Abstract
Crohn’s disease is a disease of modern Western civilization; it has experienced a tremendous increase since 1960. Incidence rates in Northern Europe and the United States are now up to 8.8/100 000 inhabitants per year and prevalence rates up to 106/100 000 inhabitants (Table 3.1). Despite very extensive investigation, the aetiology of Crohn’s disease remains unknown and, in consequence, to date no causal therapy exists. Thus Dr Crohn’s statement made in 1932 is still valid and true: ‘Medical treatment is purely palliative and supportive’1.
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References
Crohn, B.B., Ginzburg, L. and Oppenheimer, G.D. (1932). Regional ileitis. A pathological and clinical entity. J. Am. Med. Assoc., 99, 1323–9
Kyle, J. (1971). An epidemiological study of Crohn’s disease in North East Scotland. Gastroenterology, 61, 826–33
Binder, V., Both, H., Hansen, P.K. et al. (1982). Incidence and prevalence of ulcerative colitis and Crohn’s disease in the County of Kopenhagen 1962–1978. Gastroenterology, 83, 563–8
Miller, D.S., Keighly, A.C. and Langman, M.J.S. (1974). Changing patterns in epidemiology of Crohn’s disease. Lancet, 2, 691–3
Mayberry, J.F., Rhodes, J. and Hughes, L.E. (1979). Incidence of Crohn’s disease in Cardiff between 1934 and 1977. Gut, 20, 602–8
Goebell, H., Dirks, E. and Förster, S. (1987). Prospective analysis of the frequency of chronic inflammatory bowel disease in an urban population (Ruhr Area). In: Goebell, H., Peskar, B.M. and Malchow, H. (eds.) Inflammatory Bowel Disease, pp. 241–2. (Lancaster: MTP Press)
Nylin, H. and Danielsson, A. (1986). Incidence of Crohn’s disease in a defined population in Northern Sweden, 1974–1981. Scand. J. Gastroenterol., 21, 1185–92
Heller, G. (1979). Crohn’s disease in Stockholm County 1955–1974. A study of epidemiology, results of surgical treatment and long-term prognosis. Act. Chir. Scand., 490 (suppl.), 1–84
Brahme, F., Lindstrom, C. and Wenckert, A. (1975). Crohn’s disease in a defined population. An epidemiological study of incidence, prevalence, mortality and secular trends in the city of Malmö, Sweden. Gastroenterology, 69, 342–51
Sedleck, R.E., Whisnant, J., Elveback, L.R. et al. (1980). Incidence of Crohn’s disease in Olmsted County, Minnesota, 1935–1975. Am. J. Epidemiol., 112, 759–63
Nunes, G.C. and Ahlquist, R.E. (1983). Increasing incidence of Crohn’s disease. Am. J. Surg., 145, 578–81
Best, W.R., Becktel, J.M., Singleton, J.W. and Kern, F. (1976). Development of a Crohn’s Disease Activity Index. Gastroenterology, 70, 439–44
Van Hees, P.A.M., Van Eiteren, P.H., van Lier, HJJ. and van Tongeren, J.H.M. (1980). An index of inflammatory activity in patients with Crohn’s disease. Gut, 21, 279–86
Harvey, R.F. and Bradshaw, J.M. (1980). A simple index of Crohn’s disease activity. Lancet, 1, 514–5
Martini, GA and Brandes, J.W. (1976). Increased consumption of refined carbohydrates in patients with Crohn’s disease. Klin. Wschr., 54, 367–71
Thornton, J.R., Emmet, P.M. and Heaton, K.W. (1979). Diet and Crohn’s disease: characteristics of the pre-illness diet. Br. Med. J., 2, 762–4
Heaton, K.W., Thornton, J.R. and Emmet, P.M. (1979). Treatment of Crohn’s disease with an unrefined-carbohydrate fibre-rich diet. Br. Med. J., 2, 764–6
Brandes, J.W. and Lorenz-Meyer, H. (1981). Zuckerfreie Diät: Eine neue Perspektive zur Behandlung des Morbus Crohn? Z. Gastroenterol., 19, 1–12
Ritchie, J.K., Wadsworth, J., Lennard-Jones, J.E. and Rogers, E. (1987). Controlled multicentre therapeutic trial of an unrefined carbohydrate, fibre-rich diet in Crohn’s disease. Br. Med. J., 295, 517–20
Levenstein, S., Prantera, C., Luzi, C. and D’Ubaldi, A. (1985). Low residue or normal diet in Crohn’s disease: a prospective controlled study in Italian patients. Gut, 26, 989–93
