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Crohn’s Disease

What is Crohn’s Disease?Crohn's Disease

Crohn’s Disease is a disease that causes inflammation or swelling, and irritation of any part of the digestive tract—also called the gastrointestinal (GI) tract. The part most commonly affected is the end part of the small intestine, called the ileum.

The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food.

In Crohn’s Disease, inflammation extends deep into the lining of the affected part of the GI tract. Swelling can cause pain and can make the intestine—also called the bowel—empty frequently, resulting in Diarrhea. Chronic—or long-­‐lasting—inflammation may produce scar tissue that builds up inside the intestine to create a stricture. A stricture is a narrowed passageway that can slow the movement of food through the intestine, causing pain or cramps.

Crohn’s Disease is an Inflammatory Bowel Disease (IBD), the general name for diseases that cause  inflammation and irritation in the intestines. Crohn’s Disease can be difficult to diagnose because its symptoms are similar to other intestinal disorders, such as Ulcerative Colitis and other IBDs, and Irritable Bowel  Syndrome (IBS). For example, Ulcerative Colitis and Crohn’s Disease both cause Abdominal Pain and Diarrhea.

 

Who gets Crohn’s Disease?

Crohn’s Disease affects men and women equally and seems to run in some families. People with Crohn’s Disease may have a biological relative—most often a brother or sister—with some form of IBD. Crohn’s Disease occurs in people of all ages, but it most commonly starts in people between the ages of 13 and 30. Men and women who smoke are more likely than nonsmokers to develop Crohn’s Disease. People of Jewish heritage have an increased risk of developing Crohn’s Disease, and African Americans have a decreased risk.

 

What causes Crohn’s Disease?

Illustration-of-crohns-disease

The cause of Crohn’s Disease is unknown, but researchers believe it is the result of an abnormal reaction by the body’s immune system. Normally, the immune system protects people from infection by identifying and destroying bacteria, viruses, or other potentially harmful foreign substances. Researchers believe that in Crohn’s Disease the immune system attacks bacteria, foods, and other substances that are actually harmless or beneficial. During this process, white blood cells accumulate in the lining of the intestines, producing chronic inflammation, which leads to ulcers, or sores, and injury to the intestines.

Researchers have found that high levels of a protein produced by the immune system, called Tumor Necrosis Factor (TNF), are present in people with Crohn’s Disease. However, researchers do not know whether increased levels of TNF and abnormal functioning of the immune system are causes or results of Crohn’s Disease. Research shows that the inflammation seen in the GI tract of people with Crohn’s Disease involves several factors: the genes the person has inherited, the person’s immune system, and the environment.

 

What are the symptoms of Crohn’s Disease?

The most common symptoms of Crohn’s Disease are Abdominal Pain, often in the lower right area, and Diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia—a condition in which red blood cells are fewer or smaller than normal, which means less oxygen is carried to the body’s cells.

 

How is Crohn’s Disease diagnosed?

A doctor will perform a thorough physical exam and schedule a series of tests to diagnose Crohn’s Disease.

What are the complications of Crohn’s Disease?

The most common complication of Crohn’s Disease is an intestinal blockage caused by thickening of the intestinal wall due to swelling and scar tissue. Crohn’s Disease may also cause ulcers that tunnel through the affected area into surrounding tissues. The tunnels, called fistulas, are a common complication—especially in the areas around the anus and rectum—and often become infected. Most fistulas can be treated with medication, but some may require surgery. In addition to fistulas, small tears called fissures may develop in the lining of the mucus membrane of the anus. The health care provider may prescribe a topical cream and may suggest soaking the affected area in warm water.

Some Crohn’s Disease complications occur because the diseased area of the intestine does not absorb nutrients effectively, resulting in deficiencies of proteins, calories, and vitamins.

People with Crohn’s Disease often have anemia, which can be caused by the disease itself or by iron deficiency. Anemia may make a person feel tired. Children with Crohn’s Disease may fail to grow normally and may have low height for their age.

People with Crohn’s Disease may have weakness of their bones called Osteoporosis or Osteomalacia, particularly if they have been treated with steroid medications.

