Article Text

Download PDFPDF
Behaviour of Crohn's disease according to the Vienna classification
  1. D B Sachar1
  1. 1Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York, USA;

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

I hasten to congratulate Louis et al on their meticulous and insightful study on the stability of Crohn's disease phenotypes according to the Vienna classification (Gut 2001;49:777–82). It was particularly gratifying to learn from them (in a separate communication) of the remarkably high degree of interobserver agreement in classifying patients by this system.

The principal message that the authors draw from their study is that the initial “behavioural” classification of B1 (non-stricturing non-penetrating) at the onset of Crohn's disease hardly ever remains stable over the lifetimes of the patient but almost invariably progresses in time to either B2 (stricturing) or B3 (penetrating) disease. Naturally, this finding hardly comes as a surprise either to the authors of the Vienna classification1 or in fact to any clinician caring for patients with Crohn's disease. More important and revealing, in my opinion, is the observation by Louis et al that “the proportion of initially B2 patients changing from B2 to B3 was [only] 15.4% (only 2/13 patients)”.

Therefore, once “inflammatory” (B1) disease has made its almost invariable progression …

View Full Text

Linked Articles