Short Version of the Updated S3-Guideline of the German Society of Digestive and Metabolic Diseases (DGVS) and the Competence Network Inflammatory Bowel Diseases on Diagnostics and Treatment of Crohn's Disease

Short Version of the Updated S3-Guideline of the German Society of Digestive and Metabolic Diseases (DGVS) and the Competence Network Inflammatory Bowel Diseases on Diagnostics and Treatment of Crohn's Disease Crohn's disease belongs to the most common chronic inflammatory disorders of the gastrointestinal tract. Typical symptoms are diarrhea, abdominal pain, and systemic complaints such as fever and weight loss. In addition to history taking, clinical examination and laboratory tests, high-resolution abdominal ultrasound plays a key role. In addition, ile-ocolonoscopy must be performed at least initially and once at a later time point. Treatment depends on the degree of disease activity and the distribution of involved bowel segments. Severe flares must be treated by systemic corticosteroids, mild flares can be treated by topical steroids. If long small bowel segments or the upper gastrointestinal tract are involved, immunsuppressive therapy should be considered early on, while it is otherwise applied in patients with a chronically active course. Azathioprin/6-mercaptopurin are the first-choice immunosuppressive agents, methotrexate und anti-TNF-alpha antibodies are the second choice. Surgery needs to be considered in treatment-refractory patients, in patients with fistulas or long strictures as well as in those patients who have a localized problem. High-grade dysplasia or carcinomas are absolute indications for surgery. Complex disease courses require an interdisciplinary approach by gastroenterologists/gastroenterological pediatricians and abdominal surgeons. Patients must stop smoking.