Currently, information on the natural history of Crohn’s disease is limited.
The September issue of the Journal of Clinical Gastroenterolgy presents the findings of Dr Hugh Freeman, a clinician who has been treating patients with Crohn’s disease for over 2 decades.
150 patients with long-standing Crohn's disease, including 81 females and 69 males, were seen continuously by Dr Freeman for at least 20 years.
Phenotypic clinical characteristics defined by the 1998 Vienna classification for Crohn's disease were used to identify patterns in the natural history of the condition.
These characteristics included age of patients at diagnosis, diseases localisation and behaviour.
Most patients were initially diagnosed before the age of 40 years (94%) and had ileocolonic disease (65.3%).
| Disease localized to ileum alone was most often complicated by stricture formation, whereas ileocolonic disease was usually complicated by a penetrating complication.|
|Journal of Clinical Gastroenterology|
At diagnosis, both females and males were most often classified with inflammatory disease, that was non-stenosing and non-penetrating.
Hovever, over the course of the disease, particularly in the first decade, Dr Freeman reports a decreased number of patients with inflammatory disease and an increased number with penetrating crohn’s disease.
A number of patients with stenosing crohn’s at diagnosis progressed to penetrating crohn’s.
Dr Freeman concludes. “This shift in disease behavior indicates that Crohn's is a dynamic process that phenotypically evolves and progresses with time.”