# Talk:Crohn's disease

Ought Crohn's disease of the vulva be added to this page? --Iztwoz (talk) 18:36, 17 February 2018 (UTC)

A bit late, but I think it should be mentioned as extra-intenstinal manifestations. It's probably an infection. AXONOV (talk) ⚑ 14:33, 21 January 2024 (UTC)

This "47,400 with ulcerative colitis (2015)"
Represents the number of deaths together with UC.
The ref https://www.ncbi.nlm.nih.gov/pubmed/27733281 does not give them individually.Doc James (talk · contribs · email) 03:46, 4 April 2018 (UTC)

In my opinion, it is very confusing. Also keep in mind that it is intended for the general public, of all intellectual levels. What does the reader have to understand? That these are deaths of people who have both Crohn's disease and ulcerative colitis? Or that are people who only have ulcerative colitis? And where...?
I would leave these figures only on the IBD page. Here it is not informative, just the opposite. If we do not have specific figures, we do not have specific figures.
As I have said more times, attempts to simplify sometimes confuse rather than help. And that is worrisome. --BallenaBlanca 🐳 ♂ (Talk) 09:58, 4 April 2018 (UTC)
Okay. Will look for specific figures with respect to CD. Doc James (talk · contribs · email) 19:21, 4 April 2018 (UTC)

There are two new sections on oral health that have been added to the bottom of the article by @Eileeneelie:. These sections are in need of references and also need to be placed in the correct place in the article. Eileeneelie please see WP:MEDMOS for the medical manual of style to determine where this info would best fit into the present article and also WP:MEDRS for what sources are acceptable for Wikipedia. I have moved these sections to the talk page so they can be improved and then added back in.
Moved sections:


### Oral manifestations
A wide range of oral lesions has been clinically reported in Crohn disease; however, many of the abnormalities described are relatively nonspecific and may be associated with other conditions that cause orofacial granulomatosis. The more prominent findings such as diffuse or nodular swelling of the oral and perioral tissues, a cobblestone appearance of the mucosa, granulomatous appearing ulcers and pyostomatitis vegetans represent granulomatous changes that constitute the hallmark of Crohn’s disease. Patchy erythematous macules and plaques at the gingiva are termed mucogingivitis and may be one of the common lesions.
(Redacted)

JenOttawa (talk) 03:21, 24 January 2020 (UTC)

I have removed some of the above material, which is copyright material copied from the source book. Visible here — Diannaa (talk) 15:29, 24 January 2020 (UTC)
Thank you for noticing this @Diannaa:  JenOttawa (talk) 15:33, 24 January 2020 (UTC)
It was found by the bot— Diannaa (talk) 15:34, 24 January 2020 (UTC)
Thanks @Diannaa: for sharing the link to the list and for cleaning up both the talk page and the article. Have a great day! JenOttawa (talk) 15:46, 24 January 2020 (UTC)

From what I've managed to gather it appears that PD prevalence is associated in general with autoimmune diseases and IBDs not specifically with Crohn's, and even then isn't exactly a typical symptom, the article itself mentions a prevelence of around 1.2% for people with Crohn's.
PG is also mentioned in just 2 sentences throughout the article (the second of which by the way, appears strangely out of place in the paragraph it is written in). Giving it an images appears to be a somewhat out-sized representation, when other physical presentations mentioned in the article (uveitis, gallstones, Primary sclerosing cholangitis, ankylosing spondylitis, deep venous thrombosis, Clubbing, Erythema nodosum) are not pictured.
It is also notable how prominent the image is when compared to the images of symptoms actually used in the diagnosis of the CD.
Finally, I'm not certain it represents a typical presentation of PG, and not a rather severe case, while I managed to find some other images of PG online (some appeared more and some appeared less severe), I wasn't able to find much to point me either way.
TJmichael (talk) 15:17, 23 July 2020 (UTC)
Let's put it this way, for the above reasons, I really don't think the image belongs in this article, however, it has been here for a really long time, and I that means multiple editors have seen it and didn't see a reason for it to go. I'm increasingly leaning towards just remove this image. Does anyone have any justification for not doing so? TJmichael (talk) 07:41, 3 August 2020 (UTC)

