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Inflammatory Bowel Disease Learning Zone

Crohn's Disease

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Crohn's Disease

This section of the Knowledge Centre provides key details about Crohn’s disease as a presentation of IBD, introducing the condition from an epidemiological perspective. We describe the mechanism by which Crohn’s disease may develop and the symptoms that can occur. We then consider symptom management and how unmet needs can contribute to the way in which the condition impacts patients.

Epidemiology

Scroll down this page to learn more about the prevalence and incidence of Crohn’s disease as well as factors that contribute to its development.

Prevalence and incidence

In many countries in Europe, as well as in North America, over 0.3% of the population has been diagnosed with IBD (Ng et al., 2017). These regions are reported to have the highest prevalence of Crohn’s disease, one presentation of IBD, globally. 

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Pathophysiology

Learn about the mechanism by which Crohn’s disease may develop, its clinical presentation, and how unmet needs in symptom management can contribute to the way in which the condition impacts patients.

Pathogenesis

Crohn’s disease is caused by a failure to defend against intestinal microbes, this failure arises from (Matricon et al., 2010):

  • impairment of the epithelial mucosal barrier
  • altered host immune responses.

There are three stages (Matricon et al., 2010):

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Crohn's Disease References

Epidemiology

Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med. 2009;361:2066–78.

Adams SM, Bornemann PH. Ulcerative colitis. Am Fam Physician. 2013;87:699–705.

de Lange KM, Moutsianas L, Lee JC, Lamb CA, Luo Y, Kennedy NA, et al. Genome-wide association study implicates immune activation of multiple integrin genes in inflammatory bowel disease. Nat Genet. 2017;49:256–61.

Feuerstein JD, Cheifetz AS. Crohn Disease: Epidemiology, diagnosis, and management. Mayo Clin Proc. 2017;92:1088–1103.

Gajendran M, Loganathan P, Catinella AP, Hashash JG. A comprehensive review and update on Crohn’s disease. Dis Mon. 2018;64:20–57.

Hedin C, van der Gast CJ, Rogers GB, Cuthbertson L, McCartney S, Stagg AJ, et al. Siblings of patients with Crohn’s disease exhibit a biologically relevant dysbiosis in mucosal microbial metacommunities. Gut. 2016;65:944–53.

Matricon J, Barnich N, Ardid D. Immunopathogenesis of inflammatory bowel disease. Self Nonself. 2010;1:299–309.

Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2017;390:2769–78.

Ott SJ, Musfeldt M, Wenderoth DF, Hampe J, Brant O, Fölsch UR, et al. Reduction in diversity of the colonic mucosa associated bacterial microflora in patients with active inflammatory bowel disease. Gut. 2004;53:685–93.

Theochari NA, Stefanopoulos A, Mylonas KS, Economopoulos KP. Antibiotics exposure and risk of inflammatory bowel disease: a systematic review. Scand J Gastroenterol. 2018;53:1–7.

Wehkamp J, Götz M, Herrlinger K, Steurer W, Stange EF. Inflammatory bowel disease. Dtsch Arztebl Int. 2016;113:72–82.

Zhang YZ, Li YY. Inflammatory bowel disease: pathogenesis. World J Gastroenterol. 2014;20:91–9.

Zhou M, He J, Shen Y, Zhang C, Wang J, Chen Y. New frontiers in genetics, gut microbiota, and immunity: A Rosetta Stone for the pathogenesis of inflammatory bowel disease. Biomed Res Int. 2017;2017;8201672.

Pathophysiology

Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med. 2009;361:2066–78.

Feuerstein JD, Cheifetz AS. Crohn disease: epidemiology, diagnosis and management. Mayo Clin Proc. 207;92:1088–103.

Matricon J, Barnich N, Ardid D. Immunopathogenesis of inflammatory bowel disease. Self Nonself. 2010;1:299–309.

Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Diaz-Rubio M. Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn’s disease and ulcerative colitis. Med Clin (Barc). 2005;125:297–300.

Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014;14:329–42.

Roda, G. Jharap B, Neerja N, Colombel J-F. Loss of response to anti-TNFs: definition, epidemiology, and management. Clin Transl. Gastroenterol. 2016;7: e135

Scaldaferri F, Pecere S, D’Ambrosio S, Bibbò S, Petito V, Lopetuso LR, et al. Emerging mechanisms of action and loss of response to infliximab in IBD: a broader picture. Biochem Pharmacol (Los Angel). 2016;5:206.

Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G. Extraintestinal manifestations of inflammatory bowel disease. Inflamm Bowel Dis. 2015;21:1982–92.

Wehkamp J, Götz M, Herrlinger K, Steurer W, Stange EF. Inflammatory bowel disease. Dtsch Arztebl Int. 2016;113:72–82.

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