Jones, V.A., Workman, E., Freeman, A.H., Dickinson, R.J., Wilson, A.J. and Hunter, J.O. (1985). Crohn’s disease: Maintenance of remission by diet. Lancet, 2, 177–80
Driscoll, R.H. and Rosenberg, I.H. (1978). Total parenteral nutrition in inflammatory bowel disease. Med. Clin. North Am., 62, 185–201
Voitk, A.J., Echave, V., Feller, J.H. et al. (1973). Experience with elemental diet in the treatment of inflammatory bowel disease. Arch. Surg., 107, 329–33
Morin, C.L., Roulet, M., Weber, A., Roy, C.C. et al. (1979). Nasogastric infusion of elemental diet (ED) as a primary therapy in Crohn’s disease. Pediatr. Res., 13, 405 (abstract)
Hylander, E. and Jarnum, S. (1980). Klinische Erfahrungen mit Elementardiäten bei gastro-intestinalen Erkrankungen. Akt. Ernährungsmed, 5, 105–7
Lochs, H.M., Egger-Schödl, M., Schuh, R. et al. (1984). Is tube feeding with elemental diets a primary therapy of Crohn’s disease? Klin. Wschr., 62, 821–5
Teahon, K., Bjarnason, I. and Levi, A.J. (1988). Elemental diet in the management of Crohn’s disease. A 10-year review. Gastroenterology, 94, A457
Bos, L.P. and Weterman, I.T. (1980). Total parenteral nutrition in Crohn’s disease. World J. Surg., 4, 163–6
Reilly, J., Ryan, JA., Strole, W. and Fischer, J.E. (1976). Hyperalimentation in inflammatory bowel disease. Am. J. Surg., 131, 192–200
Elson, C.O., Layden, T.J., Nemchausky, BA. (1980). An evaluation of total parenteral nutrition in the management of inflammatory bowel disease. Dig. Dis. Sci., 25, 42–8
Ostro, M.J., Greenberg, J.R. and Jeejeebhoy, K.N. (1985). Total parenteral nutrition and complete bowel rest in the management of Crohn’s disease. J. Parent. Ent. Nutr., 9, 280–7
Müller, J.M., Keller, H.W., Erasmi, H. and Pichlmaier, H. (1983). Total parenteral nutrition as the sole therapy in Crohn’s disease — a prospective study. Br. J. Surg., 70, 40–3
Shiloni, E. and Freund, H.R. (1983). Total parenteral nutrition in Crohn’s disease. Is it a primary or supportive mode of therapy? Dis. Colon Rectum, 26, 275–8
Dickinson, R.J., Ashton, M.G., Axon, A.T.R. et al. (1980). Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct to the routine therapy of acute colitis. Gastroenterology, 79, 1199–204
Greenberg, G.R., Fleming, C.R., Jeejeebhoy, K.N. et al. (1985). Controlled trial of bowel rest and nutritional support in the management of Crohn’s disease. Gastroenterology, 88, 1405 (abstract)
Mclntyre, P.B., Powell-Tuck, J., Wood, S.R. et al. (1986). Controlled trial of bowel rest in the treatment of severe acute colitis. Gut, 27, 481–5
O’Morain, C., Segal, A.W. and Levi, A.J. (1984). Elemental diet as a primary treatment of acute Crohn’s disease: a controlled trial. Br. Med. J., 288, 1859–62
Saverymuttu, S., Hodgson, H.J.F. and Chadwick, V.S. (1985). Controlled trial comparing prednisolone with an elemental diet plus non-absorbable antibiotics in active Crohn’s disease. Gut, 26, 994–8
Sanderson, I.R., Udeen, S., Davies, P.S.W, et al. (1987). Remission induced by an elemental diet in small bowel Crohn’s disease. Arch. Dis. Child., 61, 123–7
Malchow, H., Steinhardt, H.J., Strohm, W.D. et al. (1985). Feasibility and effectiveness of a defined formula diet regimen in treating active Crohn’s disease. Gastroenterology, 88, 1487 (abstract)
Lochs, H., Steinhardt, H.J., Klaus-Wenz, B. et al. (1988). Enteral nutrition versus drug treatment for the acute phase of Crohn’s disease: Results of the European Co-operative Crohn’s Disease Study IV. Gastroenterology, 94, A267
Summers, R.W., Switz, D.M., Sessions, J.T. et al. (1979). National Co-operative Crohn’s Disease Study, results of drug treatment. Gastroenterology, 77, 847–69