Agree.  Less relevant here than erythema nodosum.  Changed figure and added a large (free) epidemiological study with prevalences.Jrfw51 (talk)
While you're at it I might take a look at Ulcerative colitis too, there's a large image of PG there that feels equally out of place. Not only is PG less prevalent in UC paitents (according to the chart posted on this very article), but the image also shows large PG ulcers on a person's back, which it is my understanding isn't even the typical presentation of PG (https://www.mayoclinic.org/diseases-conditions/pyoderma-gangrenosum/symptoms-causes/syc-20350386). Though I admit I have fat less knowledge of UC than I do Crohn's. TJmichael (talk) 14:51, 4 August 2020 (UTC)
The data in these Tables for complications are wrong and not supported by the cited article.  We need to revisit these for both Crohns and UC.Jrfw51 (talk) 08:53, 6 August 2020 (UTC)

Tends to start in the teens and twenties.
Usual onset 20 to 30.
Which one is true? jtg (talk) 19:01, 27 August 2021 (UTC)

From my own experience, first symptoms in my late teens, with it getting very much worse in my early 20s. Lugnuts Fire Walk with Me 19:34, 27 August 2021 (UTC)

Hello, about my edit
@Zefr: I have found many sources about it, someone professional please keep it back on this article.

https://europepmc.org/article/med/36191962
https://pubs.acs.org/doi/abs/10.1021/acs.jafc.9b02391
https://www.zora.uzh.ch/id/eprint/222379/
https://www.researchgate.net/publication/293168967_Titanium_dioxide_nanoparticles_exacerbate_DSS-induced_colitis_Role_of_the_NLRP3_inflammasome
https://www.mdpi.com/1422-0067/22/2/772
https://hal.inrae.fr/hal-03321952/document
https://particleandfibretoxicology.biomedcentral.com/articles/10.1186/s12989-021-00421-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275967/
https://gut.bmj.com/content/66/7/1216
https://eomifne.gr/images/pdf/ioibd/IOIBD%20-%20IBD%20&%20dietary%20GLs%202020.pdf
https://www.viridian-nutrition.com/blog/nutrition-news-and-views/breakthrough-study-common-colouring-titanium-dioxide-aggravates-bowel-disease
https://ibdnewstoday.com/2017/07/20/study-suggests-food-additive-titanium-dioxide-can-exacerbate-bowel-disease/
https://www.crohnscolitisfoundation.org/diet-and-nutrition/what-should-i-eat
https://www.youtube.com/watch?v=pBCiBx5YLtU
https://www.medicalnewstoday.com/articles/ibd-common-red-food-coloring-may-cause-intestinal-inflammation-colitis
https://www.nature.com/articles/srep40373
https://www.bcchr.ca/news/food-additives-inflammatory-bowel-disease
https://www.gastroscience.ch/research/inflammation/the-impact-of-nano-and-microparticles/
plus Voice of America Persian News Network made a report about it: https://ir.voanews.com/a/food-/3956976.html
Thank you. NameGame (talk) 06:14, 12 March 2023 (UTC)

We are writing for a medical topic in an encyclopedia, requiring high-quality review sources on human studies, as described in WP:MEDRS. Not one of the sources above meets the definition of "high-quality review" - see WP:MEDASSESS, left pyramid. Zefr (talk) 15:05, 12 March 2023 (UTC)
@Zefr: Thank you for your answer. my goal is to make an awareness to the inflammatory bowel disease patients.
Now, do you believe that I might be allowed to replace this significant research about the Titanium dioxide in its own article? NameGame (talk) 18:20, 12 March 2023 (UTC)
There is no review literature to indicate it is involved specifically as a factor in IBD. There are no systematic reviews of randomized controlled trials on this topic. I did add this section to the titanium dioxide article. Zefr (talk) 20:44, 12 March 2023 (UTC)
I appreciate it. NameGame (talk) 21:18, 12 March 2023 (UTC)

"Etiology" is essentially just a fancy word for "cause", so having both sections is a bit nonsensical. — Guillaume Pelletier ~ 01:05, 4 April 2023 (UTC)

@Epgui I do agree with you about the wordage issue, however both sections seem to discuss slightly different topics. The causes section seems to discuss risk factors more than true etiology, so it might be more pertinent to rename the section to risk factors rather than keep it as causes.
As far as combining them, that would work too. All just depends on how you want to go about it. Justin99887 (talk) 14:35, 8 April 2023 (UTC)

