الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Crohn’s disease is a serious chronic condition belonging to inflammatory bowel disease which is characterized by transmural inflammation of the gastrointestinal tract. The transmural inflammation often leads to fibrosis and to obstructive clinical presentations.
Approximately 80 percent of CD patients have small bowel involvement, usually in the distal ileum, with one-third of patients having exclusively ileitis.The etiology and pathogenesis of IBD remains unclear, but it seems to be multifactorial; a triggering environmental factor leads to abnormal immune response in a genetically predisposed person.The diagnosis of IBD is based on laboratory findings such as CBC, acute phase proteins, albumin and other serological markers (ANCA, ASCA) together with stool studies such as occult blood in stools, stool calprotectin, however, Ileocolonoscopy is the best tool for making the diagnosis of IBD as it allows direct visualization of the colon. Multiple tissue biopsies can be taken from both involved and uninvolved sites for histopathologic analysis to confirm the diagnosis. Activity of IBD is measured by using clinical, endoscopic, histological, and radiological activity indices.The clinical manifestations of CD are variable because of the transmural involvement and the variability of the extent of disease. Fatigue, prolonged diarrhea, with or without gross bleeding, abdominal pain, weight loss, and fever are the hallmarks of Crohn’s disease.
CD is associated with both local, extraintestinal complications (peripheral arthritis is the most common) and with complications related to malabsorption which can lead to malnutrition, osteomalacia, osteoporosis and hypocalcemia, which may cause tetany.
Malnutrition is a common feature of CD. It is caused by a combination of factors; Reduced nutrient intake, malabsorption, maldigestion, increased energy expenditure, and gastrointestinal protein loss.Consequences of malnutrition include; Growth failure, Weight loss, Hypoalbuminemia but the most important is metabolic bone disease (osteopenia, osteoporosis, osteomalacia and fractures).Metabolic bone disease is caused by many factors; including disease-related inflammatory activity, corticosteroid therapy, hypogonadism, and Vitamin D and calcium insufficiency.