Inflammatorisk tarmsjukdom, kronisk, IBD, "Management of Crohn's disease in adults", "What I need to know about Crohn's Disease", "The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients", "Problems in diagnosis of IBD in children", "The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease", "Occurrence of skin manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study", "Dietary and nutritional considerations for inflammatory bowel disease", "The aetiology and impact of malnutrition in paediatric inflammatory bowel disease", "Strategies for detecting colon cancer in patients with inflammatory bowel disease", "Increased risk of large-bowel cancer in Crohn's disease with colonic involvement", "Colorectal cancer and dysplasia in inflammatory bowel disease", "Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment", "Man of Many Problems Comes to City for Help", "IBD and Pregnancy: What You Need to Know", Crohn's and Colitis Foundation of America, "ACG Clinical Guideline: Ulcerative Colitis in Adults", "Crohn's disease risk alleles on the NOD2 locus have been maintained by natural selection on standing variation", "Crohn's disease has strong genetic link: study", "XBP1 links ER stress to intestinal inflammation and confers genetic risk for human inflammatory bowel disease", "Intestinal DMBT1 expression is modulated by Crohn's disease-associated IL23R variants and by a DMBT1 variant which influences binding of the transcription factors CREB1 and ATF-2", "Independent and population-specific association of risk variants at the IRGM locus with Crohn's disease", "Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease", "A single gene can either raise or lower Crohn's disease risk", "Innate immunity in inflammatory bowel disease: a disease hypothesis", "Mycobacterium avium subspecies paratuberculosis causes Crohn's disease in some inflammatory bowel disease patients", "NOD2 and ATG16L1 polymorphisms affect monocyte responses in Crohn's disease", "Culture independent analysis of ileal mucosa reveals a selective increase in invasive Escherichia coli of novel phylogeny relative to depletion of Clostridiales in Crohn's disease involving the ileum", "Invasive Escherichia coli are a feature of Crohn's disease", "Crohn's disease-associated adherent-invasive Escherichia coli adhesion is enhanced by exposure to the ubiquitous dietary polysaccharide maltodextrin", "Biofilm formation as a novel phenotypic feature of adherent-invasive Escherichia coli (AIEC)", "Subversion of autophagy in adherent invasive Escherichia coli-infected neutrophils induces inflammation and cell death", "Inflammation drives dysbiosis and bacterial invasion in murine models of ileal Crohn's disease", "Role for protease activity in visceral pain in irritable bowel syndrome", "Induction of intestinal inflammation in mouse by activation of proteinase-activated receptor-2", "Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection", "Fridges blamed for Crohn's disease rise", "Replication of Colonic Crohn's Disease Mucosal Escherichia coli Isolates within Macrophages and Their Susceptibility to Antibiotics", "Possible links between Crohn's disease and Paratuberculosis", "Two-year-outcomes analysis of Crohn's disease treated with rifabutin and macrolide antibiotics", "Inflammation and gastrointestinal Candida colonization", "Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan", "Isotretinoin-induced inflammatory bowel disease in an adolescent", "Dietary sources of inorganic microparticles and their intake in healthy subjects and patients with Crohn's disease", "Dietary microparticles and their impact on tolerance and immune responsiveness of the gastrointestinal tract", "Impact of Long-Term Antibiotic Use for Acne on Bacterial Ecology and Health Outcomes: A Review of Observational Studies", "Host genes related to paneth cells and xenobiotic metabolism are associated with shifts in human ileum-associated microbial composition", HCP: Pill Cam, Capsule Endoscopy, Esophageal Endoscopy, "Diffuse jejunoileitis of Crohn's disease", "Computed tomographic findings of abdominal complications of Crohn's disease--pictorial essay", "New diagnostic imaging tools for inflammatory bowel disease", "Diffusion-weighted MR imaging of the gastrointestinal tract: technique, indications, and imaging findings", "Review article: nutrition and adult inflammatory bowel disease", "The anti-Saccharomyces cerevisiae antibody assay in a province-wide practice: accurate in identifying cases of Crohn's disease and predicting inflammatory disease", "Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease", "New serological markers in inflammatory bowel disease are associated with complicated disease behaviour", "Association Between Inflammatory Bowel Disease and Vitamin D Deficiency: A Systematic Review and Meta-analysis", "Histological evaluation in ulcerative colitis", "Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests)", "Subclinical celiac disease and gluten sensitivity", "Gluten tolerance; potential challenges in treatment strategies", "Antibiotics and probiotics in inflammatory bowel disease: why, when, and how", "Crohn's Disease: 54 Tips to Help You Manage". È caratterizzata da ulcere intestinali, spesso alternate a tratti di intestino sano, e, se non curata adeguatamente, può portare a complicanze quali stenosi (restringimenti intestinali) o fistole che possono richiedere un intervento chirurgico, sebbe… [37] The second type symmetrically involves five or more of the small joints of the hands and feet. It usually affects female children more severely than males. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. It typically manifests in the gastrointestinal tract and can be categorized by the specific tract region affected. This is due to a decrease in bile acid resorption in the ileum, and the bile gets excreted in the stool. [37] The symptoms of arthritis include painful, warm, swollen, stiff joints, and loss of joint mobility or function. Crohn’s treatment aims to reduce the inflammation in the intestine and to help manage the symptoms of Crohn’s disease, such as weight-loss and abdominal pain. L’osservazione che in oltre il 90% dei pazienti affetti da malattia di Crohn le recidive postoperatorie si trovano nel tratto pre-anastomotico ci porta a supporre che il tipo di anastomosi svolga un ruolo nella comparsa delle recidive. [23], Abdominal pain is a common initial symptom of Crohn's disease,[2] especially in the lower right abdomen. [42] Involvement of the duodenum and jejunum can impair the absorption of many other nutrients including folate. [174] The monoclonal antibody briakinumab is not effective for people with active Crohn's disease and it is no longer being manufactured.