What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory disease of the intestines that can affect the digestive system from the mouth to the anus. The most commonly affected areas tend to be in the small and the large intestines (Colon).
Regional enteritis (Inflammation confined to the small intestine. The first part is called the jejunum and the second part is called the ileum)
Terminal ileitis (inflammation that affects the end of the small intestine (terminal ileum), the part of the small intestine closest to the colon.
Crohn’s colitis (inflammation confined to the colon area)
Crohn’s entero–colitis and ileo–colitis (inflammation in both the small intestine and the colon)
Crohn’s disease was first described in 1932 by an American gastroenterologist called Burrill Bernard Crohn. Together, Crohn’s disease and Ulcerative colitis are frequently referred to as inflammatory bowel disease (IBD). Unfortunately there are no medical cures for Crohn’s disease or IBD at present, but that should not dishearten any sufferer. Advanced medicine, maintaining a healthy diet and leading a healthy lifestyle can help to ease suffering and possibly send the disease into periods of remission.
Both men and women are equally affected by Crohn’s disease. It commonly begins during adolescence or early adulthood, but is also found in childhood and older patients. Crohn’s disease is more common in, but not limited to, relatives with the disease.
In the United States it is thought that up to two million (500,000) people are currently affected, with the numbers growing daily.
Crohn’s disease is not contagious.
What causes Crohn’s disease?
Unfortunately it is not known what causes Crohn’s disease, though it is believed that diet can play a key roll in assisting patients with Crohn’s disease. It is also thought that the disease could be genetically inherited, but it could also be the lifestyle and diet routine of the family that is inherited.
There are various theories surrounding the causes of Crohn’s disease that are of interest to the scientific community, but none have been proven.
Of great interest to Crohn’s Directory is the idea that the body’s immune system is reacting unfavorably in people with Crohn’s disease because the immune system mistakes components of food, bacteria and other foreign substances such as antigens as something much worse. The result is that the body responds by attacking these “intruders” by sending white blood cells the “affected” area.
The accumulation of these white blood cells in the lining of the stomach causes chronic inflammation, ulcerations and bowel scarring. Interestingly, some scientists believe that antigens themselves could be the cause of inflammation, where a protein produced by the immune system, called anti-tumor necrosis factor (TNF) creates the inflammatory problems associated with Crohn’s disease.
Symptoms of Crohn’s disease?
The symptoms of Crohn’s disease depend largely on the location of activity. Common problems can include some or all of the following: Abdominal pain, diarrhea, and weight loss. Other symptoms can include rectal bleeding, arthritis, weight loss, skin problems and fever.
Approximately 30% of Crohn’s sufferers develop one or a combination of ulcers, fissures (long ulcers) and fistulae (abnormal tunnels) causing pain and complications in the anal area.
Over time, narrowing can occur in sections of the intestine leading to increased risk of a blockage. Ulcer tracts in the gut, which are caused by the disease can also burrow into surrounding organs, including the gall bladder, the liver and skin, causing infections. With an increased risk blockage, damage and infection, doctors will generally recommend surgery to remove the diseased section of intestine.
How is Crohn’s disease diagnosed?
Blood tests can reveal an elevated white blood count in the body. In addition, sedimentation rates can be used to identify and monitor inflammation in the body. Both of these tests can show signs of infection and inflammation which are good indicators of Crohn‘s disease activity in the bowel.
Additional blood tests can be used to monitor the red blood cell count, blood proteins, and minerals that can be low due to chronic diarrhoea.
To diagnose Crohn’s disease stool samples can also be tested to show bleeding or infection in the intestines.
A Barium follow through procedure can be used to study the location and severity of Crohn’s disease before more invasive tests such as a sigmoidoscopy or a colonoscopy are considered. The Barium study involves drinking a chalky barium solution that appears white on x-ray films. Pictures or live visuals of the colon and the terminal ileum can be achieved showing ulcerations and narrowing of the bowel where Crohn’s disease is present.
More accurate visuals can be obtained using either a sigmoidoscopy or a colonoscopy. Both procedures use a small camera device on a tube (colonoscope) to view in more detail ulcers and areas of inflammation inside the bowel. A colonoscopy also gives the doctor a chance to take internal tissue samples (biopsies) that can be examined under a microscope to confirm the diagnosis of Crohn’s disease.
How is Crohn’s disease treated?
Unfortunately there is no known medical cure for Crohn’s disease. However, the chronic disease can go into periods of remission and patients with mild or no symptoms may not need treatment at all. Remission can occur without intervention but is most commonly won after surgery or treatment.
During relapse (worsening of the symptoms) treatment of Crohn’s disease can include medications to help control and induce remission. These medications can include but may not be limited to anti inflammatory drugs, immune-modulators, antibiotics, steroids and natural or herbal treatments.
The primary intention is to use medications to improve the overall quality of life for the patient by attempting to control and hopefully induce remission, although this is not guaranteed.