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World J Gastroenterol. Mar 28, 2014; 20(12): 3198-3207
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3198
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3198
Inflammatory bowel disease course in Crohn’s disease: Is the natural history changing?
Petra A Golovics, Michael D Mandel, Barbara D Lovasz, Peter L Lakatos, First Department of Medicine, Semmelweis University, H-1083 Budapest, Hungary
Author contributions: Lakatos PL designed research; Golovics PA, Mandel MD, Lovasz BD and Lakatos PL performed literature search and drafted and revised the paper.
Correspondence to: Peter Laszlo Lakatos, MD, PhD, First Department of Medicine, Semmelweis University, Koranyi S. 2/A, H-1083 Budapest, Hungary. lakatos.peter_laszlo@med.semmelweis-univ.hu
Telephone: +36-20-9117727 Fax: +36-1-3130250
Received: September 26, 2013
Revised: December 12, 2013
Accepted: January 19, 2014
Published online: March 28, 2014
Revised: December 12, 2013
Accepted: January 19, 2014
Published online: March 28, 2014
Core Tip
Core tip: Studies on the natural history of Crohn’s disease (CD) provide invaluable data on its course and clinical predictors, and may help to identify patient subsets based on clinical phenotype. New data suggest the possibility of a change in the natural history in CD, with an increasing percentage of patients diagnosed with inflammatory disease behavior. Hospitalization rates remain high, while surgery rates seem to decrease in the last decade. Mortality rates still exceed that of the general population. The impact of changes in treatment strategy, including increased, earlier use of immunosuppressives, biological therapy, and patient monitoring on the natural history of the disease are still conflictive.