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Crohn's Disease


Crohn's Disease is an inflammatory bowel disease (IBD). The inflammation caused by Crohn's disease often spreads deep into the layers of affected bowel tissue and different areas of the digestive tract can be affected.

Crohn's disease can be both painful and debilitating, and sometimes may lead to life-threatening complications.

The most common areas affected by Crohn's disease are the last part of the small intestine and the colon.

Signs & Symptoms

Signs and symptoms of Crohn's disease can range from mild to severe. They usually develop gradually, but sometimes will come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission).

When the disease is active, signs and symptoms may include:

  • Diarrhea
  • Fever
  • Fatigue
  • Abdominal pain and cramping
  • Blood in your stool
  • Mouth sores
  • Reduced appetite and weight loss
  • Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)

Causes

The exact cause of Crohn's disease remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don't cause Crohn's disease. A number of factors, such as heredity and a malfunctioning immune system, likely play a role in its development.

  • Immune system. It's possible that a virus or bacterium may trigger Crohn's disease. When your immune system tries to fight off the invading microorganism, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.
  • Heredity. Crohn's is more common in people who have family members with the disease, so genes may play a role in making people more susceptible. However, most people with Crohn's disease don't have a family history of the disease.

Treatment

There is currently no cure for Crohn's disease, and there is no one treatment that works for everyone. The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. It is also to improve long-term prognosis by limiting complications. In the best cases, this may lead not only to symptom relief but also to long-term remission.

Anti-Inflammatory drugs: Are often the first step in the treatment of inflammatory bowel disease.

  • Corticosteroids
  • Oral 5-aminosalicylates

Immune System suppresors: These drugs also reduce inflammation, but they target your immune system, which produces the substances that cause inflammation. For some people, a combination of these drugs works better than one drug alone

  • Azathioprine and mercaptopurine
  • Ifliximab
  • Methotrexate
  • Natalizumab
  • Ustekinumab

Antibiotics: Antibiotics can reduce the amount of drainage and sometimes heal fistulas and abscesses in people with Crohn's disease. Some researchers also think antibiotics help reduce harmful intestinal bacteria that may play a role in activating the intestinal immune system, leading to inflammation. Frequently prescribed antibiotics include ciprofloxacin (Cipro) and metronidazole (Flagyl).

Other medications:

  • Anti-diarrheals
  • Pain relievers
  • Iron supplements
  • Vitamin b-12 shots
  • Calcium and Vitamin D supplements

Surgery

If diet and lifestyle changes, drug therapy, or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery. Nearly half of those with Crohn's disease will require at least one surgery. However, surgery does not cure Crohn's disease.

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

The benefits of surgery for Crohn's disease are usually temporary. The disease often recurs, frequently near the reconnected tissue. The best approach is to follow surgery with medication to minimize the risk of recurrence.

When to See Your Doctor

See your doctor if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn's disease.

Risk Factors

  • Age
  • Ethnicity
  • Family history
  • Cigarette Smoking
  • NSAID
  • Where you live

Diagnosis

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

Your doctor will likely use a combination of tests to help confirm a diagnosis of Crohn's disease, including:

BloodTest

  • Test for anemia or infection
  • Fecal occult blood test

Procedures

  • Colonoscopy
  • CT Scan
  • MRI
  • Capsule endoscopy

Nutrition Therapy

Your doctor may recommend a special diet:

  • Low residue or low-fiber diet
  • Enteral nutrition
  • Parenteral nutrition

This can improve your overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term.

Your doctor may use nutrition therapy short term and combine it with medications. Such as immune system suppressors.