%0 Journal Article
%T Clinical Diagnostic Clues in Crohn's Disease: A 41-Year Experience
%A C. Quintana
%A L. Galleguillos
%A E. Benavides
%A J. C. Quintana
%A A. Z¨²£¿iga
%A I. Duarte
%A J. Klaassen
%A M. Kolbach
%A R. M. Soto
%A S. Iacobelli
%A M. ¨¢lvarez
%A A. O'Brien
%J ISRN Gastroenterology
%D 2012
%R 10.5402/2012/285475
%X Determining the diagnosis of Crohn¡¯s disease has been highly difficult mainly during the first years of this study carried out at the Pontificia Universidad Catolica (PUC) Clinical Hospital. For instance, it has been frequently confused with Irritable bowel syndrome and sometimes misdiagnosed as ulcerative colitis, infectious colitis or enterocolitis, intestinal lymphoma, or coeliac disease. Consequently, it seems advisable to characterize what the most relevant clinical features are, in order to establish a clear concept of Crohn's disease. This difficulty may still be a problem at other medical centers in developing countries. Thus, sharing this information may contribute to a better understanding of this disease. Based on the clinical experience gained between 1963 and 2004 and reported herein, the main clinical characteristics of the disease are long-lasting day and night abdominal pain, which becomes more intense after eating and diarrhoea, sometimes associated to a mass in the abdomen, anal lesions, and other additional digestive and nondigestive clinical features. Nevertheless, the main aim of this work has been the following: is it possible to make, in an early stage, the diagnosis of Crohn's disease with a high degree of certainty exclusively with clinical data? 1. Introduction The term ¡°regional ileitis¡± was described for the first time by Crohn et al. in 1932 [1, 2] as a new pathologic entity characterized by subacute or chronic necrotizing and cicatrizing inflammation of the terminal portion or portions of the small intestine. Over time, it was clear that the disease was much more complex than that. In fact, in the subsequent years, there were many attempts to characterize this new disease in more descriptive terms like terminal ileitis, regional enteritis, and ¡°ileojejunitis¡±. In the author¡¯s opinion, there is no good current definition of the disease that encompasses all the possible clinical manifestations of this entity. Given the widespread nature of the disease, the symptoms are not limited to the gastrointestinal system, in fact, it may compromise joints, skin, eyes, and other systems. The clinical picture of Crohn¡¯s disease may be confused with other ailments, such as ulcerative colitis, infectious colitis or enterocolitis, irritable bowel disease, colon cancer, coeliac disease, intestinal lymphoma, and rheumatoid arthritis. In 1967, Scadding wrote that, according to general experience, carefully describing the clinical features and pathological data of a disease is fundamental in order to properly identify it and that after a
%U http://www.hindawi.com/journals/isrn.gastroenterology/2012/285475/