Frequency of continuing mucosal inflammation in clinically inactive Crohn's disease

The treatment goal in Crohns disease is clinical remission, not complete mu cosal healing. The incidence of mucosal inflammation in Crohns disease pati ents in clinical remission is not known. Whole gut lavage is an objective m ethod of assessing mucosal inflammation. We aimed to assess levels of mucos al inflammatory activity in a group of patients with clinically inactive Cr ohns disease. We prospectively assessed 30 patients with inactive Crohn dis ease and 28 controls. Inactive disease was defined as Crohns disease activi ty index of less than 150. All underwent whole put lavage, with analysis of whole gut lavage fluid IgG, haemoglobin, interleukin-1 beta interleukin-8 and granulocyte elastase. Serum inflammatory parameters were collected for comparison. Of the 30 patients with Crohns disease, 10 (33%) had an abnormal immunoglob ulin G, 21 (70%) had an elevated interleukin-Ig 20 (66%,) interleukin-8 and 10 (33%) granulocyte elastase in the whole gut lavage fluid. 58% of patien ts had either 1 or 2 abnormal results. In contrast only 10% had 1 or 2 abno rmal serum results. Few abnormalities were present in lavage fluid or serum of the control population. We concluded that ongoing mucosal inflammation is detectable in whole gut lavage fluid of up to 2/3 of Crohns disease pati ents in clinical remission.