European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis

Abstract

Crohn’s disease (CD) is a lifelong disease arising from an interaction between genetic and environmental factors, but seen predominantly in the developed countries of the world. The precise aetiology is unknown and therefore a causal treatment is not yet available. Within Europe there is a distinct north-south gradient, but the incidence seems to have increased in southern countries in recent years.1 Many patients live with a considerable symptom burden despite medical treatment in the hope that the aetiology of the disease will shortly be discovered and curative therapies emerge. Although this seems likely to happen at some time in the next decade, clinicians have to advise patients on the basis of information available today rather than an unknown future. Despite a multiplicity of randomised trials there will always be many questions that can only be answered by the exercise of judgement and opinion. This leads to differences in practice between clinicians, which may be brought into sharp relief by differences in emphasis between countries.