Malchow, H., Ewe, K., Brandes, J.W., Goebell, H. et al. (1984). European Cooperative Crohn’s Disease Study (ECCDS): results of drug treatment. Gastroenterology, 86, 249–66
Singleton, J.W., Summers, R.W., Kern, F. et al. (1979). A trial of sulfasalazine as adjunctive therapy in Crohn’s disease. Gastroenterology, 77, 887–97
Smith, R.C., Rhodes, J., Heatley, R.V. et al. (1978). Low dose steroids and clinical relapse in Crohn’s disease: a controlled trial. Gut, 19, 606–10
Bergman, L. and Krause, U. (1976). Postoperative treatment with corticosteroids and salazosulphapyridine (salazopyrin) after radical resection for Crohn’s disease. Scand. J. Gastroenterol., 11, 651–6
Anthonisen, P., Barany, F., Folkenborg, O. et al. (1974). The clinical effect of salazosulphapyridine (salazopyrin) in Crohn’s disease. Scand. J. Gastroenterol., 9, 549–54
Van Hees, P.A.M, van Lier, H.J.J., van Eiteren, P.H., Driessen, W.M.M., van Hogezand, RA. et al. (1981). Effect of sulphasalazine in patients with active Crohn’s disease: a controlled double blind study. Gut, 22, 404–9
Baron, J.H., Bennett, P.N., Lennard-Jones, J.E. et al. (1977). Sulphasalazine in asymptomatic Crohn’s disease. A multicentre trial. Gut, 18, 69–72
Wenckert, A., Kristensen, M., Eklund, A.E. et al. (1978). The long-term prophylactic effect of salazosulphapyridine (salazopyrin) in primarily resected patients with Crohn’s disease. Scand. J. Gastroenterol., 13, 161–7
Ewe, K., Malchow, H. and Herfarth, Ch. (1985). Operative Radikalität und Rezidivprophylaxe mit Azulfidine bei Morbus Crohn: Ein prospektive multicentrische Studie. Langenbecks Arch. Chir., 364, 427–30
Rhodes, J., Beck, P., Bainton, D. and Campbell, H. (1971). Controlled trial of azathioprine in Crohn’s disease. Lancet, 12, 1273–6
Klein, M., Binder, H.J., Mitchel, M et al. (1974). Treatment of Crohn’s disease with azathioprine: a controlled evaluation. Gastroenterology, 66, 916–22
Watson, W.C. and Bukowsky, M. (1974). Azathioprine in management of Crohn’s disease: a randomized crossover study. Gastroenterology, 66, A142
Rosenberg, J.L., Levin, B., Wall, A.J. and Kirsner, J.B. (1975). A controlled trial of azathioprine in Crohn’s disease. Dig. Dis., 20, 721–6
Willoughby, J.M.T., Beckett, J., Kumar, P J. et al. (1971). Controlled trial of azathioprine in Crohn’s disease. Lancet, 2, 944–6
O’Donnoghue, D.P., Dawson, A.M., Powell-Tuck, J. et al. (1978). Double blind withdrawal trial of azathioprine as maintenance treatment for Crohn’s disease. Lancet, 2, 955–7
Nyman, M., Hansson, I. and Eriksson, S. (1985). Long-term immunosupressive treatment in Crohn’s disease. Scand. J. Gastroenterol., 20, 1197–203
Present, D.H., Korelitz, B.I., Wisch, N. et al. (1980). Treatment of Crohn’s disease with 6-mercaptopurine. N. Engl. J. Med., 302, 981–7
Korelitz, B.I. and Present, D.H. (1985). Favorable effect of 6-mercaptopurine on fistulae of Crohn’s disease. Dig. Dis. Sci., 30, 58–64
Singleton, J.W., Law, D.H., Kelley, M.L. et al. (1979). National Co-operative Crohn’s Disease Study: adverse reaction to study drugs. Gastroenterology, 77, 870–82
Rosen, A., Ursing, B., Alm, Th., Barany, F. et al. (1982). A comparative study of metronidazole and sulfasalazine for active Crohn’s disease: The Co-operative Crohn’s Disease Study in Sweden. Gastroenterology, 83, 541–9
Bernstein, L.H., Frank, M.S., Brandt, L.J. et al. (1980). Healing of perineal Crohn’s disease with metronidazole. Gastroenterology, 79, 357–65
Schneider, M.U., Laudage, G., Guggenmoos-Holzmann, I. and Riemann, J.F. (1985). Metronidazol in der Behandlung des Morbus Crohn. Dtsch. Med. Wschr., 110, 1724–30
Rasmussen, S.N., Bondesen, S., Hvidberg, E.F. et al. (1982). 5-Aminosalicylic acid in a slow release preparation: Bioavailability, plasma level and excretion in humans. Gastroenterology, 83, 1062–70
