WHAT IS CROHN’S DISEASE?

Crohn’s is a disorder of uncertain etiology. It has often been thought of as an autoimmune disease but research suggests that the chronic inflammation may not be due to the immune system attacking the body itself, but rather a result of the immune system attacking harmless virus, bacteria or food in the gut causing inflammation that leads to bowel injury.

 

In Crohn's, the intestine, bowel, or other part of the digestive tract becomes inflamed and ulcerated -- marked with sores. Along with ulcerative colitis, Crohn's disease is part of a group of diseases known as inflammatory bowel disease (IBD).

 

Crohn's disease usually affects the lower part of the small intestine, which is called the ileum, and the beginning of the colon. The disease, though, can occur in any part of the gastrointestinal system. Thus, the disorder may affect the large or small intestine, the stomach, the esophagus, or even the mouth. Crohn's can occur at any age. It is most commonly diagnosed in people who are between the ages of 15 and 30.

 

 

Crohn's disease can cause other parts of the body to become inflamed (due to chronic inflammatory activity) including the joints, eyes, mouth, and skin. In addition, gallstones and kidney stones may also develop as a result of Crohn's disease.

Moreover, children with the disease may experience decreased growth or delayed sexual development.

 

WHAT CAUSES CROHN’S DISEASE?

The cause of Crohn's disease is unknown. However, it is likely due to an abnormal response of the immune system. Food or bacteria in the intestines, or even the lining of the bowel may cause the uncontrolled inflammation associated with Crohn's disease.

 

WHO GETS CROHN’S DISEASE?

Crohn's disease is often inherited. About 20% of people with Crohn's disease may have a close relative with either Crohn's or ulcerative colitis. In addition, Jewish people of European descent (Ashkenazi) are at greater risk for the disease.

 

While Crohn's disease can affect people of all ages, it is primarily an illness of the young. Most people are diagnosed before age 30, but the disease can occur in people in their 60's, 70's, or even later in life.

 

SYMPTOMS

Lots of people have stomach cramps with diarrhea or constipation. It’s uncomfortable, but you usually get over it and forget about it.

But when you have these symptoms often, and they’re severe, there’s a chance you could have Crohn’s disease. You’ll need to see your doctor to find out for sure.

As many as 700,000 Americans have the disease. Although there’s no cure, there are treatments to manage it.

You may have:

  •   Diarrhea

  •   Stomach pain

  •   Weight loss

  •   Bleeding from your rectum

  •   Constipation

  •   Fatigue

  •   Nausea

  •   Fever

  •   Sudden and frequent need to go to the bathroom

 

You might not have all these. The disease affects different people in different ways. The symptoms can

be mild, or they can leave you very weak. At its worst, Crohn’s can cause severe complications.

Complications

The most serious cases of Crohn’s can cause:

  •   Painful tears called fissures in the lining of the anus, mostly during bowel movements

  •   Fistulas (passages that form between loops of the intestine, or between the intestines and the vagina, skin, or bladder)

  •   Thickening of intestine walls, which makes it hard for food and waste to move

  •   A partly or totally blocked intestine, for which you would need medical care right away

  •   Open sores called ulcers in the intestines, mouth, or anus

  •   Malnutrition, as your body is not able to absorb enough nutrients from food

  •   Pain, swelling, and burning in other parts of your body, such as your skin, eyes, or joints

 

Crohn’s Confusion

Crohn’s disease is often confused with another condition called ulcerative colitis. The symptoms are similar, and both involve periods of active flare-ups, followed by times when you don’t have symptoms, which is called remission.

The only way to find out if you have Crohn’s or ulcerative colitis is to see your doctor for tests.

 

A colonoscopy can provide a view of all of the large intestine and often the end of the small intestine, which is frequently affected by Crohn's. In either case, the doctor can directly view the colon to check for signs of ulcers, inflammation, or bleeding. The doctor can also take small samples of tissue to examine under a microscope, known as a biopsy. This helps determine whether the tissue shows signs of Crohn's disease or other problems.

 

CAUSE OF CHRON’S DISEASE

Although there are many theories about what causes Crohn's disease, none of them have been proven. There is a benefit, though, in understanding the possible causes of Crohn's disease and how they interact with one another. Doing so can help one better understand the symptoms, diagnosis, and treatment of Crohn's disease.

Scientists believe that Crohn's disease is caused by a combination of these factors:

  •   Immune system problems

  •   Genetics

  •   Environmental factors

How might each of these factors contribute to Crohn's disease?

 

Environmental factors may contribute to Crohn's disease in one of these two ways:

  •   They may trigger an immune system response. Once started, the response cannot stop.

  •   They may directly damage the lining of the intestines. This may cause Crohn's disease to begin or to speed up.

 

How is Crohn's disease diagnosed?

A number of tests are used to distinguish Crohn's disease from other gastrointestinal conditions. First, your doctor will review your medical history. This information is helpful because Crohn's disease is more common in people who have a first-degree relative -- mother, father, sister, or brother -- with IBD. After a physical examination is done, the doctor may order the following tests:

  •   Endoscopy (such as colonoscopy or sigmoidoscopy): During this procedure, a flexible, lighted tube called an endoscope is inserted into the rectum and used to view the inside of the rectum and colon. A colonoscopy shows a greater portion of the colon than a sigmoidoscopy does. A small sample of tissue may be taken for testing -- biopsy. An upper endoscopy may also be used to look down the esophagus, into the stomach and the first part of the small intestine, the duodenum. A capsule endoscopy uses a pill with a camera inside that is swallowed and takes pictures of the small intestine

  •   Blood tests: When testing the blood, the doctor will look for signs of anemia or a high white blood cell count that could indicate inflammation or infection somewhere in the body.

  •   Barium X-ray (barium enema or small bowel series): X-rays are often taken of either the upper or lower intestine. Barium coats the lining of the small intestine and colon and shows up

  •   white on an X-ray. This characteristic enables doctors to view any abnormalities.

  •   CT scans and an MRItaken with oral contrast are other imaging tests that are used.

 

How is Crohn's disease treated?

There is no cure for Crohn's disease. The goals for treatment are:

  •   to reduce inflammation

  •   to relieve symptoms of pain, diarrhea, and bleeding

  •   to eliminate nutritional deficiencies

Treatment might involve drugs, nutritional supplements, surgery, or a combination of these therapies. Treatment choices depend upon where the disease is located and how severe it is. They also depend on the complications associated with the disease and the way the person has responded in the past to treatment when symptoms recurred.

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