Introductory remarks on Crohn's disease. Observations from the OMGE studies

The first report of Crohn's disease (Cd) or regional enterocolitis may be that of Combe and Saunders from 1806. The first nicely described series of cases with this disease was given by Crohn, Ginzburg and Oppenheimer in 1932. Since then numerous studies have given details of Cd from centres and defined areas. The OMGE-studies give information about the presentation, severity and treatment of Cd and ulcerative colitis (uc) around the world. In a total series of 987 cases with Cd and 1,670 with uc, it was found that the accuracy of the clinical diagnosis was 86 per cent and after adding specialized examinations as endoscopy with biopsy etc. the accuracy became 93 per cent. The ratio between uc and Cd varied from 10:1 to 1:4, and the best indices for Cd were in order pulse rate, temperature, systemic complications, severe pain, distention and bowel habits. In about 60 p. cent of Cd drugs were used, salazopyrine was given to 35 per cent and systemic steroids to 23.5 per cent of cases. 25 per cent of Cd came to surgery, the early postoperative mortality being 3.8 per cent. 17 per cent of patients with Cd were at the first treatment symptomfree compared to 30 per cent of those with uc. The overall mortality was 1 per cent. A four years follow-up of 866 patients, showed that the diagnosis had changed in only 0.7 per cent from Cd to uc, and in 2.6 per cent from uc to Cd.(ABSTRACT TRUNCATED AT 250 WORDS)