REGIONAL ENTERITIS(Crohn’s Disease)
A chronic inflammatory bowel disease that affects the lining of the digestive tract.Crohn’s disease can sometimes cause life-threatening complications.
Essentials of Diagnosis:-
• Insidious onset.
• Intermittent bouts of diarrhoea, low grade fever.
• Pain, tenderness and often mass in right iliac fossa.
• Symptoms due to bowel perforation, i.e. localised abscess, internal/external fistula, peritonitis.
• Extra-intestinal manifestations like:
a. Arthritis, subacute migratory, asymmetrical, polyarthritis lasting for one to two weeks princi- pally involving knees and ankles.
b. Erythema nodosum.
-Diet should be high in calories and vitamins and low in fat and roughage.
Tab Diaphenoxylate or Loperamide.
-For general malaise—Iron vitamin B12 and supple- ments of potassium and magnesium.
-Tab Salazopyrine 500 mg thrice daily.
-Tab Prednisolone 0.25-0.75/k/day for 3-4 months.
-If seriously ill-injection Hydrocortisone 100 mg 8
hourly or IV Dexamethasone 8 mg 8 hourly. If above therapy fails then
-Azathioprine 2.5 mg/kg/day or Mercaptopurine 1.5/kg/day
-If acute suppuration indicated by fever, leucocytosis and tender mass then
-Injection Ampicillin 4-8 gm IV daily followed by 2-4 gm orally.