Enfermedad de Crohn

Abstract

Crohn's disease (CD) is a chronic inflammatory bowel disease (CIBD). Just like ulcerative colitis (UC), etiology of CD likely involves immunological factors acting on any section of the digestive tract, from the mouth to the anus (most often the distal ileum). The incidence and prevalence of CD are rising. Anus and adjacent structures are involved in perianal Crohn's disease. Diagnosis is based on clinical and imaging data, mainly endoscopy (colonoscopy with ileoscopy) and magnetic resonance enterography (or bowel ultrasound carried out by experts), and on anatomopathological findings. Topical corticosteroids (budesonide) are useful for mild-moderate ileal or ileocecal CD (they are delivered in the distal small intestine). In moderate-severe CD systemic corticosteroids are recommended. Immunomodulatory drugs (azathioprine and 6-mercaptopurine and cyclosporine) and biological drugs, such as anti-TNF (infliximab and adalimumab) are used for refractory CD. Recently, new drugs have been included: vedolizumab (anti-integrin molecule) and ustekinumab (interleukin-12 and interleukin-23 inhibitor).