Name of the Condition

• Crohn's disease of large intestine with fistula
• Commonly known as Crohn's disease; specifically involves the large intestine and presence of a fistula.

Summary

• Crohn's disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, but in this form, it affects the large intestine. The presence of a fistula, an abnormal connection between the intestine and another organ or tissue, is a complication that can lead to additional symptoms and treatment considerations.

Causes

• The exact cause of Crohn's disease is unknown, but it is believed to be due to a combination of genetic predisposition, immune system malfunctions, and environmental factors.
• An abnormal immune response may mistakenly attack the intestinal tract, leading to chronic inflammation and tissue damage.

Risk Factors

• Family history of Crohn's disease.
• Smoking, which increases the severity of the disease.
• A diet high in fat or refined foods might contribute to the condition.
• More common in younger populations and Caucasians, particularly individuals of Ashkenazi Jewish descent.

Symptoms

• Persistent diarrhea, abdominal pain, and cramping.
• Blood in stool, weight loss, and fatigue.
• The formation of fistulas can lead to unexpected stool leaks or infections.

Diagnosis

• Diagnosis may involve a combination of lab tests, endoscopic procedures such as colonoscopy with biopsy, imaging studies like MRI or CT scans, and blood tests to check for inflammation markers and anemia.

Treatment Options

• Medications such as aminosalicylates, corticosteroids, immunomodulators, and biologics can help reduce inflammation and manage symptoms.
• Antibiotics might be prescribed to treat fistulas.
• Surgery may be necessary to remove affected parts of the intestine or to treat fistulas directly.
• Nutritional therapy might be recommended to ensure proper nutrient intake and bowel rest.

Prognosis and Follow-Up

• Crohn's disease is a lifelong condition with periods of remission and flare-ups. With appropriate management, individuals can lead relatively healthy lives.
• Regular follow-up with a healthcare provider is essential to monitor the condition and adjust treatment as necessary.

Complications

• Fistulas can become infected or lead to abscesses.
• Bowel obstruction from scarring and inflammation.
• Increased risk of colon cancer with long-standing inflammation.

Lifestyle & Prevention

• Adopting a balanced diet and stress management techniques can help manage symptoms.
• Stopping smoking significantly improves the course of the disease.
• Regular exercise may support overall well-being and bowel function.

When to Seek Professional Help

• Seek immediate medical attention for severe abdominal pain, persistent vomiting, or signs of a fistula infection such as fever or pus leakage.

Additional Resources

• Crohn’s & Colitis Foundation: www.crohnscolitisfoundation.org
• National Institute of Diabetes and Digestive and Kidney Diseases: www.niddk.nih.gov

Tips for Medical Coders

• Confirm the specific location (large intestine) and presence of a fistula when coding.
• Avoid coding errors by distinguishing Crohn's disease with fistulas from other forms of Crohn's disease or IBD conditions without fistulas.