Diagnostic Criteria for Crohn’s Disease

Abstract

There is no gold standard for diagnosing Crohn’s disease (CD) yet, and the diagnosis is based on the comprehensive evaluation of clinical, endoscopic, histological, surgical, imaging, and laboratory findings. The symptoms of CD vary. However, CD should be suspected if symptoms such as abdominal pain, diarrhea, and weight loss appear for several weeks or longer, or in patients with perianal disorders, and additional evaluation should be considered. Primarily, ileocolonoscopy and biopsy are recommended for the diagnosis of CD. The endoscopic findings of CD include longitudinal ulcers, cobblestone-like appearance, discontinuous multiple aphthous ulceration, asymmetrical inflammation, and skipped lesions. In addition, fissures, fistulas, and strictures may be found. The histopathologic findings of CD include non-caseating granulomas and other chronic enteritis findings. For patients with clinically suspected small-bowel CD with no specific findings in colonoscopy or imaging studies, capsule endoscopy is recommended, and device-assisted enteroscopy may be considered if histologic confirmation or endoscopic therapies, such as dilation of the stricture site, withdrawal of a retained capsule, and hemostasis, are required.