[174]. [34] Fever may also be present, though fevers greater than 38.5 °C (101.3 °F) are uncommon unless there is a complication such as an abscess. [37], Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloarthropathy. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs. A fistula can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. [1][2], Other complications outside the gastrointestinal tract may include anemia, skin rashes, arthritis, inflammation of the eye, and fatigue. [10] The exact underlying immune problem is not clear; however, it may be an immunodeficiency state. Autoimmune hemolytic anemia, a condition in which the immune system attacks the red blood cells, is also more common in Crohn's disease and may cause fatigue, a pale appearance, and other symptoms common in anemia. [94][95], Other studies have linked specific strains of enteroadherent E. coli to the disease. Eating small meals frequently instead of big meals may also help with a low appetite. [211], Inflammatory bowel diseases were described by Giovanni Battista Morgagni (1682–1771) and by Scottish physician T Kennedy Dalziel in 1913. [2] The disease was named after gastroenterologist Burrill Bernard Crohn, who in 1932, together with two colleagues at Mount Sinai Hospital in New York, described a series of patients with inflammation of the terminal ileum of the small intestine, the area most commonly affected by the illness. During a colonoscopy, biopsies of the colon are often taken to confirm the diagnosis. [45] The most common of these are seizures, stroke, myopathy, peripheral neuropathy, headache, and depression. La malattia di Crohn o morbo di Crohn, nota anche come enterite regionale, è una malattia infiammatoria cronica dell'intestino (MICI) che può colpire qualsiasi parte del tratto gastrointestinale, dalla bocca all'ano, provocando una vasta gamma di sintomi.. [86][87], In 2007, the ATG16L1 gene was implicated in Crohn's disease, which may induce autophagy and hinder the body's ability to attack invasive bacteria. Other guidelines[176] advise oral iron as first line with parenteral iron reserved for those that fail to adequately respond as oral iron is considerably cheaper. [25] Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts.[30]. [31] Fecal incontinence may accompany perianal Crohn's disease. Trials of extracts from the worm Trichuris suis showed promising results when used in people with IBD. Bosn J Basic Med Sci. [9][11][12], About half of the overall risk is related to genetics, with more than 70 genes having been found to be involved. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. This same gene may reduce innate and adaptive immunity in gastrointestinal tissue and impair the ability to resist infection by the MAP bacterium. [16] Rates have, however, been increasing, particularly in the developing world, since the 1970s. [32], Like many other chronic, inflammatory diseases, Crohn's disease can cause a variety of systemic symptoms. [1][2] Treatment options are intended to help with symptoms, maintain remission, and prevent relapse. Section of colectomy showing transmural inflammation, Resected ileum from a person with Crohn's disease. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. A study of heritability and the influence of smoking", "The burden of inflammatory bowel disease in Europe", "Antoni Lésniowski and his contribution to regional enteritis (Crohn's disease)", "Use of antibiotics in the treatment of Crohn's disease", "Translatability of helminth therapy in inflammatory bowel diseases", "Coronado Biosciences Announces Top-Line Results From Its TRUST-I Phase 2 Clinical Trial of TSO for the Treatment of Crohn's Disease", "Coronado Biosciences Announces Independent Data Monitoring Committee Recommendation to Discontinue Falk Phase 2 Trial of TSO in Crohn's Disease", "Thalidomide and thalidomide analogues for maintenance of remission in Crohn's disease", "ACG Clinical Guideline: Management of Crohn's Disease in Adults", National Society for Colitis and Crohn's Disease, List of people diagnosed with ulcerative colitis, Esophageal intramural pseudodiverticulosis, Small bowel bacterial overgrowth syndrome, Hereditary benign intraepithelial dyskeratosis, Neuralgia-inducing cavitational osteonecrosis, https://en.wikipedia.org/w/index.php?title=Crohn%27s_disease&oldid=993692632, Steroid-responsive inflammatory conditions, Articles with dead external links from December 2019, Articles with permanently dead external links, CS1 maint: DOI inactive as of November 2020, CS1 maint: DOI inactive as of December 2020, Articles with dead external links from July 2017, Articles with unsourced statements from July 2020, Articles containing potentially dated statements from 2017, All articles containing potentially dated statements, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Crohn disease, Crohn syndrome, granulomatous enteritis, regional enteritis, Leśniowski-Crohn disease, The three most common sites of intestinal involvement in Crohn's disease, Patchy areas of inflammation (skip lesions), Deep geographic and serpiginous (snake-like), A 2006 survey in Germany found that about half of people with IBD used some form of alternative medicine, with the most common being, There are contradicting studies regarding the effect of, This page was last edited on 11 December 2020, at 23:58. Sant'anna Di Stazzema Famiglia Tucci, Via Di Francia 1 Genova, Weekend Seminar Pesaro 2019, Campionati Europei Club, Ballando Con Le Stelle 2020 Giuria, " /> Inflammatorisk tarmsjukdom, kronisk, IBD, "Management of Crohn's disease in adults", "What I need to know about Crohn's Disease", "The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients", "Problems