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RESEARCH PRODUCT

Course of Crohn’s Disease

subject

description

Crohn’s disease (CD) is an inflammatory bowel disease with a chronic course and it is characterized by different events within time, which are in relation to the heterogeneity of the disease. The main events during the course of disease are activity, remission, relapse, obstruction, fistulizing, surgical resection, cancer and death. Unselected inception cohort studies are the best ones on which rely in order to avoid the selection bias from referral centers. Data produced using inception-cohort have shown a more benign course of CD than expected, an increased risk of surgery over time, with a trend which has been being reduced in the last decades, together with an increased use of biologics and immunosuppressants. The clinical features of CD change over time with a decreasing frequency of inflammatory disease behavior and an increasing frequency of stricturing and /or penetrating disease behavior, it is possible to identify the main predictors of a disabling course. An increased risk of colorectal cancer and small bowel cancer, lymphoproliferative disorders, non-melanoma skin cancer, have been described in CD. However the risk of dying in CD patient when compared with general population is higher, even if in inception-cohort studies the increased risk is not always detectable.