CURRENT DIAGNOSIS AND MANAGEMENT OF CROHN’S DISEASE: A LITERATURE-BASED REVIEW
Abstract
Crohn’s disease is a chronic inflammatory disorder of the gastrointestinal tract with increasing global incidence, shifting from a predominantly Western condition to a rising burden in Asia and other developing regions. Diagnosis requires a multimodal approach, integrating history, laboratory testing, endoscopy with validated activity scores, histopathology, and imaging such as magnetic resonance enterography or intestinal ultrasound. The 2024 ECCO guidelines emphasize fecal biomarkers like calprotectin as non-invasive monitoring tools within a treat-to-target strategy. Management includes pharmacological therapy (corticosteroids, immunomodulators, biologics, and novel small molecules), non-pharmacological measures (exclusive enteral nutrition, micronutrient supplementation, and diet modification), and surgery for refractory strictures, perforations, or complex fistulas. Beyond physical symptoms, Crohn’s disease carries a significant psychosocial burden, underscoring the need for nutritional and psychological support. Despite therapeutic advances, no curative treatment exists. Future research should focus on identifying more accurate biomarkers, improving accessibility to advanced therapies in low-resource settings, and exploring innovative approaches such as precision medicine, microbiota-targeted therapy, and genetic-based interventions.
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Coward, S., Kuenzig, M.E., Hazlewood, G., Clement, F., McBrien, K., Holmes, R., Panaccione, R., Ghosh, S., Seow, C.H., Rezaie, A., Kaplan, G.G., 2017. Comparative Effectiveness of Mesalamine, Sulfasalazine, Corticosteroids, and Budesonide for the Induction of Remission in Crohnʼs Disease. Inflamm. Bowel Dis. 23, 461–472. https://doi.org/10.1097/MIB.0000000000001023
Feuerstein, J.D., Cheifetz, A.S., 2017. Crohn Disease: Epidemiology, Diagnosis, and Management. Mayo Clin. Proc. 92, 1088–1103. https://doi.org/10.1016/j.mayocp.2017.04.010
Gajendran, M., Loganathan, P., Catinella, A.P., Hashash, J.G., 2018. A comprehensive review and update on Crohn’s disease. Disease-a-Month 64, 20–57. https://doi.org/10.1016/j.disamonth.2017.07.001
Gomollón, F., Dignass, A., Annese, V., Tilg, H., Van Assche, G., Lindsay, J.O., Peyrin-Biroulet, L., Cullen, G.J., Daperno, M., Kucharzik, T., Rieder, F., Almer, S., Armuzzi, A., Harbord, M., Langhorst, J., Sans, M., Chowers, Y., Fiorino, G., Juillerat, P., Mantzaris, G.J., Rizzello, F., Vavricka, S., Gionchetti, P., 2017. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn’s Disease 2016: Part 1: Diagnosis and Medical Management. J. Crohn’s Colitis 11, 3–25. https://doi.org/10.1093/ecco-jcc/jjw168
Gordon, H., Minozzi, S., Kopylov, U., Verstockt, B., Chaparro, M., Buskens, C., Warusavitarne, J., Agrawal, M., Allocca, M., Atreya, R., Battat, R., Bettenworth, D., Bislenghi, G., Brown, S.R., Burisch, J., Casanova, M.J., Czuber-Dochan, W., de Groof, J., El-Hussuna, A., Ellul, P., Fidalgo, C., Fiorino, G., Gisbert, J.P., Sabino, J.G., Hanzel, J., Holubar, S., Iacucci, M., Iqbal, N., Kapizioni, C., Karmiris, K., Kobayashi, T., Kotze, P.G., Luglio, G., Maaser, C., Moran, G., Noor, N., Papamichael, K., Peros, G., Reenaers, C., Sica, G., Sigall-Boneh, R., Vavricka, S.R., Yanai, H., Myrelid, P., Adamina, M., Raine, T., 2024. ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment. J. Crohn’s Colitis 18, 1531–1555. https://doi.org/10.1093/ecco-jcc/jjae091
Hracs, L., Windsor, J.W., Gorospe, J., Cummings, M., Coward, S., Buie, M.J., Quan, J., Goddard, Q., Caplan, L., Markovinović, A., Williamson, T., Abbey, Y., Abdullah, M., Abreu, M.T., Ahuja, V., Raja Ali, R.A., Altuwaijri, M., Balderramo, D., Banerjee, R., Benchimol, E.I., Bernstein, C.N., Brunet-Mas, E., Burisch, J., Chong, V.H., Dotan, I., Dutta, U., El Ouali, S., Forbes, A., Forss, A., Gearry, R., Dao, V.H., Hartono, J.L., Hilmi, I., Hodges, P., Jones, G.-R., Juliao-Baños, F., Kaibullayeva, J., Kelly, P., Kobayashi, T., Kotze, P.G., Lakatos, P.L., Lees, C.W., Limsrivilai, J., Lo, B., Loftus, E. V., Ludvigsson, J.F., Mak, J.W.Y., Miao, Y., Ng, K.K., Okabayashi, S., Olén, O., Panaccione, R., Paudel, M.S., Quaresma, A.B., Rubin, D.T., Simadibrata, M., Sun, Y., Suzuki, H., Toro, M., Turner, D., Iade, B., Wei, S.C., Yamamoto-Furusho, J.K., Yang, S.-K., Ng, S.C., Kaplan, G.G., 2025. Global evolution of inflammatory bowel disease across epidemiologic stages. Nature 642, 458–466. https://doi.org/10.1038/s41586-025-08940-0
Inokuchi, T., Takahashi, S., Hiraoka, S., Toyokawa, T., Takagi, S., Takemoto, K., Miyaike, J., Fujimoto, T., Higashi, R., Morito, Y., Nawa, T., Suzuki, S., Nishimura, M., Inoue, M., Kato, J., Okada, H., 2019. Long‐term outcomes of patients with Crohn’s disease who received infliximab or adalimumab as the first‐line biologics. J. Gastroenterol. Hepatol. 34, 1329–1336. https://doi.org/10.1111/jgh.14624
Koutroumpakis, E., Katsanos, K., 2016. Implementation of the simple endoscopic activity score in crohn’s disease. Saudi J. Gastroenterol. 22, 183. https://doi.org/10.4103/1319-3767.182455
Kumar, V., Abbas, A.K., Aster, J.C., Robbins, S.L., 2013. Robbins Basic Pathology, 9th ed, ClinicalKey 2012. Elsevier/Saunders.