in diagnosis of IBD in children", "The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease", "Occurrence of skin manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study", "Dietary and nutritional considerations for inflammatory bowel disease", "The aetiology and impact of malnutrition in paediatric inflammatory bowel disease", "Strategies for detecting colon cancer in patients with inflammatory bowel disease", "Increased risk of large-bowel cancer in Crohn's disease with colonic involvement", "Colorectal cancer and dysplasia in inflammatory bowel disease", "Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment", "Man of Many Problems Comes to City for Help", "IBD and Pregnancy: What You Need to Know", Crohn's and Colitis Foundation of America, "ACG Clinical Guideline: Ulcerative Colitis in Adults", "Crohn's disease risk alleles on the NOD2 locus have been maintained by natural selection on standing variation", "Crohn's disease has strong genetic link: study", "XBP1 links ER stress to intestinal inflammation and confers genetic risk for human inflammatory bowel disease", "Intestinal DMBT1 expression is modulated by Crohn's disease-associated IL23R variants and by a DMBT1 variant which influences binding of the transcription factors CREB1 and ATF-2", "Independent and population-specific association of risk variants at the IRGM locus with Crohn's disease", "Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease", "A single gene can either raise or lower Crohn's disease risk", "Innate immunity in inflammatory bowel disease: a disease hypothesis", "Mycobacterium avium subspecies paratuberculosis causes Crohn's disease in some inflammatory bowel disease patients", "NOD2 and ATG16L1 polymorphisms affect monocyte responses in Crohn's disease", "Culture independent analysis of ileal mucosa reveals a selective increase in invasive Escherichia coli of novel phylogeny relative to depletion of Clostridiales in Crohn's disease involving the ileum", "Invasive Escherichia coli are a feature of Crohn's disease", "Crohn's disease-associated adherent-invasive Escherichia coli adhesion is enhanced by exposure to the ubiquitous dietary polysaccharide maltodextrin", "Biofilm formation as a novel phenotypic feature of adherent-invasive Escherichia coli (AIEC)", "Subversion of autophagy in adherent invasive Escherichia coli-infected neutrophils induces inflammation and cell death", "Inflammation drives dysbiosis and bacterial invasion in murine models of ileal Crohn's disease", "Role for protease activity in visceral pain in irritable bowel syndrome", "Induction of intestinal inflammation in mouse by activation of proteinase-activated receptor-2", "Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection", "Fridges blamed for Crohn's disease rise", "Replication of Colonic Crohn's Disease Mucosal Escherichia coli Isolates within Macrophages and Their Susceptibility to Antibiotics", "Possible links between Crohn's disease and Paratuberculosis", "Two-year-outcomes analysis of Crohn's disease treated with rifabutin and macrolide antibiotics", "Inflammation and gastrointestinal Candida colonization", "Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan", "Isotretinoin-induced inflammatory bowel disease in an adolescent", "Dietary sources of inorganic microparticles and their intake in healthy subjects and patients with Crohn's disease", "Dietary microparticles and their impact on tolerance and immune responsiveness of the gastrointestinal tract", "Impact of Long-Term Antibiotic Use for Acne on Bacterial Ecology and Health Outcomes: A Review of Observational Studies", "Host genes related to paneth cells and xenobiotic metabolism are associated with shifts in human ileum-associated microbial composition", HCP: Pill Cam, Capsule Endoscopy, Esophageal Endoscopy, "Diffuse jejunoileitis of Crohn's disease", "Computed tomographic findings of abdominal complications of Crohn's disease--pictorial essay", "New diagnostic imaging tools for inflammatory bowel disease", "Diffusion-weighted MR imaging of the gastrointestinal tract: technique, indications, and imaging findings", "Review article: nutrition and adult inflammatory bowel disease", "The anti-Saccharomyces cerevisiae antibody assay in a province-wide practice: accurate in identifying cases of Crohn's disease and predicting inflammatory disease", "Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease", "New serological markers in inflammatory bowel disease are associated with complicated disease behaviour", "Association Between Inflammatory Bowel Disease and Vitamin D Deficiency: A Systematic Review and Meta-analysis", "Histological evaluation in ulcerative colitis", "Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests)", "Subclinical celiac disease and gluten sensitivity", "Gluten tolerance; potential challenges in treatment strategies", "Antibiotics and probiotics in inflammatory bowel disease: why, when, and how", "Crohn's Disease: 54 Tips to Help You Manage". È caratterizzata da ulcere intestinali, spesso alternate a tratti di intestino sano, e, se non curata adeguatamente, può portare a complicanze quali stenosi (restringimenti intestinali) o fistole che possono richiedere un intervento chirurgico, sebbe… [37] The second type symmetrically involves five or more of the small joints of the hands and feet. It usually affects female children more severely than males. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. It typically manifests in the gastrointestinal tract and can be categorized by the specific tract region affected. This is due to a decrease in bile acid resorption in the ileum, and the bile gets excreted in the stool. [37] The symptoms of arthritis include painful, warm, swollen, stiff joints, and loss of joint mobility or function. Crohn’s treatment aims to reduce the inflammation in the intestine and to help manage the symptoms of Crohn’s disease, such as weight-loss and abdominal pain. L’osservazione che in oltre il 90% dei pazienti affetti da malattia di Crohn le recidive postoperatorie si trovano nel tratto pre-anastomotico ci porta a supporre che il tipo di anastomosi svolga un ruolo nella comparsa delle recidive. [23], Abdominal pain is a common initial symptom of Crohn's disease,[2] especially in the lower right abdomen. [42] Involvement of the duodenum and jejunum can impair the absorption of many other nutrients including folate. [174] The monoclonal antibody briakinumab is not effective for people with active Crohn's disease and it is no longer being manufactured.