ECCO-EFCCA Patient Guidelines on Crohn’s Disease (CD)

is diagnosed when other causes for the ulcers cannot be found; biopsy can help exclude
other skin disorders. Rapid healing should be the goal of treatment because this can be a
debilitating disease. Corticosteroids should be used first before calcineurin inhibitors are
tried. Infliximab is beginning to get used more often and has been shown to be effective
in one large study and two small case studies. No studies have compared systemic
steroids, anti-TNF treatment or calcineurin inhibitors to each other as yet. Surgical
interventions as in other skin ulcerations need to be avoided.
Thromboembolic complications
Prevention of thrombosis (i.e. formation of blood clots) should be considered in all
hospitalized and outpatients with severe disease. Treatment of IBD patients with venous
thromboembolism (i.e. blood clot blocking a vein) should follow established therapeutic
options against thrombosis.
For largely unknown reasons, patients with CD are at increased risk for blood clots, called
venous thromboembolism, in the veins. These are important to prevent and treat
because they can lead to complications or even death. Such blood clots should be
diagnosed using appropriate imaging techniques, such as ultrasound and venography.
In terms of treatment, blood thinning medications (called anticoagulants) should be used
to prevent and also treat blood clots. If a person has a second episode of blood clots they
should consider having long-term treatment. IBD patients do not seem to have more
bleeding complications caused by blood thinners than people without IBD. Lastly, CD
patients should be wary of long distance travel as well as oral contraceptives as these
further increase the risk of blood clots and should consider preventive anticoagulation
therapy under certain circumstances.
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