There are various studies related to treatment of CD by clarithromycin + rifabutin (both basically anti-mycobacterial / tuberculosis drugs (i.e. mycobacterium avium complex): [1][2][3]
May be worth checking. AXONOV (talk) ⚑ 14:41, 21 January 2024 (UTC)

Any WP:MEDRS ? Bon courage (talk) 14:48, 21 January 2024 (UTC)
Enough to mention in given WP:RSCONTEXT. These aren't reviews of course. So far nobody can state that therapy is efficient. AXONOV (talk) ⚑ 19:53, 21 January 2024 (UTC)
There is a review [4] with uncertain reliability. AXONOV (talk) ⚑ 08:11, 23 January 2024 (UTC)
Not a great source, but possibly okay for a mild claim like "no good evidence of benefit". Bon courage (talk) 09:02, 23 January 2024 (UTC)
ALSO: there is a limited evidence of high IgG concentrations (read antibodies) to mycobacteria in Chron's patients. AXONOV (talk) ⚑ 19:03, 12 February 2024 (UTC)

There is a limited evidence that CD patients have high IgG to Mycobacterium: [5][6][7] AXONOV (talk) ⚑ 19:40, 12 February 2024 (UTC)

Ancient primary sources. Any WP:MEDRS? Bon courage (talk) 05:31, 13 February 2024 (UTC)

The redirect Crohn s Disease has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at Wikipedia:Redirects for discussion/Log/2024 September 14 § Crohn s Disease until a consensus is reached.  1234qwer1234qwer4 16:42, 14 September 2024 (UTC)

Listing this as a risk factor is based on old and poor data. Appendectomy is not associated with increased risk of crohns onset 
https://pubmed.ncbi.nlm.nih.gov/11436010/ 130.51.28.99 (talk) 07:17, 16 September 2024 (UTC)

I noticed the majority of content of this crohn's disease wiki page has been stripped of its content. The edit history shows a single person, AdeptLearner123, who has been a busy bee the last months, consistently removing the majority of the Crohn's disease page, sources, paragraphs, etc. We had a very detailed page that had hundreds of contributers, reduced to one written by a single person, AdeptLearner123. The large majority of the content is now gone. On his User:Talk page, he is accused of removing swaths of content on other articles, without explanation, and that content had to be restored. What is going on here? I am not adept enough at editing Wikipedia articles, but I don't think a single person should be removing so much content, and rewriting a whole article. Can we start restoring this vandalism, and look on which other pages he has being doing this. This was a well-regarded article before its content was stripped.

The previous version of the article was not well-sourced and contained duplicate information across the different sections, since it had been written by so many different users. I have consolidated the sections, added a new section on the mechanism of the disease, and consolidated the sources around fewer well-sourced articles, such as from Nature or Mayo Clinic. AdeptLearner123 (talk) 01:01, 5 November 2024 (UTC)
@AdeptLearner123  While I haven’t looked through the article fully I will say in my experience sometimes it’s best to have a couple comprehensive reviews on the topic (like you’ve done Natures review Primer) and then to find more detailed articles for each section. for example using the review to get the basics of the diagnosis for a disease but then finding a couple comprehensive articles focusing on specifically the diagnostic process and using those to build details. This usually creates a more balanced article and could help fill in some of the gaps. If you would like i could focus on one of the sections and help find some articles to help fill in those gaps. IntentionallyDense (talk) 01:32, 5 November 2024 (UTC)
That sounds good. I also don't want to make each section too detailed. For the Tumor Necrosis Factor FA review I was told that some of the sections were too detailed and detracted from the overall flow of the article. AdeptLearner123 (talk) 02:13, 5 November 2024 (UTC)
I do understand this but Crohn’s disease is a huge topic and will therefore be quite long. Take for example the recent ME/CFS FA. It is quite long but appropriately so. If needed you can also make separate articles for some of the lengthier sections (i’m currently doing this with the treatment of IBS for example). I’ll get around to giving some more feedback tonight but will do so on the peer review page as that seems more appropriate (ps i’ve already given some input there as well). IntentionallyDense (talk) 02:33, 5 November 2024 (UTC)