Lee, J.M., Lee, K.-M., 2016. Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease. Clin. Endosc. 49, 370–375. https://doi.org/10.5946/ce.2016.090
Lichtenstein, G.R., Loftus, E. V, Isaacs, K.L., Regueiro, M.D., Gerson, L.B., Sands, B.E., 2018. ACG Clinical Guideline: Management of Crohn’s Disease in Adults. Am. J. Gastroenterol. 113, 481–517. https://doi.org/10.1038/ajg.2018.27
Ng, S.C., Shi, H.Y., Hamidi, N., Underwood, F.E., Tang, W., Benchimol, E.I., Panaccione, R., Ghosh, S., Wu, J.C.Y., Chan, F.K.L., Sung, J.J.Y., Kaplan, G.G., 2017. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 390, 2769–2778. https://doi.org/10.1016/S0140-6736(17)32448-0
Ramos, J.C. de S., Rezende, E.H.M., Filho, M.D.E.C., Silva, D.O., Schimin, Mayra Algeri, Araújo, L.T. de, Alves, N.C., Pinheiro, B.B., Lemos, P.H.K., 2024. Crohn’s Disease and Gastrointestinal Repercussions: A Detailed Study of Comorbidities and Clinical Implications. Brazilian J. Implantol. Heal. Sci. 6, 90–103. https://doi.org/10.36557/2674-8169.2024v6n4p90-103
Roda, G., Chien Ng, S., Kotze, P.G., Argollo, M., Panaccione, R., Spinelli, A., Kaser, A., Peyrin-Biroulet, L., Danese, S., 2020. Crohn’s disease. Nat. Rev. Dis. Prim. 6, 22. https://doi.org/10.1038/s41572-020-0156-2
Siwy, P. V., Gosal, F., 2020. Penyakit Crohn: Laporan Kasus. Med. Scope J. 2. https://doi.org/10.35790/msj.2.1.2020.29630
Torres, J., Mehandru, S., Colombel, J.-F., Peyrin-Biroulet, L., 2017. Crohn’s disease. Lancet 389, 1741–1755. https://doi.org/10.1016/S0140-6736(16)31711-1
Turner, D., Ricciuto, A., Lewis, A., D’Amico, F., Dhaliwal, J., Griffiths, A.M., Bettenworth, D., Sandborn, W.J., Sands, B.E., Reinisch, W., Schölmerich, J., Bemelman, W., Danese, S., Mary, J.Y., Rubin, D., Colombel, J.-F., Peyrin-Biroulet, L., Dotan, I., Abreu, M.T., Dignass, A., 2021. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 160, 1570–1583. https://doi.org/10.1053/j.gastro.2020.12.031
Veauthier, B., Hornecker, J.R., 2018. Crohn’s Disease: Diagnosis and Management. Am. Fam. Physician 98, 661–669.
Vuitton, L., Marteau, P., Sandborn, W.J., Levesque, B.G., Feagan, B., Vermeire, S., Danese, S., D’Haens, G., Lowenberg, M., Khanna, R., Fiorino, G., Travis, S., Mary, J.Y., Peyrin-Biroulet, L., 2016. IOIBD technical review on endoscopic indices for Crohn’s disease clinical trials. Gut 65, 1447–1455. https://doi.org/10.1136/gutjnl-2015-309903
Yu, Y.R., Rodriguez, J.R., 2017. Clinical presentation of Crohn’s, ulcerative colitis, and indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes. Semin. Pediatr. Surg. 26, 349–355. https://doi.org/10.1053/j.sempedsurg.2017.10.003
Published
2025-09-30
How to Cite
PAMBUDI, Novanda Ayu Dila Putri et al.
CURRENT DIAGNOSIS AND MANAGEMENT OF CROHN’S DISEASE: A LITERATURE-BASED REVIEW.
Mandala Of Health, [S.l.], v. 18, n. 2, p. 172-184, sep. 2025.
ISSN 2615-6954.
Available at: <https://jos.unsoed.ac.id/index.php/mandala/article/view/17307>. Date accessed: 16 oct. 2025.
doi: https://doi.org/10.20884/1.mandala.2025.18.2.17307.
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Articles
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