Crohn's Disease
Intro
Crohn's disease is a disorder of unknown etiology and complicated pathogenesis. It is defined as an inflammatory disease that most commonly attacks the terminal end (distal portion) of the small intestine (ileum) and the colon, but possibly the entire GI tract. The disease occurs at a young age, and lasts chronically, with remissions and relapses of signs and symptoms.
Signs and Symptoms
* indicates most common S&S
Referral Pattern
Since Crohn's Disease involves the terminal ileum, pain is found in the periumbilical region and may be referred to the corresponding segment of the low back. Ileum pain is intermittent and is felt in the lower right quadrant with possible associated iliospoas abscess causing hip pain. The individual may experience relief from discomfort after passing stool or flatus. The individual can have acute signs and symptoms, but Crohn's disease is usually slow and non-progressive. The individual may present with mild intermittent symptoms months before it is actually diagnosed. Crohn's Disease may cause extra-intestinal complications in the joints, skin, eyes, and other body parts as well.
Diagnostic Strategies
Crohn's disease is a disorder of unknown etiology and complicated pathogenesis. It is defined as an inflammatory disease that most commonly attacks the terminal end (distal portion) of the small intestine (ileum) and the colon, but possibly the entire GI tract. The disease occurs at a young age, and lasts chronically, with remissions and relapses of signs and symptoms.
Signs and Symptoms
- Diarrhea*
- Fever*
- Abdominal pain*
- Decreased appetite, nausea, and weight loss*
- Rectal bleeding
- Night sweats
- Skin lesions
- Arthritis
- Uveitis (inflammation of the eye)
- Migratory arthralgias
- Hip pain (iliospoas abscess)
* indicates most common S&S
Referral Pattern
Since Crohn's Disease involves the terminal ileum, pain is found in the periumbilical region and may be referred to the corresponding segment of the low back. Ileum pain is intermittent and is felt in the lower right quadrant with possible associated iliospoas abscess causing hip pain. The individual may experience relief from discomfort after passing stool or flatus. The individual can have acute signs and symptoms, but Crohn's disease is usually slow and non-progressive. The individual may present with mild intermittent symptoms months before it is actually diagnosed. Crohn's Disease may cause extra-intestinal complications in the joints, skin, eyes, and other body parts as well.
Diagnostic Strategies
- Blood tests to check for inflammatory activity, malnutrition, and iron deficiency anemia
- Imaging to check for morphological findings that are characteristic of Crohn's Disease
- Stool culture and other tests to rule out infectious enterocolitis, if necessary
- Contrast radiography
- Barium enema radiography
- Apply tests to check for intestinal complications according to symptoms
References:
Goodman, MBA, PT, C. C., & Snyder, MN, RN, OCN, T. E. (2007). Differential Diagnosis PHYSICAL THERAPISTS Screening for Referral (4thth ed.). St. Louis, MO: Saunders Elsevier
Ueno, F., Matsui, T., Matsumoto, T., Watanabe, M., Hibi, T., & Matsuoka, K. (2013, January). Evidence-based clinical practice guidelines for Crohn’s disease, integrated with formal consensus of experts in Japan. J Gastroenterol, 48(1), 31-72.
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