The main symptoms revealing IBD are:
- abdominal pain,
- transit disorders with the existence of prolonged diarrhea, often bloody,
- an alteration of the general state (fatigue, slimming, loss of appetite).
From a biological point of view, there is frequently a biological inflammatory syndrome (systemic reflection of the local inflammation) and a deficiency syndrome malabsorption, that is to say that the intestine is no longer able to absorb nutrients due to inflammation of the intestinal mucosa.
In some cases, IBD is manifested by acute diarrhea that can be falsely attributed to common viral gastroenteritis. In this case, a failure of symptomatic treatment or even antibiotic treatment after parasitological examination of stool and stool culture (search for a bacterial or parasitic infectious agent in the stool) will direct the diagnosis to a MICI.
Fecal calprotectin is a marker of more specific inflammation. It is sometimes used to guide the diagnosis and also in monitoring the effectiveness of treatments.
If IBD is suspected, endoscopic examinations will be required. This is a gastroscopy and a colonoscopy. A macroscopic (with the naked eye) and microscopic (histopathological examination of the biopsies carried out) evocative will make it possible to affirm the diagnosis. If an exploration of the small intestine is necessary, an entero-MRI or video-capsule may be performed.
Crohn's disease can induce lesions of the mouth to the anus. These are more or less deep ulcerations that can be complicated by fistula and intra-abdominal abscess. These complications also exist in the ano-perineal region inducing anal fistulas, ulcerations, stenoses or abscesses of the anal margin.
IBD is associated with a risk of extra-digestive manifestations. It can be:
- rheumatologic manifestations such as ankylosing spondylitis (inflammatory joint involvement mainly affecting the spine and / or the pelvis),
- ophthalmological involvement such as uveitis (painful red eye associated with a decrease in visual acuity),
- Hepatic involvement such as primary sclerosing cholangitis (inflammatory involvement of the hepatic or extra-hepatic biliary tract).
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