The most severe prognoses are usually found in the perianal and penetrating form of the disease in comparison with other types. The Montreal and Paris classifications of CD group patients based on localization, behavior, growth, and onset the behavior is subdivided into penetrating, non-stricturing/non-penetrating, and stricturing. A score of > 220 is used to recruit patients with active Crohn’s disease in many clinical trials, indicating a moderate to severe disease activity. The CDAI is perhaps the most useful and widespread research tool for quantifying the level of disease activity. While disease activity generally follows a tripartite classification, there is neither a standardized system of grouping nor a canonical definition of levels. Clinical disease activity is categorized by the European Crohn’s and Colitis Organization (ECCO) into severe, moderate, and mild. Īn analysis of the medical history and a physical examination of the patient is the first step towards the diagnosis of CD, supported by pathologic, endoscopic, and laboratory data, using a variety of clinical severity indices, such as the Crohn's Disease Activity Index (CDAI), Harvey and Bradshaw Index, Simple Index, Oxford Index, van Hees Index, and Cape Town Index. While the pathology and etiology of this type of IBD are elusive, a dysregulation of the mucosal immune response is thought to play an important role in the pathogenesis of the disease, together with environmental and genetic factors. Broadly, one-third of CD patients have either colitis, ileocolitis, ileitis, penetrating, or stricturing intestinal (in 50% of cases) complications at the time of diagnosis. Crohn’s disease (CD) is a form of inflammatory bowel disease (IBD), with an approximate frequency of 20.2 per 100,000 person-years in North America, 12.7 per 100,000 person-years in Europe, and 5 person-years in Asia.
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