[174]. [34] Fever may also be present, though fevers greater than 38.5 °C (101.3 °F) are uncommon unless there is a complication such as an abscess. [37], Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloarthropathy. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs. A fistula can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. [1][2], Other complications outside the gastrointestinal tract may include anemia, skin rashes, arthritis, inflammation of the eye, and fatigue. [10] The exact underlying immune problem is not clear; however, it may be an immunodeficiency state. Autoimmune hemolytic anemia, a condition in which the immune system attacks the red blood cells, is also more common in Crohn's disease and may cause fatigue, a pale appearance, and other symptoms common in anemia. [94][95], Other studies have linked specific strains of enteroadherent E. coli to the disease. Eating small meals frequently instead of big meals may also help with a low appetite. [211], Inflammatory bowel diseases were described by Giovanni Battista Morgagni (1682–1771) and by Scottish physician T Kennedy Dalziel in 1913. [2] The disease was named after gastroenterologist Burrill Bernard Crohn, who in 1932, together with two colleagues at Mount Sinai Hospital in New York, described a series of patients with inflammation of the terminal ileum of the small intestine, the area most commonly affected by the illness. During a colonoscopy, biopsies of the colon are often taken to confirm the diagnosis. [45] The most common of these are seizures, stroke, myopathy, peripheral neuropathy, headache, and depression. La malattia di Crohn o morbo di Crohn, nota anche come enterite regionale, è una malattia infiammatoria cronica dell'intestino (MICI) che può colpire qualsiasi parte del tratto gastrointestinale, dalla bocca all'ano, provocando una vasta gamma di sintomi.. [86][87], In 2007, the ATG16L1 gene was implicated in Crohn's disease, which may induce autophagy and hinder the body's ability to attack invasive bacteria. Other guidelines[176] advise oral iron as first line with parenteral iron reserved for those that fail to adequately respond as oral iron is considerably cheaper. [25] Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts.[30]. [31] Fecal incontinence may accompany perianal Crohn's disease. Trials of extracts from the worm Trichuris suis showed promising results when used in people with IBD. Bosn J Basic Med Sci. [9][11][12], About half of the overall risk is related to genetics, with more than 70 genes having been found to be involved. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. This same gene may reduce innate and adaptive immunity in gastrointestinal tissue and impair the ability to resist infection by the MAP bacterium. [16] Rates have, however, been increasing, particularly in the developing world, since the 1970s. [32], Like many other chronic, inflammatory diseases, Crohn's disease can cause a variety of systemic symptoms. [1][2] Treatment options are intended to help with symptoms, maintain remission, and prevent relapse. Section of colectomy showing transmural inflammation, Resected ileum from a person with Crohn's disease. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. A study of heritability and the influence of smoking", "The burden of inflammatory bowel disease in Europe", "Antoni Lésniowski and his contribution to regional enteritis (Crohn's disease)", "Use of antibiotics in the treatment of Crohn's disease", "Translatability of helminth therapy in inflammatory bowel diseases", "Coronado Biosciences Announces Top-Line Results From Its TRUST-I Phase 2 Clinical Trial of TSO for the Treatment of Crohn's Disease", "Coronado Biosciences Announces Independent Data Monitoring Committee Recommendation to Discontinue Falk Phase 2 Trial of TSO in Crohn's Disease", "Thalidomide and thalidomide analogues for maintenance of remission in Crohn's disease", "ACG Clinical Guideline: Management of Crohn's Disease in Adults", National Society for Colitis and Crohn's Disease, List of people diagnosed with ulcerative colitis, Esophageal intramural pseudodiverticulosis, Small bowel bacterial overgrowth syndrome, Hereditary benign intraepithelial dyskeratosis, Neuralgia-inducing cavitational osteonecrosis, https://en.wikipedia.org/w/index.php?title=Crohn%27s_disease&oldid=993692632, Steroid-responsive inflammatory conditions, Articles with dead external links from December 2019, Articles with permanently dead external links, CS1 maint: DOI inactive as of November 2020, CS1 maint: DOI inactive as of December 2020, Articles with dead external links from July 2017, Articles with unsourced statements from July 2020, Articles containing potentially dated statements from 2017, All articles containing potentially dated statements, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Crohn disease, Crohn syndrome, granulomatous enteritis, regional enteritis, Leśniowski-Crohn disease, The three most common sites of intestinal involvement in Crohn's disease, Patchy areas of inflammation (skip lesions), Deep geographic and serpiginous (snake-like), A 2006 survey in Germany found that about half of people with IBD used some form of alternative medicine, with the most common being, There are contradicting studies regarding the effect of, This page was last edited on 11 December 2020, at 23:58. Sant'anna Di Stazzema Famiglia Tucci, Via Di Francia 1 Genova, Weekend Seminar Pesaro 2019, Campionati Europei Club, Ballando Con Le Stelle 2020 Giuria, " />

