Challenges in Patient Management

Crohn’s disease is a chronic, diffuse disease which leads to a number of clinical challenges in diagnosing and monitoring disease activity:

  • Diagnosis can take up to multiple years([FOOTNOTE= Dubcenco E, Jeejeebhoy K, Petroniene R, Tang S, Zalev A, Gardiner G, et al. Capsule endoscopy findings in patients with established and suspected small-bowel Crohn’s disease. Gastrointest Endosc. 2005;62(4):538-44.],[ANCHOR=],[LINK=])
  • CT enterography and small bowel follow through expose patients to radiation
  • Regardless of whether they have surgery, 28-45% of patients have a clinical recurrence at 5 years and 36-61% at 10 years([FOOTNOTE=Buisson A, Chevaux JB, Allen PB, Bommelaer G, Peyrin-Biroulet L. Review article: the natural history of postoperative Crohn’s disease recurrence. Aliment Pharmacol Ther. 2012;35:625-33.],[ANCHOR=],[LINK=])
  • 4. Reinink AR, Lee TC, Higgins PD. Endoscopic mucosal healing predicts favorable clinical outcomes in inflammatory bowel disease: a meta-analysis. Inflamm Bowel Dis. 2016 Aug;22(8):1859-69.