History of Crohn's Disease
History of Crohn's Disease
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Was the medical history event prespecified?
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What was the category of the medical history?
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At what age did the subject's Crohn's symptoms start?
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Has the subject ever had Crohn's ileitis?
No
Yes
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Has the subject ever had Crohn's colitis?
No
Yes
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Has the subject ever had Crohn's ileocolitis?
No
Yes
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Has the subject ever had upper gastrointestinal Crohn's disease?
No
Yes
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Has the subject ever had any strictures?
No
Yes
If Yes, what is the estimated number of strictures?
If Yes, what are the anatomical location(s) of the strictures?
Ileum
Colon
Upper GI tract
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Has the subject ever had any abscesses?
No
Yes
If Yes, what is the estimated number of abscesses?
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Has the subject ever had any fistulas?
No
Yes
If Yes, what is the estimated number of fistulas?
If Yes, where are the fistulas located?
Choose
Right colon
Left colon
Transverse colon
Terminal ileum
Rectum
If Yes, what anatomical type(s) of fistulas?
Choose
Perianal
Rectovaginal
Enteroenteric
Enterocutaneous (other than perianal)
Other
If "Other", specify.
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What was the category of the medical history?
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Has the subject ever had any diagnosed pyoderma gangrenosum as an extra-intestinal manifestation of Crohn's disease?
No
Yes
If Yes, what is the estimated number of pyoderma gangrenosum lesions?
If Yes, what is the longest diameter of the primary pyoderma gangrenosum lesion?
What is the unit for the longest diameter of the primary pyoderma gangrenosum lesion?
mm
cm
in
What was the location of the primary pyoderma gangrenosum lesion?
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Has the subject ever had arthritis as an extra-intestinal manifestation of Crohn's disease?
No
Yes
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Has the subject ever had arthralgia as an extra-intestinal manifestation of Crohn's disease?
No
Yes
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Has the subject ever had erythema nodosum as an extra-intestinal manifestation of Crohn's disease?
No
Yes
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Has the subject ever suffered from malnutrition as an extra-intestinal manifestation of Crohn's disease?
No
Yes
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Mandatory field