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It is usually thought to be due to an inability of the ileum to reabsorb bile acids after resection of the terminal ileum and was the first type of bile acid malabsorption recognized. Come conservare Entyvio 6. [1] Other conditions that can present similarly include irritable bowel syndrome and Behçet's disease. [75][76] The gene variants of NOD2/CARD15 seem to be related with small-bowel involvement. After a resection, scar tissue builds up, which can cause strictures, which form when the intestines become too small to allow excrement to pass through easily, which can lead to a blockage. [214] Treating MAP using antibiotics has been examined and the results are unclear but tentatively beneficial. [18][1] Because of the 'patchy' nature of the gastrointestinal disease and the depth of tissue involvement, initial symptoms can be more subtle than those of ulcerative colitis. Penetrating disease creates abnormal passageways (fistulae) between the bowel and other structures, such as the skin. [208] Twin studies find that if one has the disease there is a 55% chance the other will too. However, individuals affected by the disease rarely fall outside these three classifications, with presentations in other areas. La European Crohn’s and Colitis Organisation è la più grande associazione al mondo di specialisti in Malattie Infiammatorie Intestinali (in inglese IBD, Inflammatory Bowel Disease), e … [19], Some evidence supports the hypothesis that the bacterium Mycobacterium avium subspecies paratuberculosis (MAP) is a cause of Crohn's disease (see also Johne's disease). Crohn's disease is one type of inflammatory bowel disease (IBD). [220][221], There is no good evidence that thalidomide or lenalidomide is useful to bring about or maintain remission. Therapeutic role of methotrexate in pediatric Crohn's disease. When symptoms are in remission, treatment enters maintenance, with a goal of avoiding the recurrence of symptoms. [85] The later hypothesis describes impaired cytokine secretion by macrophages, which contributes to impaired innate immunity and leads to a sustained microbial-induced inflammatory response in the colon, where the bacterial load is high. It usually reoccurs, although some people can remain disease-free for years or decades. This typically occurs in the area overlying lymphoid aggregates. [1], Crohn's disease may also be categorized by the behavior of disease as it progresses. [55], Crohn's disease also increases the risk of cancer in the area of inflammation. [167], Medications used to treat the symptoms of Crohn's disease include 5-aminosalicylic acid (5-ASA) formulations, prednisone, immunomodulators such as azathioprine (given as the prodrug for 6-mercaptopurine), methotrexate,[168] infliximab, adalimumab,[26] certolizumab,[169] vedolizumab, ustekinumab,[170] and natalizumab. [75][76] The gene variants of NOD2/CARD15 seem to be related with small-bowel involvement. In severe Crohn's colitis, bleeding may be copious. [115], The increased incidence of Crohn's in the industrialized world indicates an environmental component. [1] Bloody bowel movements are usually intermittent, and may be bright or dark red in color. People with Crohn's often also have issues with small bowel bacterial overgrowth syndrome, which can produce micronutrient deficiencies. [1] While surgery should be used as little as possible, it is necessary to address some abscesses, certain bowel obstructions, and cancers. A colonoscopy is the best test for making the diagnosis of Crohn's disease, as it allows direct visualization of the colon and the terminal ileum, identifying the pattern of disease involvement. Si prega di notare che Indice di attività del morbo di Crohn pediatrica non è l'unico significato di PCDAI. Crohn's lesions are nearly always found at the site of the resected bowel. Nella maggior parte dei casi, la malattia colpisce principalmente l’ultima parte dell’intestino tenue (ileo) e il colon. Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD)", "Familial empirical risks for inflammatory bowel disease: differences between Jews and non-Jews", "Crohn's disease manifests differently in boys and girls", "The genetics of inflammatory bowel disease", "Ulcerative colitis and Crohn's disease in an unselected population of monozygotic and dizygotic twins. Jejunoileitis causes spotty patches of inflammation in the top half of the small intestine, called the jejunum. The American Journal of Gastroenterology: November 2020 - Volume 115 - Issue 11 - … [164] Some find relief in eliminating casein (a protein found in cow's milk) and gluten (a protein found in wheat, rye and barley) from their diets. These categorizations formalized in the Vienna classification of the disease. [41], People with Crohn's disease may develop anemia due to vitamin B12, folate, iron deficiency, or due to anemia of chronic disease. [116] [179] For patients with an obstruction due to a stricture, two options for treatment are strictureplasty and resection of that portion of bowel. Cos'è il morbo di Crohn? J Ultrasound. [15][16] Inflammatory bowel disease resulted in 47,400 deaths in 2015,[17] and those with Crohn's disease have a slightly reduced life expectancy. [144] Serum iron, total iron binding capacity and transferrin saturation may be more easily interpreted in inflammation. Giant (multinucleate) cells, a common finding in the lesions of Crohn's disease, are less common in the lesions of lichen nitidus. [1] Diagnosis is based on a number of findings, including biopsy and appearance of the bowel wall, medical imaging, and description of the disease. It usually reoccurs, although some people can remain disease-free for years or decades. A disease of both the ileum (the last part of the small intestine that connects to the large intestine), and the large intestine, Ileocolic Crohn's accounts for fifty percent of cases. On occasion, the colonoscopy can travel past the terminal ileum, but it varies from person to person. A fistula can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. [2] Dietary microparticles, such as those found in toothpaste, have been studied as they produce effects on immunity, but they were not consumed in greater amounts in patients with Crohn's. Mild postsurgical recurrences of Crohn's disease are graded i1 and i2, moderate to severe recurrences are graded i3 and i4. [42][43] The most common is iron deficiency anemia[42] from chronic blood loss, reduced dietary intake, and persistent inflammation leading to increased hepcidin levels, restricting