Crohn’s Disease: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate the onset of Crohn’s disease:

  • Abdominal pain (abdominal pain/abdominal tenderness) in the right lower abdomen and periumbilical (around the umbilicus) (approximately 80%)
  • Diarrhea (about 70%), possibly with mucus admixtures; hemorrhagic diarrhea (bloody diarrhea), possibly with mucus admixtures (45% / 35%).
  • Fatigue
  • Growth retardation: weight stagnation (in children) or weight loss (45% / 65%) possibly also pubertal delay.
  • Performance kink (30% / 40%)
  • Anorexia (loss of appetite) (25%)
  • Fever (20% / 15%)
  • Leukocytosis – increase in white blood cells.

(At diagnosis: < 10 years in % of cases / > 10 years in % of cases).

Note: 19% of all Crohn’s disease patients are under 20 years of age, occasionally the disease begins in infancy, then a growth disorder is often groundbreaking. Notice. Because of these symptoms, the disease can easily be confused with appendicitis.Symptoms that may be added later in the course of the disease are:

  • Possibly palpable resistance in the lower abdomen.
  • Iron deficiency anemia (form of anemia caused by iron deficiency).
  • Perianal abscesses and fistulas /anal fistulas (about 40% of cases first symptom of the disease).
  • Intestinal stenosis (intestinal narrowing: risk of ileus / risk of intestinal obstruction).
  • Subileus – incomplete intestinal obstruction

Extraintestinal manifestations (signs of illness outside the gastrointestinal tract; up to 40% of cases,)

  • Respiratory system:
    • Fibrosing alveolitis – disease of the lung tissue and alveoli (air sacs).
  • Eyes and eye appendages:
  • Blood, hematopoietic organs – immune system:
  • Endocrine, nutritional, and metabolic diseases:
    • Amyloidosis – systemic disease with deposition of proteins (albumen) in various organ systems.
  • Skin and subcutaneous tissue:
    • Erythema nodosum (EN; synonyms: nodular erythema, dermatitis contusiformis, erythema contusiforme; plural: erythemata nodosa) – granulomatous inflammation of the subcutis (subcutaneous fat), also known as panniculitis, and painful nodulation (red to blue-red color; later brownish). The overlying skin is reddened. Localization: both extensor sides of the lower leg, on the knee and ankle joints; less frequently on the arms or buttocks (6%).
    • Psoriasisform manifestations (therapy-induced) (2%).
    • Pyoderma gangraenosum (PG) – painful disease of the skin in which ulceration or ulceration (ulceration or ulceration) and gangrene (tissue death due to reduced blood flow or other damage) occurs over a large area, usually in one place (2%)
    • Clock glass nails – Bulging nails.
    • Zinc deficiency dermatitis
  • Cardiovascular system:
    • Perimyocarditis (inflammation of the heart muscle).
    • Deep vein thrombosis (DVT; patients <40 years of age have a two-and-a-half-fold increased risk)
  • Liver/biliary tract/pancreas:
  • Mouth, esophagus (food pipe), stomach and intestines:
  • Musculoskeletal system and connective tissue:
    • Arthralgia (joint pain)
    • Arthritis* (joint inflammation): poly-/monoarhtitis (30%).
    • Osteoporosis (bone loss)
    • Bekhterev’s disease (ankylosing spondylitis; Latinized Greek: spondylitis “inflammation of the vertebrae” and ankylosans “stiffening”) – chronic inflammatory rheumatic disease with pain and stiffening of joints (6%).
    • Back pain (lumbalgia / lumboischialgia / lumbago).
    • Sacroiliitis – inflammatory change in the lower spine (joints between the sacrum and ilium, sacroiliac joints).
  • Urogenital system:

* Joint involvement may occur concurrently with Crohn’s disease, but may precede or follow it by years. A distinction is made between:

  • Type I: <5 joints affected; usually large joints, course strongly associated with disease activity.
  • Type II: > 5 joints affected, mostly symmetrical involvement of finger joints, rather chronic and independent of disease activity

Risk assessment for inflammatory bowel disease (IBD) or colorectal cancer (CRC) (in patients <50 years) [2}

Common features of CED and CRC) are rectal bleeding, abdominal pain (abdominal pain; abdominal pain), diarrhea (diarrhea), weight loss, and iron deficiency anemia. According to one study, 10 parameters are considered significantly associated with CED or CRC:

  • Rectal bleeding (positive predictive value (PPV): 1%).
  • Altered bowel habits (PPV: 1%).
  • Diarrhea (diarrhea)
  • Increased inflammatory markers
  • Thrombocytosis (abnormal increase in platelets (thrombocytes)).
  • Abdominal pain
  • Low mean cell volume (MCV)
  • Low hemoglobin
  • Increased leukocyte count
  • Increased liver enzymes

Constellations

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