Contents:
- Medical Video: What is Crohn's Disease?
- What are the symptoms of Crohn's disease?
- What causes Crohn's disease?
- What are the factors that trigger my risk of Crohn's disease?
- How is Crohn's disease diagnosed?
- How is Crohn's disease treated?
- Anti-inflammatory drug
- Operation
- What foods do I need to avoid?
Medical Video: What is Crohn's Disease?
Crohn's disease is a condition that causes inflammation of the digestive system, which most often affects the ileum or large intestine.
Ileum is the last part of the small intestine. Its main function is to absorb fatty acids, glycerol, vitamin B12, and other bile salts. Ileum also releases hormones and enzymes to break down carbohydrates and proteins.
The function of the large intestine is to get rid of bacteria, waste, and food scraps whose nutrients have been absorbed by the body.Because of this function, Crohn's disease can cause other conditions related to the digestive system.
What are the symptoms of Crohn's disease?
Most symptoms of Crohn's disease occur in the digestive tract, although they can cause symptoms in other parts. The most common symptoms are:
- Diarrhea.
- Mild fever and fatigue due to inflammation or infection.
- Abdominal pain and cramps are caused by inflammation and injury to the digestive tract. Cramps can cause diarrhea and discomfort, including nausea and vomiting.
- Blood in your stool.
- Anemia, a condition in which the body has fewer red blood cells than usual.
- Mouth sores due to mouth ulcers.
- Reduced appetite and weight loss due to cramps, abdominal pain, and inflammation which reduces your body's ability to digest food.
- Perianal disease, pain or discharge near or around the anus due to inflammation of the ducts into the skin (fistula).
- Inflammation of the skin, eyes and joints.
- Inflammation of the liver or bile ducts.
- Skin changes such as redness, soft lumps under the skin.
- Delayed growth or sexual development in children
Symptoms experienced by a person can vary depending on the severity of the inflammation and where it occurs.
In the early stages, Crohn's disease causes erosion in the intestinal wall. This erosion gradually enlarges and goes deeper until it forms a boil. These boils can cause scarring and stiffness in the intestine, eventually narrowing the intestines and causing holes in the intestinal wall. Bacteria can spread from the intestine through holes to other organs and around the abdominal cavity.
When the intestines narrow, this can inhibit the flow of food and fluids. Digestive symptoms are inhibited then severe abdominal cramps, nausea, vomiting, and abdominal distension.
What causes Crohn's disease?
The exact cause of Crohn's disease is unknown. However, research shows a combination of factors might influence, including:
- Genetics. People with family members who also have this condition are more likely to develop Crohn's disease.
- Immune system or previous infection. Bacteria or viruses can cause this disease. The immune system fights bacteria or viruses that enter and may attack cells due to abnormalities.
What are the factors that trigger my risk of Crohn's disease?
Risk factors for Crohn's disease can include:
- Age. Crohn's disease can occur at any age, but most cases of Crohn's disease are diagnosed before the age of 30.
- Ethnicity. Europeans are more likely to develop Crohn's disease than other ethnicities.
- Nonsteroidal anti-inflammatory medications (NSAIDs). These drugs cause inflammation of the intestine which makes Crohn's disease worse.
- Smoke. Smokers usually have more severe symptoms than non-smokers.
- Certain foods. Some foods are thought to trigger Crohn's disease.
How is Crohn's disease diagnosed?
Your doctor will check the condition and history of your family to determine Crohn's disease. They might ask for some test labs like:
- Upper GI series: You will drink a mixture of barium and water. The doctor can see the flow of this fluid through the intestine and use a X-ray photo to see it.
- Computerized tomography (CT) scan: This is a test that gives more detailed images in many plain x-ray angles.
- Intestinal endoscopy or intestinal endoscopy:A thin and flexible tube is inserted into your stomach so the doctor can see the wall layer.
- Blood test: This test is designed to look for changes in red blood cells and white blood cells.
- Stool test: This test is usually used to rule out possible causes of other digestive disorders.
How is Crohn's disease treated?
There is no cure for Crohn's disease. Treatment usually includes medication or surgery. Usually, you will be given drugs only to control this disease.
Anti-inflammatory drug
Aminosalicylates is a drug that contains 5-aminosalicyclic acid (5-ASA), which helps control inflammation. Aminosalicylates include:
- Balsalazide
- Mesalamine
- Olsalazine
- Sulfasalazin
Corticosteroids are prescribed for people with moderate to severe symptoms. In most cases, doctors may not prescribe corticksteroids for long-term use.
Corticosteroids include:
- Budesonide
- Hydrocortisone
- Methylprednisone
- Prednisone.
Suppressing the immune system, also known as immunomodulators, is used to reduce the activity of the immune system, which reduces inflammation in the digestive tract. These drugs can take several weeks to 3 months to start working. Immunomodulators include:
- 6-mercaptopurine, or 6-MP
- Azathioprine
- Cyclosporine
- Methotrexate
Biological therapy is drugs that target proteins made by the immune system. Neutralizing protein reduces inflammation in the intestine. Biological therapy works quickly to bring remission, especially in people who do not respond to other treatments. Biological therapies include
- Adalimumab
- Certolizumab
- Infliximab
- Natalizumab
- Vedolizumab.
You may also need other drugs to control or treat symptoms of Crohn's disease.
- Anti-diarrheals: psyllium powder (Metamucil) or methylcellulose (Citrucel), loperamide (Imodium).
- Painkillers: acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB), naproxen (Aleve, Anaprox).
- Iron supplements
- Vitamin B-12 shots.
- Calcium and vitamin D supplements
Operation
If the medication does not reduce symptoms, your doctor may recommend surgery. More than 20% of patients with Crohn's disease need surgery. Surgery does not cure Crohn's disease, but can treat other conditions caused by it. Surgery is often a temporary solution.
During surgery, the surgeon will remove damaged parts of the intestine, such as fistulas and intestinal obstruction, or to drain abscesses, or to expand the part of the intestine that is too narrow.
What foods do I need to avoid?
Many people with Crohn's disease report that they find one or more foods that often trigger Crohn's disease and make symptoms worse. Some common foods include:
- Alcohol (mixed drinks, beer, wine)
- Butter, mayonnaise, margarine, oil
- Soft drink
- Coffee, tea, chocolate
- Dairy products (if lactose is intolerant)
- Fatty foods (fried foods)
- Foods high in fiber
- Foods that produce gas (lentils, beans, cabbage, broccoli, onions)
- Nuts and seeds (peanut butter, other peanut butter)
- Raw fruit
- Raw vegetables
- Red meat and pork
- Spicy food
- Grains and bran.
To make sure Crohn's disease is controlled and prevent relapse, you need to combine treatment and surgery. Before you use any medication or decide to do an operation, ask your doctor about complications and side effects before you make a decision. You must tell your doctor about the medicines or supplements you are using.
