title: Approach to the Patient with Mild Crohn's Disease: a 2016 Update.
abstract: Mild Crohn's disease (CD) is classified as those patients who are ambulatory, with <10 % weight loss, are eating and drinking without abdominal mass, tenderness, obstructive symptoms, or fever, and endoscopically they have non-progressive mild findings. Initial evaluation of mild CD should focus on assessment for high-risk features requiring more aggressive therapy. In contrast to moderate-to-severe disease, where therapy is focused on mucosal healing, the management of mild CD is focused on symptom management, while exposing the individual to minimal therapeutic risks. Budesonide is the most commonly used medication for mild CD given its safety profile. Assessment of inflammatory markers, in concert with computed-tomography (CT) or magnetic resonance (MR) enterographies and endoscopic studies, should be considered in clinical remission to ensure that mucosal inflammation is not present. Endoscopic inflammation can precede clinical recurrence. Individuals with mild CD require routine vaccination, monitoring for iron-deficiency anemia and vitamin D deficiency, and colorectal cancer screening when appropriate.
authors.affiliation: Crohn's and Colitis Center, Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, 12605 E 16th Ave., Aurora, CO, 80045, USA. frank.i.scott@ucdenver.edu.
authors.forename: Frank I
authors.initials: FI
authors.lastname: Scott
authors.affiliation: Perelman Center for Advanced Medicine, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 7-South, Room 753, Philadelphia, PA, 19104, USA.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Lichtenstein
mesh_terms: D019819:Budesonide / Q000627:therapeutic use; D003424:Crohn Disease / Q000175:diagnosis* / Q000628:therapy*; D018450:Disease Progression; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011159:Population Surveillance / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D005765:Gastrointestinal Agents; D005938:Glucocorticoids; D019819:Budesonide
keywords: Budesonide; CRP; Fecal calprotectin; Health maintenance in inflammatory bowel disease; Mesalamine; Mild Crohn’s disease; Prognostic factors in Crohn’s disease