Recent advances in clinical practice: a systematic review of isolated colonic Crohn's disease: the third IBD?

Gut. 2017 Feb;66(2):362-381. doi: 10.1136/gutjnl-2016-312673. Epub 2016 Oct 6.

Abstract

The genetics of isolated colonic Crohn's disease place it approximately midway between Crohn's disease with small intestinal involvement and UC, making a case for considering it as a separate condition. We have therefore systematically reviewed its epidemiology, pathophysiology and treatment. Key findings include a higher incidence in females (65%) and older average age at presentation than Crohn's disease at other sites, a mucosa-associated microbiota between that found in ileal Crohn's disease and UC, no response to mesalazine, but possibly better response to antitumour necrosis factor than Crohn's disease at other sites. Diagnostic distinction from UC is often difficult and also needs to exclude other conditions including ischaemic colitis, segmental colitis associated with diverticular disease and tuberculosis. Future studies, particularly clinical trials, but also historical cohorts, should assess isolated colonic Crohn's disease separately.

Keywords: CROHN'S COLITIS.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adalimumab / therapeutic use
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Colitis / diagnosis
  • Colitis / epidemiology*
  • Colitis / genetics
  • Colitis / therapy*
  • Colitis, Ulcerative / diagnosis
  • Colon / microbiology
  • Crohn Disease / diagnosis
  • Crohn Disease / epidemiology*
  • Crohn Disease / genetics
  • Crohn Disease / therapy*
  • Diagnosis, Differential
  • Gastrointestinal Agents / therapeutic use
  • Gastrointestinal Microbiome
  • Humans
  • Incidence
  • Infliximab / therapeutic use
  • Mesalamine / therapeutic use
  • Risk Factors
  • Sex Factors

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Gastrointestinal Agents
  • Mesalamine
  • Infliximab
  • Adalimumab