Rasmussen, S.N., Binder, V., Maier, K. et al. (1983). Treatment of Crohn’s disease with peroral 5-aminosalicylic acid. Gastroenterology, 85, 1350–3
Maier, K., Frühmorgen, P., Bode, J. Ch. et al. (1985). Erfolgreiche Akutbehandlung chronisch-entzündlicher Darmerkrankungen mit oraler 5-Aminosalicylsäure. Dtsch. Med. Wschr., 110, 363–8
Saverymuttu, S.H., Gupta, S., Keshavarzian, A. et al. (1986). Effect of a slow release 5-aminosalicylic acid preparation on disease activity in Crohn’s disease. Digestion, 33, 89–91
Rasmussen, S.N., Lauritsen, K., Tage-Jensen, U. et al. (1987). 5-Aminosalicylic acid in the treatment of Crohn’s disease. Scand. J. Gastroenterol., 22, 877–33
Jenss, H., Hartmann, F. and Schölmerich, J. (1988). Therapie des aktiven Morbus Crohn mit 5-Aminosalicylsäure oder Methylprednisolon. Z. Gastroenterol., (Abstract) 24, 473
Segal, A.W., Levi, A.J. and Loewi, G. (1977). Levamisole in the treatment of Crohn’s disease. Lancet, 2, 382–4
Wesdorp, E., Schellekens, P.T.A., Weening, R et al. (1978). Levamisole in Crohn’s disease. Digestion, 18, 186–91
Sachar, D.B., Rubin, K.P. and Gumaste, V. (1987). Levamisole in Crohn’s disease: a randomized, double-blind, placebo-controlled clinical trial. Am. J. Gastroenterol., 82, 536–9
Modigliani, R, Pieddeloup, C., Hecketsweiler, P. et al. (1983). Effet du levamisole sur la prevention des pousees évolutives de la maladie de Crohn quiescente. Gastroenterol. Clin. Biol., 7, 683–92
Rohr, G., Kusterer, K, Schule, M. et al. (1987). Treatment of Crohn’s disease and ulcerative colitis with 7S-immunoglobulin. Lancet, 1, 170 (letter)
Allison, M.C. and Pounder, RE. (1984). Cyclosporin for Crohn’s disease. Lancet, 1, 902–3 (letter)
Peltekian, K.M., Williams, C.N., MacDonald, A.S. et al. (1987). Open study of cyclosporin A in Crohn’s disease. Gastroenterology, 92, 1571 (abstract)
Brynskov, J., Binder, V., Riis, P. et al. (1987). Clinical experience with cyclosporin (cyclosporin A) in chronically-active, therapy-resistant Crohn’s disease. A pilot study. Gastroenterology, 92, 1330 (abstract)
Allison, M.C. and Pounder, RE. (1987). Cyclosporin for Crohn’s disease. Aliment. Pharmacol. Ther., 1, 39–43
Chiodini, R.J., van Kruiningen, H.J., Thayer, W.R, Merkal, R.S. and Coutu, J.A. (1984). Possible role of mycobacteria in inflammatory bowel disease. I. An unclassified mycobacterium species isolated from patients with Crohn’s disease. Dig. Dis. Sci., 29, 1073–9
McFadden J.J., Butcher, P.D., Chiodini, R and Hermon-Taylor, J. (1987). Crohn’s disease isolated mycobacteria are identical to Mycobacterium paratuberculosis, as determined by DNA-probes that distinguish between mycobacterial species. J. Clin. Microbiol., 25, 796–801
Gitnick, G. (1984). Is Crohn’s disease a mycobacterial disease after all? Dig. Dis. Sci., 25, 1086–8
Rutgerts, P., Vantrappen, G., Van Meldt, K et al. (1988). Rifabutin therapy in patients with recurrent Crohn’s disease after ileocolonic resection. Gastroenterology, 94, A391
Thayer, W.R., Coutu, J.A., Chiodini, R.A. et al. (1988). Use of rifabutin and streptomycin in the therapy of Crohn’s disease. Gastroenterology, 94, A458
Hampson, S.J., Parker, M.C., Saverymuttu, S.H. et al (1988). Results of quadruple antimycobacterial chemotherapy in 17 Crohn’s disease patients completing six months treatment. Gastroenterology, 94, A170
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Wietholtz, H., Thon, H.J., Büchsel, R., Matern, S. (1989). Conservative treatment of Crohn’s disease. In: Matern, S. (eds) Clinical Research in Gastroenterology 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2488-8_3
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DOI: https://doi.org/10.1007/978-94-009-2488-8_3
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