Crohn’s disease is a chronic inflammatory condition of the intestine. The disease can be very mild or quite severe. It may occur anywhere in the intestinal tract but most often is present at the end of the small intestine and the colon. When the disease is mild, the only findings may be those seen on Image 1. These small lesions are call aphthous or target ulcers, much like ulcers that may occur in the inside of the mouth. There is a shallow, whitish ulcer with surrounding reddening. In Image 2, there is a more or less diffuse reddening and inflammation, which may be difficult to distinguish from ulcerative colitis, another chronic inflammatory bowel disorder.
As the disease progresses, discreet white ulcers may appear as in Image 3. These ulcers are present in the ileum, the end portion of the small bowel. Image 4 demonstrates what happens when these ulcers then join together, creating a great deal of whitish ulceration, spreading across the rectum in this instance.
In severe disease, the ulcerations burrow deep into the bowel wall, creating scar formation, which can narrow the bowel. The same type of very advanced disease is where almost the entire bowel wall is ulcerated. These types of lesions are difficult to heal with medicine and may require surgery.