title: [Focus on Crohn's disease].
abstract: Crohn's disease is an inflammatory bowel disease that affects the entire digestive tract, from the mouth to the anus. The inflammatory disease is transmural and may be complicated by abscesses, fistulas, strictures. Budesonide is used as first-line treatment for a first episode of ileitis. Thiopurines and methotrexate are used as immunosuppressive maintenance therapy. Anti-tumour necrosis factors (TNF) alpha therapy is used as induction and maintenance therapy in case of severe flares or corticodependence. Combination of immunosuppressive therapy and anti-TNF-alpha (combotherapy) prevents the appearance of specific anti drug antibodies. Combotherapy is used in case of severe disease. The goal of the treatment is to achieve clinical remission, endoscopic mucosal healing, and to prevent the occurrence of complications such as strictures, fistulas or abscesses. Anoperineal lesions are found in 10% of the patients at diagnosis. Surgical treatment is indicated for severe medical treatment-resistant patients or complications such as symptomatic stenosis, fistula or abscess unresponsive to medical treatment or immediately complicated.
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Klotz
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France; Université Sorbonne Paris V, faculté de médecine, 75014 Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Dhooge
authors.affiliation: AP-HP, hôpital Cochin, service de radiologie, 75014 Paris, France.
authors.forename: Ammar
authors.initials: A
authors.lastname: Oudjit
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France; Université Sorbonne Paris V, faculté de médecine, 75014 Paris, France.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.affiliation: AP-HP, hôpital Cochin, service d'anatomopathologie, 75014 Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Beuvon
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France; Université Sorbonne Paris V, faculté de médecine, 75014 Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France; Université Sorbonne Paris V, faculté de médecine, 75014 Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.affiliation: AP-HP, hôpital Cochin, service de gastro-entérologie, 75014 Paris, France. Electronic address: vered.abitbol@cch.aphp.fr.
authors.forename: Vered
authors.initials: V
authors.lastname: Abitbol
mesh_terms: D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans