diagnose the illness.

Celiac disease and intestional infections would need to be ruled out. This is because both can result in inflamed mucous membranes.

A lack of an effective test for detecting Crohn’s disease can lead to a significant delay in diagnosis.

Endoscopy

An endoscopy is used in the initial differential diagnosis. So, this helps determine how far it has extended, and the severity of the damage. Additionally, it determines the presence of neoplasm to evaluate the response to treatment, and as a treatment method, in some cases.

Endoscopy for a Chron's disease diagnosis

The ileocolonoscopy is the preferred test for initial evaluation before a Crohn’s disease daignosis.

Imaging

Different imaging studies are done. These include upper GI, ultrasound, CAT scan, and MRI. Imaging helps detect edema, ulcers, stenosis, fistulas, and extraintestonal problems.

Histology

A biopsy can be very important in the differential Crohn’s disease diagnosis. Some of the main related characteristics of Crohn’s disease are:

  • Granulomas
  • Lymphocytes
  • Irregularities in the intestinal wall

Laboratory tests

First, doctors will administer a calprotectin test. Then, this will determine if there is intestinal inflammation or not. It has to do with whether this protein is found in the stool.

Classification of a Crohn’s disease diagnosis

Patients are classified according to the age at which the disease began. Also, the location of the pathology, and the behavior of the illness, according to the Montreal classification.

Age

  • A1: Less than 16 years old
  • A2: From 16 to 40 years old
  • A3: 40 up

 Location

  • L1: Ileal
  • L2: colonic
  • L3: ileocolonic
  • L4: isolated upper disease

 Behavior

  • B1: non-stricturing, non-penetrating
  • B2: stricturing
  • B3: penetrating
  • p: perianal disease modifier
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