Tian Chenlu, Ranasinghe Indika R., Hsu Ronald
UT Southwestern Medical Center
Univ of Calif, Davis, School of Medicine
Crohn disease is a chronic inflammatory bowel disease (IBD) distinct from ulcerative colitis, often presenting with subtle or nonspecific symptoms. Crohn disease is an immunologically mediated gastrointestinal disorder characterized by transmural inflammation that can involve any segment of the gastrointestinal tract. Population-based studies from Northern Europe and Minnesota report ileal, ileocolonic, and colonic involvement in roughly equal proportions, with disease migration occurring in only 6% to 14% of patients. Pathology limited to the upper gastrointestinal tract, ileum, or ileocolonic region is associated with a higher risk of stricturing and fistulizing complications than isolated colonic involvement. Minnesota data indicate that 19% of patients present with stricturing or fistulizing disease within 90 days of diagnosis, and approximately 50% develop complications such as fistulae, phlegmons, strictures, or abscesses within 20 years. Extraintestinal manifestations may involve the eyes, skin, liver, and joints. The disease follows a chronic, progressive course. Diarrhea, abdominal pain, nausea, and vomiting are common, while weight loss, fever, and fatigue reflect systemic inflammation. Without timely intervention, persistent inflammation can result in disabling complications. Early diagnosis and evidence-based management are essential to optimize long-term outcomes and preserve quality of life.
克罗恩病是一种炎症性肠病(IBD),与溃疡性结肠炎类似,不过克罗恩病的症状往往更为隐匿。克罗恩病是一种免疫介导的炎症性胃肠道疾病,其病理变化累及肠壁全层。该病可累及胃肠道的任何部位。明尼苏达州的数据显示,19%的患者在确诊后90天内出现狭窄或瘘管形成性疾病。在所有患者中,约有一半在确诊后20年内会出现肠道并发症,如瘘管、蜂窝织炎、狭窄和脓肿。来自北欧和明尼苏达州的基于人群的研究表明,克罗恩病累及回肠、回结肠或结肠的概率各为三分之一,只有6%至14%的患者会出现病情迁移。与结肠受累相比,上消化道、回肠或回结肠区域的病变预示着更高的狭窄和瘘管形成风险。克罗恩病还可能有肠外表现,常累及眼睛、皮肤、肝脏和关节。该病呈慢性病程,且往往会进展。常见症状包括腹泻、腹痛、恶心或呕吐。体重减轻、发热和疲劳是该病的全身表现。若不进行治疗,长期炎症会导致使人衰弱的并发症。早期诊断和管理有助于优化克罗恩病患者的生活质量和治疗效果。