All are true regarding Crohn's disease except:
Ref: Harrison s Principles of Internal Medicine, 18th edition, pg 2486 Explanation: Crohn's disease- MC site-terminal ileum with rectal sparing, skip areas + It is transmural, hence more of fistula formation More of systemic symptoms, pain, abdominal mass Toxic megacolon - Perforation Intraabdominal abscess, fallopian tube scarring - infertility Intestinal obstruction, massive hemorrhage, malabsorption, severe perianal disease Cobblestoning on endoscope Response to antibiotics and recurrence after surgery ASCA(anti-saccharomyces cerevisiae antibody)-positive Treatment - Antibiotics, corticosteroids, sulfasalazine, mercaptopurine, azathioprine, methotrexate. cyclosporine, tacrolimus Anti-TNF: Infliximab, adalimumab. certolizumab pegol Anti-integrin: Natalizumab Risk of Ca increases with duration & severity of the disease (See the following table)
Infertility
Risk of Ca
Medical treatment includes antibiotics, probiotics and TNF alpha blockers
ASCA-negative