Working Definition of Crohn's Disease Activity

Last reviewed 05/2022

The degree of activity of Crohn's disease has been classified by the American College of Physicians as a guide to the physician.

• mild to moderate disease - patient is ambulatory and able to tolerate oral alimentation without manifestations of dehydration, toxicity (high fevers, rigors, prostration), abdominal tenderness, painful mass, obstruction, or >10% weight loss
  
  
• moderate to severe disease - patients have failed to respond to treatment for mild-moderate disease or have more prominent symptoms of fevers, significant weight loss, abdominal pain or tenderness, intermittent nausea or vomiting (without obstructive findings), or significant anaemia
  
  
• severe to fulminant disease - patients have persisting symptoms despite the introduction of steroids as outpatients, or present with high fever, persistent vomiting or evidence of intestinal obstruction, rebound tenderness, cachexia or evidence of an abscess
  
  
• remission - patients are asymptomatic or without inflammatory sequelae.Definition includes patients who have responded to acute medical intervention or have undergone surgical resection without gross evidence of residual disease. Patients requiring steroids to maintain well-being are considered to be steroid-dependent and are usually not considered to be in remission (1)

Reference:

• 1. Feldman PA, Wolfson D, Barkin JS. Medical management of Crohn's disease. Clin Colon Rectal Surg. 2007;20(4):269-81