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Related Concept Videos

Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

825
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
825
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

350
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
350
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

377
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
377
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

383
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
383
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

693
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
693
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

557
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
557

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Updated: Dec 22, 2025

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ACR Appropriateness Criteria® Crohn Disease.

, David H Kim1, Kevin J Chang2

  • 1Panel Chair, University of Wisconsin Hospital & Clinics, Madison, Wisconsin.

Journal of the American College of Radiology : JACR
|May 7, 2020
PubMed
Summary

This document provides guidelines on appropriate imaging for Crohn disease diagnosis and monitoring. It rates imaging methods for common clinical situations to aid physician decision-making.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaCrohn diseaseGastrointestinalImagingInflammatory bowel disease

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Area of Science:

  • Gastroenterology
  • Radiology
  • Clinical Guidelines

Background:

  • Crohn disease diagnosis and management require appropriate imaging.
  • Clinical practice varies in selecting imaging modalities for Crohn disease.
  • Evidence-based guidelines are needed to standardize imaging use.

Framework:

  • The American College of Radiology Appropriateness Criteria provide evidence-based guidelines.
  • A multidisciplinary expert panel reviews and updates criteria annually.
  • Methodologies like RAND/UCLA and GRADE are used for rating appropriateness.

Implementation:

  • Guidelines cover initial Crohn disease evaluation, exacerbation assessment, and therapy monitoring.
  • Imaging appropriateness is rated as usually appropriate, may be appropriate, or usually not appropriate.
  • Pediatric cases and specific imaging appropriateness are outside the scope of this document.

Implications:

  • These criteria aim to optimize imaging selection for Crohn disease patients.
  • Standardized imaging use can improve diagnostic accuracy and patient outcomes.
  • Guidelines assist clinicians in making informed decisions for Crohn disease management.