5. Crohn’s disease: a chronic inflammatory disease causing ulcerations in the small and large intestines. The immune system seems to react to a variety of substances and/or bacteria in the intestines, causing inflammation, ulceration, and bowel injury. Called Crohn’s colitis when only large intestine is involved; Crohn’s enteritis when only small intestine is involved; terminal ileitis when lowest part of small intestine is involved; Crohn’s enterocolitis or ileocolitis when both small and large intestines are involved.
   1. Pathophysiology: one of two conditions called “inflammatory bowel disease" (ulcerative colitis is the other) that affects all layers of the ileum, the colon, or both, causing patchy, shallow, longitudinal mucosal ulcers; possible correlation with autoimmune disease and adenocarcinoma of the bowel. Small, scattered shallow crater-like areas cause scarring and stiffness of the bowel—> bowel becomes narrow —» obstruction, then pain, nausea, and vomiting.
   2. Risk factors:
      1. Age: 15-20,55-60 yr.
      2. Caucasian, especially Jewish.
      3. Familial predisposition.
      4. Possible virus involvement.
      5. Possible psychosomatic involvement.
      6. Possible hormonal or dietary influences.
   3. Assessment:
      1. Subjective data:
      1. Abdominal pain.
      2. Anorexia.
      3. Nausea.
      4. Malaise.
      5. History of isolated, intermittent, or recurrent attacks.
      2. Objective data:
         1. Diarrhea.
         2. Weight loss, vomiting.
         3. Fever, signs of infection.
         4. Fluid/electrolyte imbalances.
         5. Malnutrition, malabsorption.
         6. Occult blood in feces.