Chapter 72
Crohn's Disease: Clinical Manifestations and Management
Gil Y. Melmed,
Stephan R. Targan,
Gil Y. Melmed
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Search for more papers by this authorStephan R. Targan
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Search for more papers by this authorGil Y. Melmed,
Stephan R. Targan,
Gil Y. Melmed
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Search for more papers by this authorStephan R. Targan
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Search for more papers by this authorBook Editor(s):Daniel K. Podolsky MD,
Michael Camilleri MD,
J. Gregory Fitz MD FAASLD,
Anthony N. Kalloo MD,
Fergus Shanahan MD,
Timothy C. Wang MD,
Daniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorFirst published: 27 November 2015
Summary
Crohn's disease can result in a variety of symptoms, and significantly impacts quality of life. The varied manifestations of Crohn's disease may reflect the extensive heterogeneity of genetic susceptibility, clinical expression, anatomic distribution, disease phenotype, natural history, and response to therapy. There are several goals of therapy in the treatment Crohn's disease. For the patient suffering with debilitating symptoms, the primary goal may be relief of symptoms, including bowel frequency, urgency, bleeding, pain, fatigue, or debilitating extra intestinal manifestations. Mechanisms of action, trial data or metaanalyses of clinical trials, and adverse events are presented. Patients should be screened for latent tuberculosis with either a purified protein derivative skin test, or serum interferon release assay, patients with positive results should undergo chest x-ray and potentially initiate antituberculosis therapy prior to starting an anti-TNF drug particularly if any risk factors for prior tuberculosis exposure are present.
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