Some people with Crohn’s Disease may have restless legs syndrome—extreme leg discomfort a person feels while sitting or lying down. Some of these problems clear up during treatment for Crohn’s Disease, but some must be treated separately.

Other complications may include arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, or diseases related to liver function.

 

What is the treatment for Crohn’s Disease?

Treatment may include medications, surgery, nutrition supplementation, or a combination of these options. The goals of treatment are to control inflammation, correct nutritional deficiencies, and relieve symptoms such as Abdominal Pain, Diarrhea, and rectal bleeding. Treatment for Crohn’s Disease depends on its location, severity, and complications.

Treatment can help control Crohn’s Disease and make recurrences less frequent, but no cure exists. Someone with Crohn’s Disease may need long-lasting medical care and regular doctor visits to monitor the condition. Some people have long periods—sometimes years—of remission when they are free of symptoms, and predicting when a remission may occur or when symptoms will return is not possible. This changing pattern of the disease makes it difficult to be certain a treatment has helped.

Despite possible hospitalizations and the need to take medication for long periods of time, most people with Crohn’s Disease have full lives—balancing families, careers, and activities.

 

Medications

  • Anti-inflammation medications
  • Cortisone or steroids
  • Immune system suppressors
  • Biological therapies
  • Antibiotics
  • Anti-diarrheal medications and fluid replacements

 

Nutrition Supplementation

The health care provider may recommend nutritional supplements, especially for children whose growth has been slowed. Special high-calorie liquid formulas are sometimes used. A small number of people may receive nutrition intravenously for a brief time through a small tube inserted into an arm vein. This procedure can help people who need extra nutrition temporarily, such as those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food.

The doctor may prescribe calcium, vitamin D, and other medications to prevent or treat Osteoporosis for patients taking corticosteroids. People should take vitamin supplements only after talking with their doctor.

 

Eating, Diet, and Nutrition Chron's Diisease & Nutrition

No special diet has been proven effective for preventing or treating Crohn’s Disease, but it is important that people who have Crohn’s Disease follow a nutritious diet and avoid any foods that seem to worsen symptoms. People with Crohn’s Disease often experience a decrease in appetite, which can affect their ability to receive the daily nutrition needed for good health and healing. In addition, Crohn’s Disease is associated with diarrhea and poor absorption of necessary nutrients. Foods do not cause Crohn’s Disease, but foods such as bulky grains, hot spices, alcohol, and milk products may increase diarrhea and cramping. The health care provider may refer a person with Crohn’s Disease to a dietitian for guidance about meal planning.

 

Points to Remember

  • Crohn’s Disease is a disease that causes inflammation, or swelling, and irritation of any part of the digestive tract—also called the gastrointestinal (GI) tract.
  • Crohn’s Disease affects men and women equally and seems to run in some families.
  • The cause of Crohn’s Disease is unknown, but researchers believe it is the result of an abnormal reaction by the immune system.
  • The most common symptoms of Crohn’s Disease are Abdominal Pain and Diarrhea.
  • A doctor can diagnose Crohn’s Disease by performing a physical exam, blood and stool tests, and imaging tests such as a CT scan, upper GI series, lower GI series, flexible Sigmoidoscopy, and Colonoscopy.
  • The most common complication of Crohn’s Disease is an intestinal blockage caused by thickening of the intestinal wall due to swelling and scar tissue.
  • Doctors treat Crohn’s Disease with medications, surgery, nutrition supplementation, or a combination of these options.
  • No special diet has been proven effective for preventing or treating Crohn’s Disease, but it is important that people who have Crohn’s Disease follow a nutritious diet and avoid any foods that seem to worsen symptoms.
  • Some people with Crohn’s Disease report having a flare-up when experiencing a stressful event or situation. The health care provider may suggest a counselor or support group to help decrease stress for people with Crohn’s Disease.
  • Women with Crohn’s Disease can become pregnant and have a baby. Even so, women with Crohn’s Disease should talk with their health care provider before getting pregnant.

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