# Diagnosing Crohn's Disease In Remission

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If Crohn's Disease is in remission at the time of a colonoscopy, can there still be evidence of disease? I know there is no definitive test for it, but colonoscopies do provide clues sometimes. Are those clues there only during a flare-up?

If Crohn's Disease is in remission at the time of a colonoscopy, can there still be evidence of disease? I know there is no definitive test for it, but colonoscopies do provide clues sometimes. Are those clues there only during a flare-up?

There is evidence of increased activity of immunocompetent cells and increased levels of the cytokine TNF-$\alpha$ (tumor necrosis factor) in the intestinal mucosa during at least some remissions. It's not clear how specific this is for Crohn's disease if no prior diagnosis has been made, nor is it clear that this is the case during long remissions (years) with or without ongoing treatment.

Otherwise the best evidence for prior activation of undiagnosed Crohn's disease is the patient's personal and family history AFAIK. Fistulas, intestinal wall thickening and localized narrowing of the intestinal lumen are evidence of recent inflammatory bowel disease activation.

http://onlinelibrary.wiley.com/stor...1590A84005ACD2.d02t02?v=1&t=hla204cu&d771f933

The link is blocked for me. The reference is Aliment. Pharmacol. Ther. 2002; 16 (supple. 4) 29-33

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Staff Emeritus
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That's about what I suspected. Thanks!

I guess the silver lining is, when it's in remission there are no symptoms at all.

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