Crohn’s disease

Crohn’s disease is a type of IBD (inflammatory bowel disease). In this disease, the lining of digestive tract gets inflamed and leads to various symptoms including:

-       Abdominal pain

-       Fatigue

-       Severe diarrhea

-       Malnutrition

-       Weight loss

The inflammation due to this disease affects the deeper layers of the digestive tract and can be debilitating, painful and can also lead to life threatening complications in some cases too.

Crohn’s disease can involve different part of digestive tract in different people.

There is no absolute cure to crohn’s disease, however it can be managed effectively to reduce the symptoms greatly and to avoid remission of the disease, helping patients to lead a functional and comfortable life.

Symptoms of Crohn’s disease

Commonly, the last part of small intestine and colon are affected by this disease. However in some patients only the last segment of the small intestine called ileum is affected while in some the colon (part of large intestine).

Symptoms may vary from mild to severe, developing gradually usually, however sometimes they may appear without any warning. There can be phases of remission with no symptoms.

Symptoms of active disease include:

-       Diarrhea

-       Abdominal pain and cramps

-       Fever

-       Fatigue

-       Blood in stools

-       Sores in mouth

-       Weight loss

-       Loss of appetite

-       Perianal disease

Some patients may also experience not so common symptoms of Crohn’s disease too, including:

-       Inflammation of:

o   Eyes

o   Joints

o   Skin

o   Liver

o   Bile ducts

o   Delayed growth in children

o   Delayed sexual development in children

When to see a doctor?

If you’re experiencing any of the symptoms of Crohn’s disease and have persistent changes in bowel habits, consult a doctor as soon as possible. See your doctor if you experience any of these symptoms:

-       Blood in stools

-       Abdominal pain

-       Constant bouts of diarrhea that doesn’t respond well to medication

-       Unexplained weight loss

-       Unexplained fever for more than a day

Causes of Crohn’s disease

Exact cause of crohn’s disease is unknown. Initially, stress and diet were considered the cause for crohn’s disease, however now they’re simply considered aggravating factor, not the causative ones.

There are various factors that play a role in the development of crohn’s disease, including:

-       Hereditary

-       Immune system

Risk factors for Crohn’s disease

Risk factors for the disease include:

-       Family history

o   Almost 20% of the patients have a family history

-       Age

o   Can occur at any age, but is usually diagnosed before 30 years of age

-       Ethnicity

o   Can affect any ethnicity, however most risked ones are:

§  White people

§  Ashkenazi (eastern European jewish descent) people

-       Cigarette smoking

o   Smoking aggravates the disease a lot and increases the risk of having surgery

-       NSAIDs (Non-steroidal anti-inflammatory drugs)

o   Various NSAIDs may not cause it, however they can result in inflammation of the digestive tract, worsening the disease

-       Region

o   People living in industrial and urban region are at a higher risk of developing the disease

o   People living in northern climates have a higher risk of developing Crohn’s disease

-       Diet

o   Diet high in fat and refined food items is linked with Crohn’s disease

Complications of Crohn’s disease

If unmanaged, crohn’s disease can lead to following complications:

-       Bowel obstruction

-       Inflammation, leading to:

o   Stenosis

o   Fistula

-       Ulcers, anywhere along the digestive tract, including:

o   Mouth

o   Perineum (genital region)

o   Anus

-       Fistulas

-       Anal fissures

-       Colon cancer

-       Malnutrition

-       Other health issues, like:

o   Anemia

o   Liver disease

o   Osteoporosis

Diagnosis of Crohn’s disease

Your doctor will ask you about your current and past medical history. He will examine you for physical signs and will rule out any other possible cause of your presenting signs and symptoms.

There is no specific test to diagnose Crohn’s disease, however the doctor may advice various investigations to confirm the diagnosis, including endoscopy along with radiological imaging and biopsies.

Usually the tests and procedures performed include:

-       Blood tests

o   Complete blood picture

-       Fecal occult blood (blood in stools)

-       Colonoscopy

-       Flexible sigmoidoscopy

-       CT-scan (computerized tomography scan)

-        MRI (magnetic resonance imaging)

-       Double-balloon endoscopy

-       Capsule endoscopy

-       Small bowel imaging, following a barium meal, through:

o   X-rays

o   CT scan

o   MRI

Treatment of Crohn’s disease

Crohn’s disease is usually treated through medicines, however some cases might need surgical treatment too.

There is no one treatment that works for every patient, as there isn’t any definitive treatment for the disease.

The goal of the treatment is to reduce the inflammation that causes the symptoms and to improve the long-term prognosis by avoiding complications.

Drugs used for the treatment of Crohn’s disease include:

-       Anti-inflammatory drugs

o   Oral 5-aminosalicylates

o   Corticosteroids

-       Immune system suppressors

-       Antibiotics

-       Pain killers

-       Anti-diarrheals

-       Supplements

o   Iron

o   Vitamin B12

o   Calcium

o   Vitamin D

-       Nutrition therapy

-       Surgery

Consult your doctor if you’re experiencing any symptoms of Crohn’s disease to get diagnosed properly and to get best treatment possible in your specific case.