Crohn's Disease Test

Crohn's disease is a disease characterized by localized areas of non- specific, granulomatous inflammation of the bowel. Formerly called as ileitis or enteritis, those names were considered a total misnomer, because Crohn's disease is not limited to the small intestine or the large intestine.

It can affect the whole alimentary canal beginning from the mouth and ending in the rectum.

Pathology of Crohn's disease:

The Crohn's disease is a basically an area of inflammation in the bowel. When seen under the microscope, the small intestine looks totally narrowed ulcerated and there is atypical cobble stone appearance of the terminal ileum.

When the disease has affected the large intestine, it looks totally similar to the findings in Ulcerative colitis. The segments affected are quite short, but there is lot of strictures and ulceration. Proctitis alone may be present or may be fistulas also may be present.

When affecting the anus, there are chronic fissures, fistula and ulceration.

When the duodenum is affected, there are ulcerations, thickening of the folds and narrowing of the lumen.

When affecting the stomach, Crohn's disease can resemble Carcinoma or cancer and there is thickening of the antrum of the stomach.

When affecting the mouth, there are buccal ulcers like apthae.

Croh's disease can rarely affect the skin too and it results in ulceration of the perineum, genitalia and abdominal wall.

Clinical Tests:

The diagnosis of Crohn's disease is usually done clinically depending on the symptoms of the disease. The other investigative procedures are done only to assess the extent of the disease.

The extent of the disease is assessed by many tests like Barium Meal, Barium follow through, Barium enema examination etc.

The barium meal and follow through reveals a typical string sign, which is diagnostic of the Crohn's disease. In long standing case there is stricture formation also.

Endoscopy of the stomach and duodenum may be required if the barium studies turn out abnormal.

Sigmoidoscopy and colonoscopy are usually required when the abnormalities extend in to the colon and are capable of finding out or detecting the rectal Crohn's disease when the barium X-ray has failed to detect it.

Biopsies of the rectum and/ or the colon can reveal the ulcers even if they are not visible with the naked eye.

Blood tests show a moderate Anemia (normochromic, normocytic, or hypochromic anemia)

Additionally there may be a raises ESR level, marked leucocytosis, abnormal liver function tests and also hyproteinaemia

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