CROHN’S DISEASE
Can occur in any part of the GI; Most common locations: terminal
LOCATION Restricte
ileum and colon (rectal sparing)
MONTREAL CLASSIFICATION
Diarrhea and Abdominal Pain Dyspepsia
Bloody diarrhea
malabsorption Diarrhea Epigastric pain
Anorexia Nausea and vomiting
INFLAMMATION Transmural inflammation, Non-caseating granulomas C
Bimodal distribution: 1st incidence peak at 15–35 yea
EPIDEMIOLOGY
Higher incidence population: Northern europeans +
Childhood: Increased hygiene, less contact with
Infections: C.difficile (can be a trigger), salmo
RISK FACTORS
Medications: NSAIDs, DOACs, antibiotics (1s
Diet: low fiber, high unsaturated fats, processed foods, vita
SMOKING Risk factor
Pain in lower right abdomen, fatigue, weight loss, diarrhea, perianal
CLINICAL FEATURES Pain in l
disease (fistulas, abscesses)
Many children have: diarrhea, nocturnal defecation, low-grade
Most comm
intermittent fever, oral ulcers, weight loss, and failure to thrive. 30%
PEDIATRIC SPECIFICS urgency to
of children have Gastroduodenal disease which presents with
epigastric pain.
Arthralgia/Arthritis, Erythema nusodum, Pyoderma gangrenosum,
Ocular manifestation (more common in Crohn’s) - uveitis,
EXTRA-INTESTINAL Arthralgia/
episcleritis
MANIFESTATIONS Prim
Higher prevalence of gallstone formation (cholesterol) and Oxalate
kidney stones
Fistulas, Abscess formation, Bowel perforation,
Stenosis/Stricturing ➡️ obstruction, Colo-rectal cancer, Bile acid Colo-rec
COMPLICATIONS
malabsorption (kidney stones + gallstones), Malabsorption
syndromes (anemia, vitamin B12 deficiency, osteoporosis)
Skip lesions, cobble stone mucosa, fissures, rectal sparing,
Rectal involve
ENDOSCOPY aphthous or deep linear ulcers anywhere along the GI tract (usually
with rectal sparing)
Can occur in any part of the GI; Most common locations: terminal
LOCATION Restricte
ileum and colon (rectal sparing)
MONTREAL CLASSIFICATION
Diarrhea and Abdominal Pain Dyspepsia
Bloody diarrhea
malabsorption Diarrhea Epigastric pain
Anorexia Nausea and vomiting
INFLAMMATION Transmural inflammation, Non-caseating granulomas C
Bimodal distribution: 1st incidence peak at 15–35 yea
EPIDEMIOLOGY
Higher incidence population: Northern europeans +
Childhood: Increased hygiene, less contact with
Infections: C.difficile (can be a trigger), salmo
RISK FACTORS
Medications: NSAIDs, DOACs, antibiotics (1s
Diet: low fiber, high unsaturated fats, processed foods, vita
SMOKING Risk factor
Pain in lower right abdomen, fatigue, weight loss, diarrhea, perianal
CLINICAL FEATURES Pain in l
disease (fistulas, abscesses)
Many children have: diarrhea, nocturnal defecation, low-grade
Most comm
intermittent fever, oral ulcers, weight loss, and failure to thrive. 30%
PEDIATRIC SPECIFICS urgency to
of children have Gastroduodenal disease which presents with
epigastric pain.
Arthralgia/Arthritis, Erythema nusodum, Pyoderma gangrenosum,
Ocular manifestation (more common in Crohn’s) - uveitis,
EXTRA-INTESTINAL Arthralgia/
episcleritis
MANIFESTATIONS Prim
Higher prevalence of gallstone formation (cholesterol) and Oxalate
kidney stones
Fistulas, Abscess formation, Bowel perforation,
Stenosis/Stricturing ➡️ obstruction, Colo-rectal cancer, Bile acid Colo-rec
COMPLICATIONS
malabsorption (kidney stones + gallstones), Malabsorption
syndromes (anemia, vitamin B12 deficiency, osteoporosis)
Skip lesions, cobble stone mucosa, fissures, rectal sparing,
Rectal involve
ENDOSCOPY aphthous or deep linear ulcers anywhere along the GI tract (usually
with rectal sparing)
