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Crohn's Disease

Crohn’s Disease is a chronic inflammatory disease affecting the intestinal wall. Terminal ileum and colon are the more frequent locations. Most of the people develop the symptoms before being 35 years old, both genders are equally affected and the incidence of the disease has been increasing for the last decades. Several members of the same family are often affected. There is no cure and people suffering from it may present long periods of remission.

TreatCauses and Risk Factorsment

In fact, the cause of the Crohn’s disease is currently unknown. It is believed to result from an exaggerated immune response to some environmental factors, diets or infections. Genetics seems to play an important role. Among the risk factors, smoking contributes to the development of the disease and to an increasing number of recurrent crises too. Past family history of the disease and Jewish ancestry are also factors of increased risk.

Symptoms

Recurring diarrhea, fever, abdominal pain that worsen after eating, cramping, bloody and mucous stools, swollen gums, asthenia and weight loss are the main and most common symptoms. Usually, the first ones to show up are the fever, the diarrhea and the loss of appetite and weight as well. They may last for days or weeks. The Crohn’s is characterized by irregular recurring active periods or crises. One third of the patients display some anal fissures and/or fistulas along with the disease.

Diagnosis

Main features are :

  • Palpable abdominal mass
  • Palpable abdominal mass
  • Anemia
  • Positive colonoscopy and biopsy
  • CT scan (may be useful to differential diagnosis)

Treatment

Crohn’s disease is incurable and chronic. Then the treatment is mostly symptomatic.

Diet and life : Patients should have a balanced diet. However, they must avoid eating large amounts of food each time and stay away from high-fat, greasy or high-fibber foods as well. Drinking lots of water is of major importance. Avoiding and managing the Stress and worries will help on controlling the symptoms.

Medicines :

  • Anti-diarrhoeics (loperamide)
  • Anti-inflammatories (corticosteroids)
  • Immunomodulators (to control the immune response of the body, such as methotrexate and infliximab)
  • Antibiotics (in case of infectious complications and/or fistulas)

Surgery :

  • If the medicines don’t help or if fistulas have developed, surgery may be needed.

Prognosis

There is no cure. However, Crohn’s does not decrease or compromise one’s life expectancy by itself.

Complications

Development of abscesses, fistulas (connecting the bowel with the skin, bladder or vagina), intestinal occlusion, erythema nodosum, eye lesions (uveitis), impaired growth (children) and articular inflammation (artritis) are common complications of Crohn’s disease. Accumulation of amyloid protein (amyloidosis) and nutritional deficits (due to vitamin B12 deficiency) also are extraintestinal manifestations of the disease.

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