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Crohns sykdom: Symptomer og tegn

Den typiske plagen ved denne sykdommen er tilbakevendende magesmerter. Ofte er det også diaré, med eller uten blod. Andre symptomer kan være følelse av oppblåsthet, kvalme, brekninger, nedsatt matlyst og vekttap. Noen har sykdom hovedsaklig rundt og i endetarmsåpningen. Typisk er da betennelser, byller og sprekkdannelser.

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Hos 10-20 prosent finner man sykdomsforandringer også i andre organer, som for eksempel hud, øyne, ledd og lever. Barn med Crohns sykdom kan bli forsinket i sin vekst og utvikling.

Dette dokumentet er basert på det profesjonelle dokumentet Crohns sykdom . Referanselisten for dette dokumentet vises nedenfor

  1. Wilkins T, Jarvis K, Patel J. Diagnosis and management of Crohn's disease. Am Fam Physician 2011; 84: 1365-75. American Family Physician
  2. Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. Journal of Crohn's and Colitis, Volume 13, Issue 2, February 2019, Pages 144–164K. DOI: 10.1093/ecco-jcc/jjy113 DOI
  3. Buer LCT, Moum BA. Inflammatorisk tarmsykdom – diagnostikk og behandling. Indremedisineren, publisert 10.08.2016. indremedisineren.no
  4. Kalla R, Ventham NT, Satsangi J, et al. Crohn's disease. BMJ. 2014;349:g6670. doi: 10.1136/bmj.g6670 DOI
  5. Suryaprasad AG, Prindiville T. The biology of TNF blockade. Autoimmun Rev 2003; 2: 346-57. PubMed
  6. Halme L, Paavola-Sakki P, Turunen U, et. al. Family and twin studies in inflammatory bowel disease. World J Gastroenterol 2009; 12: 3668-72. PubMed
  7. Podolsky DK. Inflammatory bowel disease. N Engl J Med 2002; 347: 417-29. PubMed
  8. Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med 2009; 361: 2066-78. New England Journal of Medicine
  9. Takeuchi K, Smale S, Premchand P, et al. Prevalence and mechanism of nonsteroidal anti-inflammatory drug-induced clinical relapse in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2006; 4: 196-202. PubMed
  10. Feagan BG. Maintenance therapy for inflammatory bowel disease. Am J Gastroenterol 2003; 98: 6-17. PubMed
  11. Marks DJ, Rahman FZ, Sewell GW, Segal AW. Crohn's disease: an immune deficiency state. Clin Rev Allergy Immunol. 2010 Feb;38(1):20-31. doi: 10.1007/s12016-009-8133-2. DOI
  12. Yamamato T. The clinical value of faecal calprotectin and lactoferrin measurement in postoperative Crohn's disease. United European Gastroenterology Journal 2015; 3: 5-10. doi:10.1177/2050640614558106 DOI
  13. de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743-752. PubMed
  14. Holtman GA, Lisman-van Leeuwen Y, Reitsma JB, et al. Noninvasive tests for inflammatory bowel disease: A meta-analysis. Pediatrics 2016; 137:1-11. doi: 10.1542/peds.2015-2126 DOI
  15. Jahnsen J, Røseth AG, Aadland A. Måling av kalprotektin i feces. Tidsskr Nor Legeforen 2009; 129: 743-5. Tidsskrift for Den norske legeforening
  16. van Rheenen PF, de Vijver EV, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ 2010; 341: c3369. BMJ (DOI)
  17. Yang Z, Clark N, Park KT. Effectiveness and cost-effectiveness of measuring fecal calprotectin in diagnosis of inflammatory bowel disease in adults and children. Clin Gastroenterol Hepatol 2014; 12: 253-62. pmid:23883663 PubMed
  18. Kennedy NA, Jones G-R, Plevris N, et al. Association between level of fecal calprotectin and progression of Crohn's disease. Clinical Gastroenterology and Hepatology Available online 14 February 2019. doi:10.1016/j.cgh.2019.02.017 DOI
  19. Solem CA, Loftus EV Jr, Fletcher JG, et al. Small-bowel imaging in Crohn's disease: a prospective, blinded, 4-way comparison trial. Gastrointest Endosc 2008; 68: 255-66. PubMed
  20. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology 2008; 247: 64-79. Radiology
  21. Wang H, Zhao J, Zhu W, et al. Ultrasound as a diagnostic tool in detecting active Crohn's disease: a meta-analysis of prospective studies. Eur Radiol. 2014 ;24(1):26-33. doi: 10.1007/s00330-013-2973-0. DOI
  22. Potthast S, Rieber A, von Tirpitz C, Wruk D, Adler G, Brambs HJ. Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison. Eur Radiol 2002; 12: 1416 - 22. PubMed
