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Crohn’s Disease

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Crohn's Disease

Crohn’s disease is a chronic (long-term) inflammatory disease of the digestive tract. It is a type of condition called Inflammatory Bowel Disease (IBD).

Crohn’s disease can affect any part of the gastrointestinal (GI) tract from your mouth to anus. However, the disease mostly occurs in the small intestine and the colon. It affects people of all ages.

The scope of severity can be from mild to debilitating. In rare cases, the disease may lead to life-threatening complications.

Causes

The exact cause of Crohn’s disease is unknown. Previously, diet and stress were suspected. But now the doctors know that these factors may aggravate but don’t cause the Crohn’s disease.

Some factors play a major role in causing the disease include:

  • Immune system: A problem with the immune system, which attacks healthy cells in your body. Bacteria in your digestive tract can trigger your immune system. This immune system response causes inflammation which leads to the symptoms of Crohn’s disease.
  • Genes: Researches has proved that you may be more likely to develop the disease if you have a parent or sibling with Crohn’s disease.
  • Environment: The environmental factors, including a diet high in fat or refined foods, may play a major role in causing  Crohn’s disease.

Symptoms

Crohn’s disease symptoms often develop gradually. Certain symptoms may become worse over time.

Symptoms of Crohn’s disease include:

  • Abdominal pain and cramping
  • Diarrhea
  • Fever
  • Fatigue
  • Blood in stools
  • Mouth sores
  • Loss of appetite
  • Weight loss
  • The frequent feel of bowel movements

Other possible signs and symptoms

People with severe Crohn’s disease may also experience symptoms include:

  • A perianal fistula, which causes pain and drainage near or around the anus
  • Inflammation of joints, eyes, and skin.
  • Inflammation of the liver or bile duct.
  • Shortness of breath or decreased ability to exercise due to anemia.
  • Delayed growth or sexual development in children.

Risk Factors

Some factors that increase your chance of developing Crohn’s disease include:

  • Smoking may increase your chance of developing Crohn’s disease.
  • Nonsteroidal anti-inflammatory drugs such as ibuprofen, antibiotics and birth control may increase the risk of developing the Crohn’s disease.
  • Family history, you are at higher risk if your close family member has the Crohn’s disease

Complications

Crohn’s disease may lead to the following complications:

  • Bowel obstruction: Crohn’s disease may affect the thickness of the intestinal wall. So, part of the bowel can scar and narrow, which blocks the flow of digestive contents. You may be suggested surgery to remove the diseased portion of the bowel.
  • Ulcers: Chronic inflammation can lead to ulcers (open sores) anywhere in the digestive tract, including your mouth and anus, and in the perineum (genital area)
  • Fistulas: Sometimes ulcers can expand totally through the intestinal divider, making a fistula – an abnormal connection between various body parts. Fistulas can develop between intestine and skin or between the intestine and another organ. The Fistulas which are near or around the anal area is most common kind.
  • Anal Fissure: A small tear in the tissue of the skin around the anus where the infections can occur. It is regularly connected with painful bowel movements and may lead to the perianal fistula.
  • Malnutrition: Diarrhea, abdominal pain, and cramping may make it difficult for the intestine to absorb enough nutrients to keep you nourished. It also develops anemia due to iron deficiency or vitamin B12 caused by the disease.
  • Colon cancer: Having Crohn’s disease which affects your colon builds the risk of colon cancer. Ask your doctor whether you need to have a colon cancer screening test done sooner.
  • Other health problems: Crohn’s disease can cause problems such as skin disorders, osteoporosis, arthritis, and gallbladder or liver disease.
  • Medication risks: Certain Crohn’s disease drugs which block the functions of the immune system are associated with small risk of developing cancers such as lymphoma and skin cancers.

Early detection and diagnosis can help you avoid severe complications and allow to start the treatment as early as possible.

Diagnosis

There is no single test result to diagnose Crohn’s disease. Your Crohn’s disease doctor will likely diagnose only after ruling out other possible causes for your signs and symptoms.

Your doctor may use a combination of tests to confirm a diagnosis, include:

  • Blood tests: Blood tests can help your doctor look for certain indicators of problems such as anemia and inflammation.
  • Stool test: A Stool test helps your doctor to detect blood in the stool.
  • Endoscopy: An endoscopy to get a  better image of the inside of your upper gastrointestinal tract.
  • Colonoscopy: Doctor may perform a colonoscopy to examine the large bowel.
  • CT scan and MRI: Imaging tests like CT scans and MRI scans give more details than an average X-ray. Both tests allow doctors to see specific areas of your tissues and organs.
  • Capsule Endoscopy: For this test, you have to swallow a capsule that has a camera in it. That camera takes images of your small intestine, which are then transmitted to a recorder you wear on your belt. The images are downloaded to a computer, displayed on the monitor and then checked for signs of Crohn’s disease.
  • Biopsy: A biopsy or taking a tissue sample during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.

Treatment

Currently, there is no cure for Crohn’s disease but it can be manageable. A variety of Chron’s disease treatment options such as medications, Nutrition therapy, and surgery are able to lessen the severity and frequency of symptoms.

In some cases, people can have long periods, even years without any symptoms. This is called as remission. However, there will be usually recurrences.

Medications of Crohn’s  disease
  • Anti-inflammatory drugs: The doctor will most likely start with a drug called mesalamine which helps control inflammation.
  • Corticosteroids: Corticosteroids such as prednisone and budesonide helps in reducing inflammation.
  • Immunosuppressant drugs: These are the drugs which reduce the patient’s immune response. The doctor may prescribe 6-mercaptopurine or azathioprine to treat inflammation. Side include nausea, vomiting, and weak resistance to infection.
  • Infliximab (Remicade): This drug blocks the body’s inflammatory response.
  • Antibiotics: Fistulas or prior surgery may cause bacterial overgrowth. Doctors will generally treat this bacteria by prescribing ampicillin, sulfonamide, cephalosporin, and tetracycline.
  • Antidiarrheal and fluid replacements: When the inflammation subsides, diarrhea usually becomes less problematic. So, sometimes the patient may need something for abdominal pain and diarrhea.
Nutritional Therapy

The doctor may recommend a special diet given via a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition) to treat Crohn’s disease. This leads to improve your overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in a very short term.

Doctor / Specialist may use nutrition treatment short-term and combine it with medications such as immune system suppressors. Enteral and parenteral nutrition are typically used when other medications fail to control symptoms or to get people healthier prior to surgery.

You may also be recommended a low residue or low-fiber diet to reduce the risk of intestinal blockage if you have narrowed bowel (stricture). A low residue diet can reduce the size and number of stools.

Surgery

The majority of Crohn’s disease patients need surgery. When medication doesn’t control symptoms, then the one and the only solution is to operate. Surgery is to relieve the symptoms that did not react to the medication or to fix complications such as abscess, bleeding, and blockage.

During surgery, the surgeon removes a damaged portion of your digestive tract and then reconnects the healthy sections. Surgery may be also used to close fistulas and drain abscesses.

The benefits of surgery for Crohn’s disease are not permanent. The disease often has recurrences,  frequently near the reconnected tissue. Hence we take various other measures to cure your disease rather than going to surgery.

At SIICP, we #SayNoToSurgery.

But if needed, our Chron’s disease experts are highly skilled to perform all kinds of Colo-proctology related operations.

Qualified Colo-proctologist is always your best source of information for anything you do not understand about your disease, so do not hesitate to consult our experts to know about your health condition.

Contact SIICP today!

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