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## Meet the editor

Dr. Partha Pal, MD, DNB, MRCP(UK), FASGE, is a consultant gastroenterologist and inflammatory bowel disease (IBD) specialist at the Asian Institute of Gastroenterology. His areas of interest include IBD, small bowel diseases, interventional endoscopy, and intestinal ultrasound. He has published more than 100 peer-reviewed articles on IBD, small bowel diseases, intestinal ultrasound, interventional endoscopy, and pancreatic

diseases. He achieved high honors at the undergraduate and postgraduate levels, receiving awards as the best student. He won the National Young Scholar Award in 2017. Dr. Pal also received the 2021 Endoscopic Training Award from the American Society of GI Endoscopy (ASGE) and an International GI Training Grant from the American College of Gastroenterology (ACG) in 2023 for his training on interventional IBD and small bowel endoscopy.

### Contents


Preface

Crohn's disease (CD) is a subgroup of inflammatory bowel disease that can affect any part of the intestine from mouth to anus. CD can be differentiated from its counterpart ulcerative colitis (UC) by transmural nature and discontinuous involvement of any part of the bowel. The sequence of events in untreated CD is chronic inflammation, stricture, fistula, and abscess formation. Early diagnosis and timely treatment can prevent the complications of this chronic, lifelong illness. This book presents a

From its first description in 1913 as "chronic interstitial enteritis," the understanding of CD has evolved over the last century. Chapter 1 discusses the evolution in clinical

The series of pathogenetic events leading to the development of CD as opposed to UC is not clearly known. Genetic predisposition, impaired gut permeability, and environmental factors triggering dysregulated immune response have been implicated. Rapid industrialization and improved sanitary conditions, as well as Westernization of diet and changing lifestyle factors, have been postulated to be contributing factors to rising incidence in developing countries. There is increasing evidence that these factors contribute to the development of CD by change in the gut microbiome. Chapter 2 discusses the crosstalk between dysbiosis and CD. Although there is conclusive evidence to support the bidirectional relation between gut microbiome and CD, fecal microbiota transfer has not been as successful as it has been in UC. A better under-

One of the major causes of diagnostic delay in CD is the inability to differentiate it from mimics like intestinal tuberculosis (ITB) and Behcet's disease. The inability to differentiate ITB from CD, especially in tuberculosis-endemic countries, leads to treatment with empirical anti-tubercular drugs and delayed diagnosis ultimately resulting in stricture complications and high risk of surgery. Chapter 3 discusses all the differential diagnoses of CD and how to differentiate them from CD. This chapter provides valuable information for treating practitioners on early diagnosis and

Once CD is suspected or initially diagnosed, mapping out the disease extent is of prime importance to guide therapy. Isolated small bowel involvement can occur in 10% of CD cases, and one-third of patients with ileocolonic disease will have small bowel involvement. Capsule endoscopy is a non-invasive, radiation-free modality with high accuracy that allows pan-enteric evaluation. Chapter 4 discusses the use of

The most dreaded phenotype of CD is the fistulizing type, which leads to fistula and abscess. The treatment options include anti-tumor necrosis factor agents along with drainage of the abscess or dilation of stricture. In recent years, endoscopic therapy

comprehensive overview of CD.

improving outcomes.

capsule endoscopy in CD.

observations, diagnosis, and treatment of CD over time.

standing of the underlying factors needs evaluation.