iron absorption in the duodenum. Negli stessi anni, si è osservato un rischio maggiore del Morbo di Crohn per: [1] Bowel obstruction may occur as a complication of chronic inflammation, and those with the disease are at greater risk of colon cancer and small bowel cancer. [47][48] Medications that are commonly prescribed to treat CD, such as anti-inflammatory and sulfa-containing drugs, may cause lichenoid drug reactions in the mouth. As a result, a barium follow-through X-ray, wherein barium sulfate suspension is ingested and fluoroscopic images of the bowel are taken over time, is useful for looking for inflammation and narrowing of the small bowel. [91][92], NOD2 is a gene involved in Crohn's genetic susceptibility. During a colonoscopy, biopsies of the colon are often taken to confirm the diagnosis. Certain characteristic features of the pathology seen point toward Crohn's disease; it shows a transmural pattern of inflammation, meaning the inflammation may span the entire depth of the intestinal wall. Some people should follow a low fiber diet to control acute symptoms especially if fibrous foods cause symptoms. [74] Over 30 genes have been associated with Crohn's; a biological function is known for most of them. [146] Furthermore, increasing amounts and levels of serological antibodies such as ASCA, antilaminaribioside [Glc(β1,3)Glb(β); ALCA], antichitobioside [GlcNAc(β1,4)GlcNAc(β); ACCA], antimannobioside [Man(α1,3)Man(α)AMCA], antiLaminarin [(Glc(β1,3))3n(Glc(β1,6))n; anti-L] and antichitin [GlcNAc(β1,4)n; anti-C] associate with disease behavior and surgery, and may aid in the prognosis of Crohn's disease. [137], CT and MRI scans are useful for evaluating the small bowel with enteroclysis protocols. Ci può [5] It is less common in Asia and Africa. [2] The disease was named after gastroenterologist Burrill Bernard Crohn, who in 1932, together with two colleagues at Mount Sinai Hospital in New York, described a series of patients with inflammation of the terminal ileum of the small intestine, the area most commonly affected by the illness. The granulomas of Crohn's disease do not show "caseation", a cheese-like appearance on microscopic examination characteristic of granulomas associated with infections, such as tuberculosis. It is associated with macrophages' diminished ability to phagocytize MAP. [217][218][219] However these trials (TRUST -I & TRUST -II) failed in Phase 2 clinical trials and were then discontinued after consistent failure in both North America and Europe. All agree that severe anemia (hemoglobin under 10g/dL) should be treated with parenteral iron. [134] [186] Counselling as well as antidepressant or anxiolytic medication may help some people manage. [147][148][149][150], Low serum levels of vitamin D are associated with Crohn's disease. Some people should follow a low fiber diet to control acute symptoms especially if fibrous foods cause symptoms. Erythema nodosum is the most common type of skin problem, occurring in around 8% of people with Crohn's disease, producing raised, tender red nodules usually appearing on the shins. Cosa deve sapere prima che le venga somministrato Entyvio 3. [222][223], "Crohn" redirects here. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension, and weight loss. [1] In those newly diagnosed, a corticosteroid may be used for a brief period of time to rapidly improve symptoms, alongside another medication such as either methotrexate or a thiopurine used to prevent recurrence. [47], Crohn's disease can lead to several mechanical complications within the intestines, including obstruction,[52] fistulae,[53] and abscesses. Rarely, the esophagus and stomach may be involved in Crohn's disease. Il Morbo di Crohn o Malattia di Crohn (Crohn’s disease – CD), in alcuni casi impropriamente chiamata Sindrome di Crohn, è classificata assieme alla Colite Ulcerosa o Rettocolite Ulcerosa, come Malattia Infiammatoria Cronica Intestinale, in acronimo MICI o IBD (acronimo inglese per Inflammatory Bowel Disease… [4] Irritable bowel syndrome is excluded when there are inflammatory changes. [35], Crohn's disease can affect many organ systems beyond the gastrointestinal tract. [1] Among children, growth failure is common. [186] Counselling as well as antidepressant or anxiolytic medication may help some people manage. [24] It is often accompanied by diarrhea, which may or may not be bloody. [citation needed], The first mutation found to be associated with Crohn's was a frameshift in the NOD2 gene (also known as the CARD15 gene),[73] followed by the discovery of point mutations. Anemia of chronic disease results in a normocytic anemia. Itchiness or pain around the anus may be suggestive of inflammation, fistulization or abscess around the anal area[1] or anal fissure. This bacterium then produces mannins, which protect both itself and various bacteria from phagocytosis, thereby causing a variety of secondary infections. [183] Diarrhea is the main symptom, but others may include weight loss, cramping, bloating, and heartburn. [1] Ulceration is an outcome seen in highly active disease. Many children are first diagnosed with Crohn's disease based on inability to maintain growth. [176], Crohn's cannot be cured by surgery, as the disease eventually recurs, though it is used in the case of partial or full blockage of the intestine. Rarely autoimmune hemolysis may occur. [186], As of 2017[update] there is a small amount of research looking at mindfulness-based therapies, hypnotherapy, and cognitive behavioural therapy.[187]. "The Gastrointestinal tract, Chapter 17". [15][16] Inflammatory bowel disease resulted in 47,400 deaths in 2015,[17] and those with Crohn's disease have a slightly reduced life expectancy. [25] Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts.