Skip to main content
SpringerLink
Log in

Anorectal and Colonic Crohn’s Disease

  • Chapter
Anorectal and Colonic Diseases

  • 1712 Accesses

Abstract

Crohn’s disease most frequently presents in late adolescence or early adulthood and is equally distributed between the genders [1]. Symptoms at presentation vary depending on the location, behaviour and severity of disease, as well as extraintestinal manifestations and medication. The aim is to establish the diagnosis and distribution of disease using appropriate techniques, since this influences the choice of therapy. Originally, Dr. Burrill Crohn and colleagues described regional ileitis as a chronic inflammatory disease restricted to the terminal ileum in association with intestinal stenoses or fistulae, but not crossing the ileocaecal valve [2]. Although Crohn subsequently recognised colonic disease in conjunction with ileitis [3], it was Basil Morson and Lyn Lockhart-Mummery who put colonic Crohn’s disease on the diagnostic map [4, 5].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Stange EF, Travis SP, Vermeire S, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. Gut 2006;55:i1–i15

    Article  PubMed  Google Scholar 

  2. Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis. J Am Med Assoc 1932;99:1323–1329

    Google Scholar 

  3. Crohn BB, Rosenak BD. A combined form of ileitis and colitis. J Am Med Assoc 1936;106:1–7

    Google Scholar 

  4. Morson BC, Lockhart-Mummery HE. Crohn’s disease of the colon. Gastroenterologia 1959;92:168–173

    Article  CAS  PubMed  Google Scholar 

  5. Lockhart-Mummery HE, Morson BC. Crohn’s disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut 1960;1:87–105

    Article  CAS  PubMed  Google Scholar 

  6. Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol 2005;19:5A–36A

    Google Scholar 

  7. Sands BE. From symptom to diagnosis: clinical distinctions among various forms of intestinal inflammation. Gastroenterology 2004;126:1518–1532

    Article  PubMed  Google Scholar 

  8. Lennard-Jones JE, Shivananda S, the EC-IBD Study Group. Clinical uniformity of inflammatory bowel disease at presentation and during the first year of disease in the north and south of Europe. Eur J Gastroenterol Hepatol 1997;9:353–359

    CAS  PubMed  Google Scholar 

  9. Caprilli R, Gassull MA, Escher JC, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: special situations. Gut 2006;55:i36–i58

    Article  PubMed  Google Scholar 

  10. Hellers G, Bergstrand O, Ewerth S, et al. Occurrence and outcome after primary treatment of anal fistulae in Crohn’s disease. Gut 1980;21:525–527

    Article  CAS  PubMed  Google Scholar 

  11. Schwartz DA, Loftus EV Jr, Tremaine WJ, et al. The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology 2002;122:875–880

    Article  PubMed  Google Scholar 

  12. Pera A, Bellando P, Caldera D, et al. Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score. Gastroenterology 1987;92:181–185

    CAS  PubMed  Google Scholar 

  13. Nahon S, Bouhnik Y, Lavergne-Slove A, et al. Colonoscopy accurately predicts the anatomical severity of colonic Crohn’s disease attacks: correlation with findings from colectomy specimens. Am J Gastroenterol 2002;97:3102–3107

    Article  PubMed  Google Scholar 

  14. Ota Y, Matsui T, Ono H, et al. Value of virtual computed tomographic colonography for Crohn’s colitis: comparison with endoscopy and barium enema. Abdom Imaging 2003;28:778–783

    Article  CAS  PubMed  Google Scholar 

  15. Geboes K. Pathology of inflammatory bowel diseases (IBD): variability with time and treatment. Colorectal disease 2001;3:2–12

    Article  CAS  PubMed  Google Scholar 

  16. Low RN, Francis IR, Politoske D, et al. Crohn’s disease evaluation: comparison of contrast-enhanced MR imaging and single-phase helical CT scanning. J Magn Reson Imaging 2000;11:127–135

    Article  CAS  PubMed  Google Scholar 

  17. Haggett PJ, Moore NR, Shearman JD, et al. Pelvic and perineal complications of Crohn’s disease: assessment using magnetic resonance imaging. Gut 1995;36:407–410

    Article  CAS  PubMed  Google Scholar 

  18. Price AB. Overlap in the spectrum of non-specific inflammatory bowel disease – ‘colitis indeterminate’. J Clin Pathol 1978;31:567–577

    Article  CAS  PubMed  Google Scholar 

  19. Bell SJ, Williams AB, Wiesel P, et al. The clinical course of fistulating Crohn’s disease. Aliment Pharmacol Ther 2003;17:1145–1151

    Article  CAS  PubMed  Google Scholar 

  20. Parks AG, Gordon PH, Hardcastle J. A classification of fistula-in-ano. Br J Surg 1976;63:1–12

    Article  CAS  PubMed  Google Scholar 

  21. Sandborn WJ, Fazio VW, Feagan BG, et al. AGA technical review on perianal Crohn’s disease. Gastroenterology 2003;125:1508–1530

    Article  PubMed  Google Scholar 

  22. Travis SPL, Stange EF, Lémann M, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut 2006;55:i16–i35

    Article  PubMed  Google Scholar 

  23. Farmer RG, Whelan G, Fazio VW. Long-term follow-up of patients with Crohn’s disease. Relationship between the clinical pattern and prognosis. Gastroenterology 1985;88:1818–1825

