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European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis
  1. E F Stange1,
  2. S P L Travis2,
  3. S Vermeire3,
  4. C Beglinger4,
  5. L Kupcinkas5,
  6. K Geboes6,
  7. A Barakauskiene7,
  8. V Villanacci8,
  9. A Von Herbay9,
  10. B F Warren10,
  11. C Gasche11,
  12. H Tilg12,
  13. Stefan W Schreiber13,
  14. J Schölmerich14,
  15. W Reinisch15,
  16. for the European Crohn’s and Colitis Organisation (ECCO)
  1. 1Chefarzt, Abteilung für Innere Medizin 1 Schwerpunkte Gastroenterologie, Hepatologie und Endokrinologie, Robert Bosch Krankenhaus, Stuttgart, Germany
  2. 2John Radcliffe Hospital, Oxford, UK
  3. 3University Hospital KULeuven, Leuven, Belgium
  4. 4Department of Gastroenterology, The University Hospital, Basle, Switzerland
  5. 5Kaunas University of Medicine hospital, Department of Gastroenterology, Kaunas, Lithuania
  6. 6Department of Pathology, University Hospital KULeuven, Leuven, Belgium
  7. 7Clinic of Gastroenterology, Vilnius University Hospital, Vilnius, Lithuania
  8. 8Cattedra di Chirurgia Generale, Universita degli Studi di Brescia, UO1 Chirurgia Generale, Spedali Civili Brescia, Brescia, Italy
  9. 9St Mark’s Hospital, Harrow, Middlesex, UK
  10. 10Department of Histopathology, John Radcliffe Hospital, Oxford, UK
  11. 11Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria
  12. 12University Hospital Innsbruck, Department of Medicine, Innsbruck, Austria
  13. 13University Hospital Schleswig-Holstein UKSH, Department of General Internal Medicine, Kiel, Germany
  14. 14Department of Internal Medicine I, University of Regensburg, Germany
  15. 15Univ-Klinik Innere Medizin IV, Abt Gastroenterology and Hepatology, Vienna, Austria
  1. Correspondence to:
    Dr S P L Travis
    John Radcliffe Hospital, Oxford OX3 9DU, UK; simon.travis{at}orh.nhs.uk; Professor E F Stange, Department of Internal Medicine 1, Robert Bosch Krankenhaus, PO Box 501120, Auerbachstr 110, 70341 Stuttgart, Germany; Eduard.Stange{at}rbk.de

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1.0 INTRODUCTION

Crohn’s disease (CD) is a lifelong disease arising from an interaction between genetic and environmental factors, but seen predominantly in the developed countries of the world. The precise aetiology is unknown and therefore a causal treatment is not yet available. Within Europe there is a distinct north-south gradient, but the incidence seems to have increased in southern countries in recent years.1 Many patients live with a considerable symptom burden despite medical treatment in the hope that the aetiology of the disease will shortly be discovered and curative therapies emerge. Although this seems likely to happen at some time in the next decade, clinicians have to advise patients on the basis of information available today rather than an unknown future. Despite a multiplicity of randomised trials there will always be many questions that can only be answered by the exercise of judgement and opinion. This leads to differences in practice between clinicians, which may be brought into sharp relief by differences in emphasis between countries.

The consensus endeavours to address these differences. The consensus is not meant to supersede the guidelines of different countries (such as those from the UK,2 Germany,3 or France), which reach broadly the same conclusions as they are, after all, based on the same evidence. Rather, the aim of the consensus is to promote a European perspective on the management of CD and its dilemmas. As the development of guidelines is an expensive and time consuming process, it may help to avoid duplication of effort in the future. A consensus is also considered important because an increasing number of therapeutic trials are based in Europe, especially in eastern European countries where practice guidelines have yet to be published.

This document sets out the current European consensus on the diagnosis and management of CD, reached …

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