Why was this passage removed by @Adeptlearner123 on the previous version of the article? It was well sourced and accurate.
"While Crohn's is an immune-related disease, it does not seem to be an autoimmune disease (the immune system is not triggered by the body itself). The exact underlying immune problem is not clear; however, it may be an immunodeficiency state." 2A00:23C6:9C67:7D00:CC27:86CA:20F6:6A9B (talk) 18:23, 11 January 2025 (UTC)

Most sources I've read, including information from medical school and textbooks classify it as an autoimmune disease because of the autoantibodies. I wanted to edit this on the article page, but I decided to comment here first. I view it as an autoimmune disease, especially due to the fact that Crohn's patients are at a higher risk of having other autoimmune conditions, which is quite common in individuals with autoimmune diseases. Summerfell1978 (talk) 22:43, 14 February 2025 (UTC)
That's all well and good, but current research, as I understand it, is exploring Crohn's as a (over)reaction to environmental bacteria in the gut (see MAP vaccine, etc).  Auto-antibodies are much less common in Crohn's than they are in UC (https://pmc.ncbi.nlm.nih.gov/articles/PMC4716040/) (specifically for pANCA, but not inherently true for anti-pancreas) however microbial antibodies have a significantly higher positive rate 130.246.242.14 (talk) 10:26, 18 August 2025 (UTC)
I note now that the page has since been reverted and the original language describing the exact classification of Crohn's has been restored. I think the new language is well cited and a big improvement on the vandalism that was done before 130.246.242.14 (talk) 10:35, 18 August 2025 (UTC)

This was a Good Article that has now been entirely rewritten by someone who does not appear to be a medical professional. The entire page is either reliant on a single source, or (in the treatment section) is reliant on a second source that does not corroborate with the cited content whatsoever. Major topics are missing from the page, particularly in the treatment section - for example, there is no mention whatsoever of sulfasalazine, which was the first-line for mild to moderate disease until very recently (and seemingly still is, by some opinions). 
I'm honestly at a loss for what to do here. The current version is a disaster, but the previous one was a GA. Can we revert it?
oldid=1251397700 is the last revision before the large-scale destruction of the page began. Just-a-can-of-beans (talk) 15:32, 27 January 2025 (UTC)

@Just-a-can-of-beans, thanks for alerting WPMED here as i feel that is often the best way to get a varied amount of feedback. I’m going to ping AdeptLearner123 here as they have made a significant amount of changes to this article recently. These changes have been questioned both on this talk page and on the peer review as well as WP:MED. I’m going to repeat what I said earlier on this topic: in my experience it’s best to have a couple comprehensive reviews on the topic and then to find more detailed articles for each section. for example using the review to get the basics of the diagnosis for a disease but then finding a couple comprehensive articles focusing on specifically the diagnostic process and using those to build details. This usually creates a more balanced article and could help fill in some of the gaps.
Regardless of which direction this article goes in (reverting or keeping) i think it can be hard to find the balance between including a million different sources and just using a couple less in depth sources. Ideally an article should fall somewhere in the middle. A systematic review focused on Crohn’s disease as a whole will be helpful for writing a one or two paragraph summary on how Crohn’s is diagnosed, however a systematic review focused on solely the diagnosis of Crohn’s disease will be much more helpful and comprehensive for writing the diagnosis section in a way that is informative for both casual readers just wanting to know what tests are used and more advanced readers who wish to know what values are looked for, specific histological sign, sensitivity/specificity, what’s considered the “gold standard” and what’s outdated and so forth. A well written Wikipedia article should be able to satisfy both learners without compromising readability or depth. IntentionallyDense (Contribs) 20:09, 27 January 2025 (UTC)
agreed, needs a revert asap. 130.246.242.14 (talk) 15:15, 3 February 2025 (UTC)

After comparing versions and letting this get more people to see it, I went ahead with the reversion. The page still needs some work with bringing cites in line and updating with some recent (past few years) recommendations, but nonetheless it represents a more balanced and comprehensive overview. @AdeptLearner123 since this reversion overwrites a lot of work on your part, when and if you return to Wikipedia, I hope this ping helps you see this. Just-a-can-of-beans (talk) 22:02, 4 February 2025 (UTC)

agree with reversion as well as identification by adept that original version needed work. Bluethricecreamman (talk) 02:17, 5 February 2025 (UTC)