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Chapter 18 - Inflammatory bowel disease

from Section 5 - Gastroenterology

Published online by Cambridge University Press:  05 September 2013

Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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Summary

Introduction

Inflammatory bowel disease is an idiopathic chronic inflammatory condition of the gastrointestinal tract. Crohn’s disease and ulcerative colitis are two different forms of the condition. While the exact etiology is unclear, it is thought to be the result of a complex interplay of genetic, environmental, and microbial factors. Diagnosis is based on clinical, radiological, endoscopic, and histopathologic findings. The distinction between ulcerative colitis and Crohn’s disease has major implications on indications, timing, type, and outcomes of surgical intervention. [1]. However, the distinction remains unclear in a subgroup of 10–15% of cases termed ‘indeterminate colitis’ [2].

Crohn’s disease

The incidence of Crohn’s disease in the USA is around 5.0 cases per 100,000 person-years with a prevalence of about 50 cases per 100,000 persons [3]. There is a bimodal pattern of incidence with the first peak between the 2nd–3rd decades of life, and the second peak in the 6th decade [4]. While any part of the gastrointestinal tract can be involved, the most common site of involvement is the ileo-colonic region (50%), but isolated small bowel (30%) and isolated colonic involvement (20%) can also be seen [5].

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 203 - 207
Publisher: Cambridge University Press
Print publication year: 2013

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