• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.169-173
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• 2017

Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.

• 대한한방소아과학회지
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• 제16권2호
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• pp.51-58
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• 2002

Crohn's disease is an indolent, chronic inflammatory bowel disease capable of involving the entire alimentary tract. The exact etiology and pathogenesis remain unknown despite a long and intensive research, but the finding of various abnormalities of the immune response in patients with Crohn's disease has led to the concepts that immune mechanism is involved in the pathogenesis of this disease. Recently, we have experienced a case of Crohn's disease. So the purpose of this study is to examine the efficacy of Oriental medicine for Crohn's disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권3호
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• pp.149-159
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• 2015

Crohn's disease is a chronic idiopathic inflammatory disease of the intestines characterized by frequent relapse and remission. It often develops in children and adolescents, who are vulnerable to repeated exposure to ionizing radiations. Magnetic resonance enterography (MRE) is an increasingly important radiation-free imaging modality that is used to evaluate pediatric patients with Crohn's disease. MRE can evaluate extraluminal and extraintestinal abnormalities as well as the status of the bowel wall. In addition, MRE has an advantage in the evaluation of the small bowel involvement. MRE can be used for the initial diagnosis of Crohn's disease, and can aid in the assessment of disease activity and complications such as penetrating and fibrostenotic diseases. The aims of this article are to review the MRE technique for obtaining diagnostic and high-quality images and to discuss interpretations of imaging findings in patients with Crohn's disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.19-22
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• 2012

Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract and characterized by relapsing and remitting episodes, with progression over time to complications of stricture, fistulas, or abscesses. The etiology is unknown, although the common opinion is that the disease arises from a disordered immune response to the gut contents in genetically predisposed individuals. Infliximab is a mouse-human chimeric antibody against tumor necrosis factor ${\alpha}$, and has proven to be effective in active Crohn's disease for both induction and maintenance therapy. Despite the growing experience with infliximab in Crohn's disease, optimal treatment strategies still need to be determined. The purpose of this review is to summarize the current knowledge on the use of infliximab in Crohn's disease and to discuss the yet-unsolved issues.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.830-833
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• 2010

Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

• 대한약침학회지
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• 제26권3호
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• pp.211-226
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• 2023

Objectives: Crohn's disease is a chronic gastrointestinal disease that belongs to inflammatory bowel disease. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture for Crohn's disease. Methods: We searched 12 databases from the date of the establishment of each database up to May, 2023 for relevant RCTs. The risk of bias of each study was assessed independently by three reviewers. The level of evidence of meta-analysis was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Results: A total of 12 studies were included. The effective rate (odds ratio [OR] 3.23, 95% confidence interval [CI] 1.43, 7.30) for mild to moderate Crohn's disease patients showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. CDAI change (mean difference [MD] -74.15, 95% CI -93.28, -55.01) for mild to moderate Crohn's disease showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. Conclusion: Although acupuncture with moxibustion showed significant effects compared to sham-acupuncture with sham-moxibustion, the effect of acupuncture alone is inconclusive. Moreover, only the effect of acupuncture treatment on mild to moderate Crohn's disease patients was derived as a remarkable result. To confirm the effectiveness of acupuncture treatment for Crohn's disease, studies using only acupuncture for intervention or more RCTs targeting various Crohn's disease patients according to the CDAI are required.

• 기본간호학회지
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• 제17권4호
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• pp.557-565
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• 2010

Purpose: This study was conducted to investigate the factors influencing the quality of life among the patients with Crohn's disease. Method: Data were collected from 97 Crohn's disease patients between September 17 and October 20 in 2009. The collected data were analyzed by SPSS program. Results: There were significant differences in the participants' quality of life depending on their age, economic status, pain, diarrhea, weight loss, Crohn's disease activity index (CDAI), and use of medications such as antidiarrhotica, steroid, and analgesics. The results also showed the correlations between the participants' qualities of life and thier pain, CDAI, anxiety, depression, perceived health condition, and of body image. Finally, the factors affecting the quality of life in patients with Crohn's disease included anxiety, perceived health state, pain, and CDAI. The explanatory power of these factors was 79.5%. Conclusion: The results imply that controlling the patients' pain and providing emotional support for anxiety reduction are crucial. In a similar vein, tailored nursing interventions considering individual patients' conditions are believed to help the patients positively perceive their disease. A future research, can conduct further investigations of these factors from more diverse perspectives, which is expected to promote more effective nursing strategies for Crohn's disease patients.

• Journal of Oral Medicine and Pain
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• 제42권1호
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• pp.25-27
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• 2017

Crohn's disease is an inflammatory bowel disease which affects whole gastrointestinal tract from mouth to anus. Crohn's disease may present both oral manifestation and gastrointestinal symptom-abdominal pain, diarrhea, weight loss, anorexia, fever, and growth failure. The prevalence rate of oral manifestation is approximately between 0.5% and 20%. The oral lesion could be the first sign of Crohn's disease. We present a case of Crohn's disease in a patient who did not show typical oral manifestations but had nonspecific aphthous like ulceration and burning sensation for many years. Through this case, we suggest approaches for the diagnosis and treatment of the oral lesion of Crohn's disease.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제7권11호
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• pp.443-450
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• 2018

최근 국내에서도 발병률이 증가하고 있는 크론병은 위장관의 모든 부위에서 발병할 수 있으며, 나타나는 증상도 다양하다. 특히, 크론병은 다른 궤양성 대장질환과 유사한 증상을 보일 수 있어 크론병을 진단하는데 어려움을 겪는다. 이로 인해 크론병 진단 가이드라인이나 크론병과 유사한 증상을 보이는 질병의 감별에 대한 연구가 진행되고 있다. 하지만 기존 연구에는 크론병에 대한 순차적인 진단 과정이 기술되지 않아, 크론병 진단을 위한 검사 과정에서 과다한 검사가 시행될 우려가 있다. 따라서 본 논문에서는 크론병과 유사한 증상을 보이는 궤양성 대장 질환을 감별하기 위해 중복성 및 순차적인 연관성, 질병의 진단 조건을 분석하여 감별 규칙으로 정의하고, 이를 기반으로 크론병 진단 프로세스를 제안한다. 또한, 제안하는 프로세스 중심의 연관성을 온톨로지로 정의함으로써 크론병과 유사한 증상을 보이는 대장 질환을 감별하고, 효과적으로 크론병을 진단하는데 도움을 줄 수 있다. 제안한 온톨로지를 5개의 사례에 적용해 본 결과, 모두 올바른 진단을 내렸으며 1개의 사례에서 더 적은 수의 검사로 진단할 수 있었다.

• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.139-144
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• 2008

Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.