Synopsis
Diagnose and phenotype Crohn disease across the gastrointestinal tract, distinguish inflammation from structural damage, and choose timely medical, nutritional, endoscopic or surgical care.
- Crohn disease causes discontinuous transmural inflammation anywhere from mouth to anus, most often involving terminal ileum or colon, and may produce strictures, fistulae or abscesses.
- Diagnosis requires compatible clinical, endoscopic, histological and imaging evidence after excluding infection and other mimics; no single blood or stool marker is diagnostic.
- At diagnosis document location, inflammatory versus stricturing or penetrating behaviour, perianal involvement, upper gastrointestinal disease, growth or nutrition and extra-intestinal manifestations.
Key red flags
Peritonism, sepsis, a tender mass or free perforation requires emergency surgical and gastroenterology assessment rather than empiric steroid escalation.
Investigation priorities
Quantify inflammation, complications and treatment readiness.
Management branches
Persistent gastrointestinal, perianal, nutritional or extra-intestinal features suggest Crohn disease.
- Assess symptom pattern, weight, smoking, family history, medicines, infection exposure, perianal symptoms, growth and extra-intestinal features, with examination for complications.
- Obtain blood, faecal inflammatory and microbiological tests, arranging urgent imaging first when obstruction, abscess or perforation is possible.
Key medicines
Systemic corticosteroidTime-limited oral or intravenous induction regimen tapered through the specialist pathway.
Exclusive enteral nutritionComplete formula-based nutrition course supervised by the IBD dietetic team.