Topic Highlight
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 7, 2014; 20(1): 31-36
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.31
Natural history and long-term clinical course of Crohn’s disease
Hugh James Freeman
Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia Hospital, Vancouver, BC V6T 1W5, Canada
Author contributions: Freeman HJ contributed all to this paper.
Correspondence to: Hugh James Freeman, MD, CM, FRCPC, FACP, Professor, Department of Medicine (Gastroenterology), University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: October 10, 2013
Revised: November 7, 2013
Accepted: November 12, 2013
Published online: January 7, 2014
Processing time: 509 Days and 15.7 Hours
Core Tip

Core tip: Crohn’s disease remains an intriguing heterogeneous disorder characterized by a granulomatous inflammatory process. The phenotypic clinical expression of Crohn’s disease is clearly age-onset dependent as most children and adolescents suffer more severe, more extensive and more complicated disease than most adults, and the elderly. If evaluated over a long period of time, the disease appears to be progressive, but only intermittently active, with some appearing to have prolonged periods of sub-clinical disease and others expressing complex disease with stricture formation and penetrating complications, even at the time of initial clinical presentation. Although the precise cause of Crohn’s disease remains a mystery, an increasing appreciation for the long-term natural history may permit development of more effective treatment regimens. Ultimately, however, both clinical and fundamental investigative efforts should focus on discovering the cause of the disorder since this approach may offer the best opportunity for cure.