title: Course of Crohn's disease prior to establishment of the diagnosis.
abstract: BACKGROUND
  The course of Crohn's disease prior to the establishment of the diagnosis is widely unknown. Therefore, we instigated a survey amongst newly diagnosed patients.
  
  
  METHODS
  Patients diagnosed with CD less than 12 months before enrollment were included. Data on demography, social status, time interval to diagnosis, symptoms, and health care service use were collected in a retrospective, web-based, census. Patients were contacted in cooperation with two organizations: a German patients' organization (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung e.V. [DCCV]) and a professional organization of German gastroenterologists (Berufsverband der Niedergelassenen Gastroenterologen Deutschlands e.V. [bng]). Study participation was anonymous by use of a transaction number.
  
  
  RESULTS
  The median interval period between onset of first symptoms and diagnosis was 13 months. During this time, participants reported having five doctor consultations on average, with 44% of them having a mean of 1.5 hospitalizations. 65% were unfit for work with a 14 day median (2 to 480 days) due to their symptoms. A mean (+/-SD) of 8.6 (+/-7.1) diagnostic tests were performed before the diagnosis was established. Overall health state was judged as temporarily bad or very bad by 84% of the participants. Age at diagnosis, characteristic symptoms, and localization of the disease for the participants did not differ from previously reported international data.
  
  
  CONCLUSIONS
  This web-based survey shows a substantial time interval of over one year until diagnosis of Crohn's disease amongst the study participants. This period is characterized by both psychological stress and impaired ability to work.
authors.affiliation: Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität, Halle. joerg.albert@medizin.uni-halle.de
authors.forename: J G
authors.initials: JG
authors.lastname: Albert
authors.forename: J
authors.initials: J
authors.lastname: Kotsch
authors.forename: W
authors.initials: W
authors.lastname: Köstler
authors.forename: S
authors.initials: S
authors.lastname: Behl
authors.forename: B
authors.initials: B
authors.lastname: Kaltz
authors.forename: B
authors.initials: B
authors.lastname: Bokemeyer
authors.forename: M M
authors.initials: MM
authors.lastname: Dollinger
authors.forename: J
authors.initials: J
authors.lastname: Haerting
authors.forename: W E
authors.initials: WE
authors.lastname: Fleig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003424:Crohn Disease / Q000175:diagnosis*; D003625:Data Collection; D003627:Data Interpretation, Statistical; D004493:Education; D004651:Employment; D005240:Feasibility Studies; D005858:Germany; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors