Clinical index for the evaluation of the activity of Crohn's disease. The Harvey-Bradshaw index is easier to use than the CDAI in daily practice, the collection of data being made during consultation but significant fluctuations can be observed from one day to the next. It is closely correlated with the CDAI.
Data to be collected by the doctor on the data of the day (24 hours) preceding the visit.
Interpretation according to the 2010 ECCO consensus:
Non -active disease: <4
Slight activity of the disease: > = 4 and <= 8
Moderate disease activity: > 8 and <= 12
Severe disease activity: > 12
Most often, Crohn's disease evolves by more or less close and more or less intense thrusts, interspersed with periods of remission during which the person has no more symptoms. The evolution of this disease differs from person to person. Some patients experience daily difficulties during thrusts and their quality of life is altered.
Various problems can arise during the evolution of Crohn's disease:
intestinal stenoses (narrowing of the intestinal diameter);
fistulas or intra-abdominal abscesses by perforation of the intestinal wall;
anal cracks, abscesses and anal fistulas in the event of anal channel damage;
undernutrition and vitamin deficiencies by poor absorption of nutrients and vitamins through the intestinal wall;
Anemia (due to poor iron absorption and inflammation ...)
Certain acute complications of Crohn's disease require immediate treatment in the hospital (most often surgical):
Intestinal occlusion (stopping the progression of stool in the intestine), is most often linked to stenosis;
peritonitis (peritoneum infection) by perforation of the intestinal wall;
a digestive hemorrhage;
An abscess in the anus and perineum area.
Other diseases can associate with the digestive damage of Crohn's disease:
joint damage (joint pain with frequent impairment of the spine or spondylarthritis);
Uveitis (inflammation of certain structures of the eye: iris, choroid): red, painful, and tearful eye, with vision disorders;
Knotty erythema (stockings the size of a nut, hard, red and painful, on the legs and forearms);
Buccal canopies, frequent in Crohn's disease;
Vascular problems are favored by inflammation ...
In addition, in children and adolescents with Crohn's disease, we can observe stunning and/or puberty delay, as well as academic difficulties due to the impact of Crohn's disease on daily life.
In adults, everyday life can also be affected, with particular psychological repercussions and a socio-professional impact.
Finally, in the long term, the risk of colon or intestine cancer increases in patients affected by Crohn's disease (especially if they have extensive lesions). Ileocoloscopies are made regularly to detect a suspicious lesion as soon as possible.