  23. Reese G, Woodfield G, Patel PH. Crohn's disease. BMJ Best Practice, last updated Feb 2018.
  24. Benchimol EI, Seow CH, Steinhart AH, Griffiths AM. Traditional corticosteroids for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2008; 16: CD006792. pmid:18425970 PubMed
  25. Townsend CM, Parker CE, MacDonald JK, et al. Antibiotics for induction and maintenance of remission in Crohn`s disease. Cochrane Database Syst Rev. 2019 Feb 7;2:CD012730. doi: 10.1002/14651858.CD012730.pub2. DOI
  26. Solberg IC, Vatn MH, Høie O, et al. Clinical course in Crohn's disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol. 2007 Dec;5(12):1430-8. PMID: 18054751 PubMed
  27. Steinhart AH, Ewe K, Griffiths AM et al. Corticosteroids for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2008, Issue 4. The Cochrane Library
  28. 5.16 Inflammatorisk tarmsykdom (IBD). Generell veileder i pediatri. Norsk barnelegeforening. Sist oppdatert 2009
  29. Cosnes J, Beaugerie L, Carbonnel F et al. Smoking cessation and the course of Crohn's disease: an intervention study. Gastroenterology 2001;120:1093-9. Gastroenterology
  30. Lambert B, Lemberg DA, Leach ST, Day AS. Longer-term outcomes of nutritional management of Crohn's disease in children. Dig Dis Sci 2012; 57: 2171-7. pmid:22661250 PubMed
  31. Buchanan E, Gaunt WW, Cardigan T et al. The use of exclusive enteral nutrition for induction of remission in children with Crohn's disease demonstrates that disease phenotype does not influence clinical remission. Aliment Pharmacol Ther 2009; 30: 501-7. pmid:19549288 PubMed
  32. Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database of Syst Rev 2007; 1: CD000542. doi:10.1002/14651858.CD000542.pub2 DOI
  33. Akobeng AK, Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database of Syst Rev 2007; 3: CD005984. doi:10.1002/14651858.CD005984.pub2 DOI
  34. Zhan YL, Zhan YA, Dai SX. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clin Nutr. 2017 May 24 . pmid:28587774 PubMed
  35. Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on Therapeutics in Crohn's Disease: medical treatment. European Crohn’s and Colitis Organisation (ECCO), 2019. outlook.office365.com
  36. Jahnsen J. Crohns sykdom. Legemiddelhåndboka, sist oppdatert 15.04.2016. m.legemiddelhandboka.no
  37. Rezaie A, Kuenzig ME, Benchimol EI, Griffiths AM, Otley AR, Steinhart AH, Kaplan GG, Seow CH. Budesonide for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD000296. DOI: 10.1002/14651858.CD000296.pub4 DOI
  38. Kuenzig ME, Rezaie A, Seow CH, et al. Budesonide for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2014 ;8:CD002913. doi: 10.1002/14651858.CD002913.pub3 DOI
  39. Ringerike T, Elvsaas I-KØ, Coll P, et al. TNFα-hemmere ved inflammatorisk tarmsykdom. Rapport fra Kunnskapssenteret - Systematisk oversikt nr. 32 2008.
  40. Ford AC, Peyrin-Biroulet L. Opportunistic infections with anti-tumor necrosis factor-alpha therapy in inflammatory bowel disease: meta-analysis of randomized controlled trials. Am J Gastroenterol 2013 May 7. pmid:23649185. PubMed
  41. Singh S, Garg SK, Pardi DS, et al. Comparative efficacy of pharmacologic interventions in preventing relapse of Crohn's disease after surgery: a systematic review and network meta-analysis. Gastroenterology. 2015 ;148(1):64-76.e2; quiz e14. doi: 10.1053/j.gastro.2014.09.031.