[30]. A food diary may help with identifying foods that trigger symptoms. ", "Genome-wide association defines more than 30 distinct susceptibility loci for Crohn's disease", "Epidemiology and clinical course of Crohn's disease: results from observational studies", "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015", "Crohn's Disease: Get Facts on Symptoms and Diet", internetmedicin.se > Inflammatorisk tarmsjukdom, kronisk, IBD, "Management of Crohn's disease in adults", "What I need to know about Crohn's Disease", "The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients", "Problems in diagnosis of IBD in children", "The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease", "Occurrence of skin manifestations in patients of the Swiss Inflammatory Bowel Disease Cohort Study", "Dietary and nutritional considerations for inflammatory bowel disease", "The aetiology and impact of malnutrition in paediatric inflammatory bowel disease", "Strategies for detecting colon cancer in patients with inflammatory bowel disease", "Increased risk of large-bowel cancer in Crohn's disease with colonic involvement", "Colorectal cancer and dysplasia in inflammatory bowel disease", "Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment", "Man of Many Problems Comes to City for Help", "IBD and Pregnancy: What You Need to Know", Crohn's and Colitis Foundation of America, "ACG Clinical Guideline: Ulcerative Colitis in Adults", "Crohn's disease risk alleles on the NOD2 locus have been maintained by natural selection on standing variation", "Crohn's disease has strong genetic link: study", "XBP1 links ER stress to intestinal inflammation and confers genetic risk for human inflammatory bowel disease", "Intestinal DMBT1 expression is modulated by Crohn's disease-associated IL23R variants and by a DMBT1 variant which influences binding of the transcription factors CREB1 and ATF-2", "Independent and population-specific association of risk variants at the IRGM locus with Crohn's disease", "Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease", "A single gene can either raise or lower Crohn's disease risk", "Innate immunity in inflammatory bowel disease: a disease hypothesis", "Mycobacterium avium subspecies paratuberculosis causes Crohn's disease in some inflammatory bowel disease patients", "NOD2 and ATG16L1 polymorphisms affect monocyte responses in Crohn's disease", "Culture independent analysis of ileal mucosa reveals a selective increase in invasive Escherichia coli of novel phylogeny relative to depletion of Clostridiales in Crohn's disease involving the ileum", "Invasive Escherichia coli are a feature of Crohn's disease", "Crohn's disease-associated adherent-invasive Escherichia coli adhesion is enhanced by exposure to the ubiquitous dietary polysaccharide maltodextrin", "Biofilm formation as a novel phenotypic feature of adherent-invasive Escherichia coli (AIEC)", "Subversion of autophagy in adherent invasive Escherichia coli-infected neutrophils induces inflammation and cell death", "Inflammation drives dysbiosis and bacterial invasion in murine models of ileal Crohn's disease", "Role for protease activity in visceral pain in irritable bowel syndrome", "Induction of intestinal inflammation in mouse by activation of proteinase-activated receptor-2", "Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection", "Fridges blamed for Crohn's disease rise", "Replication of Colonic Crohn's Disease Mucosal Escherichia coli Isolates within Macrophages and Their Susceptibility to Antibiotics", "Possible links between Crohn's disease and Paratuberculosis", "Two-year-outcomes analysis of Crohn's disease treated with rifabutin and macrolide antibiotics", "Inflammation and gastrointestinal Candida colonization", "Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan", "Isotretinoin-induced inflammatory bowel disease in an adolescent", "Dietary sources of inorganic microparticles and their intake in healthy subjects and patients with Crohn's disease", "Dietary microparticles and their impact on tolerance and immune responsiveness of the gastrointestinal tract", "Impact of Long-Term Antibiotic Use for Acne on Bacterial Ecology and Health Outcomes: A Review of Observational Studies", "Host genes related to paneth cells and xenobiotic metabolism are associated with shifts in human ileum-associated microbial composition", HCP: Pill Cam, Capsule Endoscopy, Esophageal Endoscopy, "Diffuse jejunoileitis of Crohn's disease", "Computed tomographic findings of abdominal complications of Crohn's disease--pictorial essay", "New diagnostic imaging tools for inflammatory bowel disease", "Diffusion-weighted MR imaging of the gastrointestinal tract: technique, indications, and imaging findings", "Review article: nutrition and adult inflammatory bowel disease", "The anti-Saccharomyces cerevisiae antibody assay in a province-wide practice: accurate in identifying cases of Crohn's disease and predicting inflammatory disease", "Anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic antibodies as predictors of inflammatory bowel disease", "New serological markers in inflammatory bowel disease are associated with complicated disease behaviour", "Association Between Inflammatory Bowel Disease and Vitamin D Deficiency: A Systematic Review and Meta-analysis", "Histological evaluation in ulcerative colitis", "Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests)", "Subclinical celiac disease and gluten sensitivity", "Gluten tolerance; potential challenges in treatment strategies", "Antibiotics and probiotics in inflammatory bowel disease: why, when, and how", "Crohn's Disease: 54 Tips to Help You Manage". È caratterizzata da ulcere intestinali, spesso alternate a tratti di intestino sano, e, se non curata adeguatamente, può portare a complicanze quali stenosi (restringimenti intestinali) o fistole che possono richiedere un intervento chirurgico, sebbe… [37] The second type symmetrically involves five or more of the small joints of the hands and feet. It usually affects female children more severely than males. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. It typically manifests in the gastrointestinal tract and can be categorized by the specific tract region affected. This is due to a decrease in bile acid resorption in the ileum, and the bile gets excreted in the stool. [37] The symptoms of arthritis include painful, warm, swollen, stiff joints, and loss of joint mobility or function. Crohn’s treatment aims to reduce the inflammation in the intestine and to help manage the symptoms of Crohn’s disease, such as weight-loss and abdominal pain. L’osservazione che in oltre il 90% dei pazienti affetti da malattia di Crohn le recidive postoperatorie si trovano nel tratto pre-anastomotico ci porta a supporre che il tipo di anastomosi svolga un ruolo nella comparsa delle recidive. [23], Abdominal pain is a common initial symptom of Crohn's disease,[2] especially in the lower right abdomen. [42] Involvement of the duodenum and jejunum can impair the absorption of many other nutrients including folate. [174] The monoclonal antibody briakinumab is not effective for people with active Crohn's disease and it is no longer being manufactured.