Crohn's disease: common findings in active disease were diarrhoea, weight loss and abdominal pain.

Clinical bottom line (level 4)

  1. Crohn's disease affected both small and large bowel in over half of all patients.
  2. The commonest features of active disease were diarrhoea, weight loss, abdominal pain and fever.
Mekhjian et al: Gastroenterology 1979; 77 (4): 898-906
Expires May 2003

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: 14 acute hospitals, USA

1084 patients (aged mean 33 years, 51% female) active Crohn's disease (diagnosed on histology or radiography; CDAI score > 150)



Outcomes studied:
  • disease location: small bowel only
  • colon only
  • colon and small bowel
  • clinical finding: diarrhoea
  • weight loss (>2.5 kg)
  • abdominal pain
  • fever
  • lower GI bleeding
  • anal fistula, abscess
  • other intestinal fistula
  • enterocutaneous fistula
  • arthritis or spondylitis
  • iritis
  • hepatitis, pericholangitis
  • erythema nodosum/ pyoderma gangrenosum

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    disease location: small bowel only ? 329/1084 30%
    (28% to 33%)
    colon only ? 156/1084 14%
    (12% to 17%)
    colon and small bowel ? 599/1084 55%
    (52% to 58%)
    clinical finding: diarrhoea ? / 92%
    (% to %)
    weight loss (>2.5 kg) ? / 85%
    (% to %)
    abdominal pain ? / 95%
    (% to %)
    fever ? / 56%
    (% to %)
    lower GI bleeding ? / 41%
    (% to %)
    anal fistula, abscess ? / 36%
    (% to %)
    other intestinal fistula ? / 16%
    (% to %)
    enterocutaneous fistula ? / 5%
    (% to %)
    arthritis or spondylitis ? / 19%
    (% to %)
    iritis ? / 4%
    (% to %)
    hepatitis, pericholangitis ? / 4%
    (% to %)
    erythema nodosum/ pyoderma gangrenosum ? / 5%
    (% to %)

    Citation

    1. Mekhjian HS, Switz DM, Melnyk CS, et al: Clinical features and natural history of Crohn's disease. Gastroenterology 1979; 77 (4): 898-906
    Search Terms: reference from review article
    Contributor: Chris Ball and Clare Wotton, May 2003
    Reviewer:

    Clinical Question.
    Patient Crohn's disease
    Intervention or Exposure prevalence
    Outcome location, features