%0 Journal Article
%T Musings on genome medicine: Crohn's disease
%A David G Nathan
%A Stuart H Orkin
%J Genome Medicine
%D 2009
%I BioMed Central
%R 10.1186/gm103
%X Approximately a half million children and adults deal with Crohn's disease (CD) in North America for a prevalence of about 170/100,000 [1], while the prevalence averages about 40/100,000 in Europe [2]. Curiously, the prevalence and incidence are higher in the northern parts of Europe and North America than in the southern parts [2].There are well-established risk factors for CD, including being Ashkenazi Jewish, having a first-degree relative with CD, stress and smoking. Although there is female predominance in Canada, Europe and the United States report a small excess of males [2]. The incidence is much higher in developed than in less developed countries, leading to an hypothesis that improved hygiene may influence the onset of the disease. This concept has led to interesting experiments in which helminths are deliberately fed to patients with CD [3,4].Crohn's disease was described first in 1904 by a Polish surgeon, Antoni Lesniowski [5], and more thoroughly by Burrill Crohn and his colleagues at the Mount Sinai Hospital of New York in 1932 [6]. The clinical presentation of CD and its pathology differs from that of ulcerative colitis (UC), in that the former may be far more widespread throughout the gastrointestinal tract, may extend deeply into the intestinal wall, is associated with granuloma formation and is characterized by skip areas. Hence the original and now unused name 'regional enteritis'. It tends to localize in the terminal ileum, where it may narrow the bowel and cause malabsorption of vitamin B12 and intestinal obstruction. The latter site is so frequently involved that the disease is also called terminal ileitis. The age of onset is usually in the teens or twenties and another peak is said to occur in the fifties to seventies, but CD may occur (or be correctly diagnosed) at any age. The major symptoms include abdominal pain, diarrhea (occasionally bloody), constipation, vomiting, and weight loss. CD is often associated with various skin rashes (incl
%U http://genomemedicine.com/content/1/11/103