    CAS  PubMed  Google Scholar 

  24. Vermeire S, Louis E, Carbonez A, et al. Demographic and clinical parameters influencing the short-term outcome of anti-tumor necrosis factor (infliximab) treatment in Crohn’s disease. Am J Gastro 2002;97:2357–2363

    Article  CAS  Google Scholar 

  25. Sands BE, Anderson FH, Bernstein CN, et al. Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med 2004;350:876–885

    Article  CAS  PubMed  Google Scholar 

  26. Lindsey I, Humphreys CM, George BD, et al. The role of anal ultrasound in the management of anal fistulas. Colorectal Dis 2002;4:118–122

    Article  PubMed  Google Scholar 

  27. Travis SPL. Advances in therapeutic approaches to ulcerative colitis and Crohn’s disease. Curr Gastroenterol Rep 2005;7:475–484

    Article  PubMed  Google Scholar 

  28. Sands BE, Blank MA, Patel K, et al. Long-term treatment of rectovaginal fistulas in Crohn’s disease: response to infliximab in the ACCENT II Study. Clin Gastroenterol Hepatol 2004;2:912–920

    Article  CAS  PubMed  Google Scholar 

  29. Sahmoud T, Hoctin-Boes G, Modigliani R, et al. Identifying patients with a high risk of relapse in quiescent Crohn’s disease. The GETAID Group. Gut 1995;37:811–818

    Article  CAS  PubMed  Google Scholar 

  30. Cosnes J, Carbonnel F, Beaugerie L, et al. Effects of cigarette smoking on the long-term course of Crohn’s disease. Gastroenterology 1996;110:424–431

    Article  CAS  PubMed  Google Scholar 

  31. Akobeng AK, Gardener E. Oral 5-aminosalicylic acid for maintenance of medically induced remission in Crohn’s disease. Cochrane Database Syst Rev 2005;(1):CD003715

    Google Scholar 

  32. Lémann M, Mary JY, Duclos B, et al. Infliximab plus azathioprine for steroid-dependent Crohn’s disease patients: a randomized placebo-controlled trial. Gastroenterology 2006;130:1054–1061

    Article  PubMed  Google Scholar 

  33. Travis SPL. Infliximab and azathioprine: bridge or parachute? Gastroenterology 2006;130:1354–1357

    Article  CAS  PubMed  Google Scholar 

  34. Siegel CA, Sands BE. Risk factors for colorectal cancer in Crohn’s colitis: a case-control study. Inflamm Bowel Dis 2006;12:491–496

    Article  PubMed  Google Scholar 

  35. Levine D, Reid B. Endoscopic biopsy technique for acquiring larger mucosal samples. Gastrointest Endosc 1991;37:332–337

    Article  CAS  PubMed  Google Scholar 

  36. Sjodahl RI, Myrelid P, Soderholm JD. Anal and rectal cancer in Crohn’s disease. Colorectal Dis 2003;5:490–495

    Article  CAS  PubMed  Google Scholar 

  37. Belaiche J, Louis E, D’Haens G, et al. Acute lower gastrointestinal bleeding in Crohn’s disease: characteristics of a unique series of 34 patients. Belgian IBD Research Group. Am J Gastroenterol 1999;94:2177–2181

    Article  CAS  PubMed  Google Scholar 

  38. Mortensen NJ, Ritchie JK, Hawley PR, et al. Surgery for acute Crohn’s colitis: results and long term follow up. Br J Surg 1984;71:783–784

    Article  CAS  PubMed  Google Scholar 

  39. Edwards CM, George BD, Jewell DP, et al. Role of a defunctioning stoma in the management of large bowel Crohn’s disease. Br J Surg 2000;87:1063–1066

    Article  CAS  PubMed  Google Scholar 

  40. Tekkis PP, Purkayastha S, Lanitis S, et al. A comparison of segmental vs subtotal/total colectomy for colonic Crohn’s disease: a meta analysis. Colorectal Dis 2006; 2:82–90

    Article  Google Scholar 

  41. Roe AM, Mortensen NJ. Perineal reconstruction with rectus abdominus flap after resection of anal carcinoma in Crohn’s disease. J R Soc Med 1989;82:369–370

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Neil Mortensen

  2. Gastroenterology Unit, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Simon Travis

Authors
  1. Neil Mortensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simon Travis
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland

    Jean-Claude R. Givel

  2. Department of Colorectal Surgery, The John Radcliffe Hospital, OX3 9DU, Headington, Oxford, UK

    Neil Mortensen

  3. Responsable de l’Unité de Proctologie, Hôpital Cantonal Universitaire de Genève, Rue Gabrielle Perret-Gentil 4, 1211, Genève 14, Switzerland

    Bruno Roche

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Mortensen, N., Travis, S. (2010). Anorectal and Colonic Crohn’s Disease. In: Givel, JC., Mortensen, N., Roche, B. (eds) Anorectal and Colonic Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69419-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-69419-9_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69418-2

  • Online ISBN: 978-3-540-69419-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation