Research Finds Predictors of Disease Behavior Change in Crohn’s Disease

It has been shown in clinic-based cohorts that there can be a significant change in disease behavior over time, whereas disease location remains relatively stable

It has been shown in clinic-based cohorts that there can be a significant change in disease behavior over time, whereas disease location remains relatively stable as per the Vienna classification system.

Clinical and environmental factors as well as medical therapy might be relevant in predicting disease behavior change in patients with CD. In previous studies, early age at diagnosis, disease location, perianal disease and, in some studies, smoking were associated with the presence of complicated disease and surgery.

Crohn’s Disease
Crohn’s disease or regional enteritis is an inflammatory bowel disease that involves the small intestine and causes abdominal pain, diarrhea and bleeding.

The combined effect of markers of disease phenotype (e.g., age, gender, location, perianal diesease) and medical therapy (steroid use, early immunosupression) on the probability of disease behavior change were, however, not studied thus far in the published literature.

A research article to be published on July 28, 2009 in the World Journal of Gastroenterology addresses this question. Members of the Hungarian IBD Study Group led by Dr Peter Laszlo Lakatos from the Semmelweis University investigated 340 well-characterized, unrelated, consecutive CD patients (M/F: 155/185, duration: 9.4 ± 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification,extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits.

They found that perianal disease, current smoking, prior steroid use, early azathioprine or azathioprine/biological therapy are predictors of disease behavior change in CD patients.

Ulcerative Colitis
Ulcerative colitis is characterized by bouts of diarrhea, bleeding per rectum and pain, which remits and relapses. Fulminant colitis is a possibility, which may require colectomy.

The new data with easily applicable clinical information as presented in the article may assist clinicians in practical decision-making or in choosing the treatment strategy for their CD patients.

An Explanation for Crohn's Disease - Maybe
A mutation in the NOD2 gene is present in 25% of patients with Crohn's disease, but it is not precisely known how this mutation influences the disease.

Source-Eurekalert
RAS

Smoking Influences Crohn's Disease
A new study in The American Journal of Gastroenterology suggests that smoking may determine which part of the intestinal tract is attacked in those who suffer from Crohn’s disease.