  42. Rutgeerts P, Hiele M, Geboes K, et al. Controlled trial of metronidazole treatment for prevention of Crohn's recurrence after ileal resection. Gastroenterology. 1995 Jun;108(6):1617-21. . pmid:7768364 PubMed
  43. Chande N, Townsend CM, Parker CE, et al. Azathioprine or 6-mercaptopurine for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2016 Oct 26;10:CD000545. Epub ahead of print. pmid: 27783843 PubMed
  44. Conway R, Low C, Coughlan RJ, et al. Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials. BMJ. 2015 Mar 13;350:h1269. doi: 10.1136/bmj.h1269.
  45. Stidham RW, Lee TC, Higgins PD, et al. Systematic review with network meta-analysis: the efficacy of anti-TNF agents for the treatment of Crohn's disease. Aliment Pharmacol Ther. 2014 Jun;39(12):1349-62. doi: 10.1111/apt.12749. DOI
  46. Gionchetti P, Dignass A, Danese S, et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 2: Surgical management and special situations. J Crohns Colitis. 2017 Feb;11(2):135-149. PubMed
  47. Tøttrup A. Laparoskopisk kirurgi ved inflammatorisk tarmsygdom. Ugeskr Læger 2010; 172: 2287. PubMed
  48. Schwartz DA, Wiersema MJ, Dudiak KM et al. A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas. Gastroenterology 2001;121:1064-72. Gastroenterology
  49. Singh S, Ding N S, Mathis K L, et al (2015). Systematic review with meta-analysis: faecal diversion for management of perianal Crohn's disease. Alimentary Pharmacology & Therapeutics, 42: 783–792. doi: 10.1111/apt.13356 DOI
  50. Prefontaine E, Sutherland LR, MacDonald JK, Cepoiu M. Azathioprine or 6-mercaptopurine for maintenance of remission in Crohn's disease. Cochrane Database of Syst Rev 2008; 1: CD000067. doi:10.1002/14651858.CD000067.pub2 DOI
  51. Gisbert JP, Gomollon F, Mate J, Pajares JM. Role of 5-aminosalicylic acid (5-ASA) in treatment of inflammatory bowel disease. A systematic review. Dig Dis Sci 2002; 47: 471 - 88. PubMed
  52. Torres J, Boyapati RK, Kennedy NA, et al. Systematic Review of Effects of Withdrawal of Immunomodulators or Biologic Agents From Patients With Inflammatory Bowel Disease. Gastroenterology. 2015 ;149:1716-30. doi: 10.1053/j.gastro.2015.08.055. PMID:26381892 PubMed
  53. Lofthus EV, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16: 51-60. PubMed
  54. Moum B. Svangerskap og fødsel ved ulcerøs kolitt og Crohns sykdom. Tidsskr Nor Lægeforen 2001; 121: 322-5. Tidsskrift for Den norske legeforening
  55. Nørgård B, Pedersen L, Christensen LA, Sørensen HT. Therapeutic drug use in women with Crohn`s disease and birth outcomes: a danish nationwide cohort study. Am J Gastroenterol 2007; 102: 1406-13. PubMed
  56. Grimstad T, Norheim KB. Utmattelse ved inflammatorisk tarmsykdom. Tidsskr Nor Lægeforen 2016; 136: 1721-24. pmid:27830906 PubMed
  57. Grimstad T, Norheim KB, Isaksen K et al. Fatigue in Newly Diagnosed Inflammatory Bowel Disease. J Crohns Colitis 2015; 9: 725-30. pmid:25994356 PubMed
  58. Hovde O, Kempski-Monstad I, Smastuen MC, et al. Mortality and causes of death in Crohn`s disease: results from 20 years of follow-up in the IBSEN study. Gut. 2013 Jun 6. PMID: 23744613. PubMed
  59. Olén O, Askling J, Sachs MC et al. Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014. Gut 2019. Epub. 317572 pmid:31092591 PubMed
  60. Ewe K, Herfarth C, Malchow H, Jesdinsky HJ. Postoperative recurrence of Crohn's disease in relation to radicality of operation and sulphasalazine prophylaxis: a multicenter trial. Digestion 1989; 42: 224-32. PubMed
  61. Melek J, Sakuraba A. Efficacy and safety of medical therapy for low bone mineral density in patients with inflammatory bowel disease: a meta-analysis and systematic review. Clin Gastroenterol Hepatol 2014; 12: 32-44. doi: 10.1016/j.cgh.2013.08.024 DOI
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