ClinResHepatolGastroenterol. 2024Nov15:102500.doi:10.1016/j.clinre.2024.102500. Online ahead of print.

Christophe Souaid ¹, Eddy Fares ¹, Paul Primard ¹, Gilles Macaigne ¹, Weam El Hajj ¹, Stephane Nahon ²

Author information

¹Gastroenterology unit, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, France.

²Gastroenterology unit, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, France. Electronic address: stephane.nahon@ght-gpne.fr.

Abstract

Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract where early diagnosis and timely, appropriate management are essential to prevent severe complications and reduce the need for surgery. This review sought to investigate factors contributing to diagnostic delays in CD, which typically ranged from 5 to 16 months. Delays were often due to nonspecific symptoms that could be mistaken for irritable bowel syndrome (IBS) and were influenced by various factors including age, education level, smoking, NSAID use, and disease characteristics like isolated ileal involvement. Healthcare system disparities also played a significant role, with delays varying by access to care. The review highlighted that delayed diagnosis was linked to worse disease outcomes, such as increased severity and complications, and underscored the importance of early intervention combined with timely management. Strategies to mitigate delays included implementing red flag tools, using inflammatory biomarkers like fecal calprotectin, and enhancing public and healthcare provider awareness. Addressing these factors and improving referral pathways and healthcare system efficiencies were crucial for enhancing early diagnosis and patient outcomes.