[174]. [34] Fever may also be present, though fevers greater than 38.5 °C (101.3 °F) are uncommon unless there is a complication such as an abscess. [37], Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloarthropathy. Alternatives include aminosalicylates alone, though only a minority are able to maintain the treatment, and many require immunosuppressive drugs. A fistula can develop between two loops of bowel, between the bowel and bladder, between the bowel and vagina, and between the bowel and skin. [1][2], Other complications outside the gastrointestinal tract may include anemia, skin rashes, arthritis, inflammation of the eye, and fatigue. [10] The exact underlying immune problem is not clear; however, it may be an immunodeficiency state. Autoimmune hemolytic anemia, a condition in which the immune system attacks the red blood cells, is also more common in Crohn's disease and may cause fatigue, a pale appearance, and other symptoms common in anemia. [94][95], Other studies have linked specific strains of enteroadherent E. coli to the disease. Eating small meals frequently instead of big meals may also help with a low appetite. [211], Inflammatory bowel diseases were described by Giovanni Battista Morgagni (1682–1771) and by Scottish physician T Kennedy Dalziel in 1913. [2] The disease was named after gastroenterologist Burrill Bernard Crohn, who in 1932, together with two colleagues at Mount Sinai Hospital in New York, described a series of patients with inflammation of the terminal ileum of the small intestine, the area most commonly affected by the illness. During a colonoscopy, biopsies of the colon are often taken to confirm the diagnosis. [45] The most common of these are seizures, stroke, myopathy, peripheral neuropathy, headache, and depression. La malattia di Crohn o morbo di Crohn, nota anche come enterite regionale, è una malattia infiammatoria cronica dell'intestino (MICI) che può colpire qualsiasi parte del tratto gastrointestinale, dalla bocca all'ano, provocando una vasta gamma di sintomi.. [86][87], In 2007, the ATG16L1 gene was implicated in Crohn's disease, which may induce autophagy and hinder the body's ability to attack invasive bacteria. Other guidelines[176] advise oral iron as first line with parenteral iron reserved for those that fail to adequately respond as oral iron is considerably cheaper. [25] Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitis, a type of inflammation of the bile ducts.[30]. [31] Fecal incontinence may accompany perianal Crohn's disease. Trials of extracts from the worm Trichuris suis showed promising results when used in people with IBD. Bosn J Basic Med Sci. [9][11][12], About half of the overall risk is related to genetics, with more than 70 genes having been found to be involved. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. This same gene may reduce innate and adaptive immunity in gastrointestinal tissue and impair the ability to resist infection by the MAP bacterium. [16] Rates have, however, been increasing, particularly in the developing world, since the 1970s. [32], Like many other chronic, inflammatory diseases, Crohn's disease can cause a variety of systemic symptoms. [1][2] Treatment options are intended to help with symptoms, maintain remission, and prevent relapse. Section of colectomy showing transmural inflammation, Resected ileum from a person with Crohn's disease. [188] These include diets, probiotics, fish oil and other herbal and nutritional supplements. A study of heritability and the influence of smoking", "The burden of inflammatory bowel disease in Europe", "Antoni Lésniowski and his contribution to regional enteritis (Crohn's disease)", "Use of antibiotics in the treatment of Crohn's disease", "Translatability of helminth therapy in inflammatory bowel diseases", "Coronado Biosciences Announces Top-Line Results From Its TRUST-I Phase 2 Clinical Trial of TSO for the Treatment of Crohn's Disease", "Coronado Biosciences Announces Independent Data Monitoring Committee Recommendation to Discontinue Falk Phase 2 Trial of TSO in Crohn's Disease", "Thalidomide and thalidomide analogues for maintenance of remission in Crohn's disease", "ACG Clinical Guideline: Management of Crohn's Disease in Adults", National Society for Colitis and Crohn's Disease, List of people diagnosed with ulcerative colitis, Esophageal intramural pseudodiverticulosis, Small bowel bacterial overgrowth syndrome, Hereditary benign intraepithelial dyskeratosis, Neuralgia-inducing cavitational osteonecrosis, https://en.wikipedia.org/w/index.php?title=Crohn%27s_disease&oldid=993692632, Steroid-responsive inflammatory conditions, Articles with dead external links from December 2019, Articles with permanently dead external links, CS1 maint: DOI inactive as of November 2020, CS1 maint: DOI inactive as of December 2020, Articles with dead external links from July 2017, Articles with unsourced statements from July 2020, Articles containing potentially dated statements from 2017, All articles containing potentially dated statements, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License, Crohn disease, Crohn syndrome, granulomatous enteritis, regional enteritis, Leśniowski-Crohn disease, The three most common sites of intestinal involvement in Crohn's disease, Patchy areas of inflammation (skip lesions), Deep geographic and serpiginous (snake-like), A 2006 survey in Germany found that about half of people with IBD used some form of alternative medicine, with the most common being, There are contradicting studies regarding the effect of, This page was last edited on 11 December 2020, at 23:58.

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