Crohn’s Disease: Medical History

Medical history (history of illness) represents an important component in the diagnosis of Crohn’s disease.

Family history

  • Is there a history of frequent gastrointestinal disease in your family?

Social history

  • Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • Do you have pain in the right lower abdomen?
  • Do you have mucous or bloody diarrhea?
  • Do you have pain during bowel movements?
  • Do you have an increased frequency of bowel movements?
    • What is the number of liquid bowel movements within a week?
  • Do you suffer from increased urge to defecate?
  • Do you have to get up at night to have a bowel movement?
  • Do you not feel completely emptied after a bowel movement?
  • Do you/have you had a fever recently?
  • Do you feel sluggish and tired?
  • Do you suffer from nausea and vomiting?
  • Have you noticed any weight loss recently?
  • Do you have increased joint pain?
  • Have you noticed skin changes such as redness or ulceration?
  • Have you noticed eye conditions such as inflammation?

Vegetative anamnesis including nutritional history.

  • Please tell us your body weight (in kg) and height (in cm).
  • Do you have a balanced diet?
    • Do you have a diet low in complex carbohydrates (cereal grains and flakes, whole grain bread, potatoes, legumes, etc.) and fiber or high in refined carbohydrates (white sugar, white flour products)?
  • Has your appetite changed?
  • Have your bowel movements and/or urination changed? In quantity, consistency, admixtures?
  • Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
  • Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
  • Do you use drugs? If yes, what drugs and how often per day or per week?

Self-history

  • Previous illnesses (gastrointestinal diseases)
  • Operations
  • Allergies
  • Environmental history (influence of bacteria, viruses as well as pollutants that lead to infections as well as inflammation of the intestinal mucosa).

Medication history

  • Repeated and early use of antibiotics, especially those with a broad spectrum of activity.
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs).
  • TNF blockers (biologics that neutralize tumor necrosis factor alpha): etanercept: adjusted hazard ratio of 2.0 (95% confidence interval 1.4 to 2.8); no increased risk was detectable for infliximab and adalimumab.