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Crohns sjukdom

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Definition:
Kronisk inflammatorisk sjukdom med segmentell, transmural inflammation som kan påverka alla avsnitt av magtarmkanalen.
Förekomst:
Incidensen i Sverige är cirka 10 per 100 000 per år och är högst i åldersgruppen 15–40 år.
Symtom:
Beror på lokalisation och allvarlighetsgrad av inflammationen. Typiska symtom är buksmärtor, diarré, perianala besvär och viktminskning.
Kliniska fynd:
Olika kliniska bilder. Vid kronisk inflammatorisk sjukdom finns ofta fokal palpationsömhet i höger nedre kvadrant. Intestinal obstruktion, fistelbildning, perianal sjukdom och extraintestinala manifestationer (hud, ögon, leder, lever, osteoporos, tillväxthämning hos barn) kan förekomma.
Diagnostik:
Kalprotektin i avföring är vanligtvis förhöjt. CRP kan vara förhöjt. Endoskopi med biopsier och bildundersökningar kan bekräfta diagnosen.
Behandling:
Behandlingen inriktas på näringstillstånd, symtomkontroll och specifik läkemedelsbehandling för att minska sjukdomsaktivitet och komplikationer.
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  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet
  • Bjørn Moum, professor i gastroenterologi, Oslo Universitetssykehus