Crohn's Disease

Crohn's Disease is a condition that affects men and women.  It is characterized by an inflammation of the bowels, most commonly the small intestine.  For this reason Crohn's Disease is also referred to as Inflammatory Bowel Disease (IBD).  Symptoms of this condition are similar to that of ulcerative colitis and Irritable Bowel Syndrome (IBS).

Currently, there is no known cause for Crohn's Disease.  Scientists believe that it may be caused by a combination of factors.  Individuals whose primary relatives have been affected with this condition are more likely to experience Crohn's Disease.  Scientists also believe that abnormalities of the immune system may also be a major factor; whereby, the immune system attacks the intestines either without known cause or because there is a certain unknown bacteria present.  Individuals whose NOD2 gene has mutated are also more likely to develop Crohn's Disease.

The early stages of Crohn's Disease are characterized by small, shallow erosions called aphthous ulcers, which become deeper and larger with time.  As these ulcers grow the bowels become narrowed and with time will finally become fully obstructed causing severe complications.  In some cases, the ulcers will puncture a hole in the wall of the intestine allowing bacteria and infection to spread to other organs.  In other cases, the growing ulcers may create tunnels to other organs.  Ulcer tunneling, whereby a channel has been formed between two organs is called a fistula.  In the case of Crohn's Disease a fistula may form between the intestines and other organs such as the abdomen or rectum.  This will allow the excretion of gas and feces through other organs which can lead to infection and in some cases abdominal abscesses: a collection of infected pus inside the of abdominal cavity.

Symptoms

There are several non-specific symptoms associated with Crohn's Disease:

Crohn's Disease also has a few sub-classifications depending on the areas of the bowel that are being affected:

The development of Crohn's Disease may also show symptoms in the anal area:

Complications

There are two types of complications resulting from Crohn's Disease: intestinal and extra-intestinal.  The following are intestinal complications:

Extra-intestinal complications most commonly affect the skin, joints, spin, eyes, liver and bile ducts:

Diagnosis

Diagnosis of Crohn's Disease is primarily based on symptoms.  Physicians will conduct further lab and blood tests to diagnose Crohn's Disease in patients that are suffering from any of the above symptoms.  If the patient suffers from Crohn's Disease, the lab tests will show elevated white blood cells, a sign of inflammation, and low red blood cells, protein and minerals, which may result from diarrhea. 

The physician may also opt to perform a barium x-ray.  Barium is a white, chalky substance that shows up on a x-ray machine.  After the patient ingests barium or has it inserted as an enema, the physician can monitor its flow through the digestive system and determine if ulcers, fistulae or a narrowing of the bowel has occurred. 

Another procedure which is used to diagnose Crohn's Disease and is more reliable than a barium x-ray is a colonoscopy.  During a colonoscopy, a thin viewing tube is inserted into the rectum and colon in order to determine if there are areas of inflammation.

Finally, a CAT (Computerized Axial Tomography) Scan can be used to gain a detailed view of the entire abdomen and pelvic area.

Treatment

There is no medical cure for Crohn's Disease.  Individuals suffering from Crohn's Disease may either be in a state of relapse or remission.  During remission, the individual either does not suffer from symptoms or the symptoms are very mild.    Remission may occur with medication, surgery or no treatment at all.  If treatment is necessary, its primary purpose is to:

There are general measure that can be taken to reduce symptoms and help alleviate some of the discomforts associated with Crohn's Disease.  For example, fiber is difficult to digest and may aggravate the bowels; thus, a low-fiber diet may be recommended.  Anti-diarrheal agents such as Imodium and anti-spasmodic agents can also reduce symptoms such as cramps and diarrhea.  In some cases, the intestines may be severely overworked; in such cases, the patient may be fed intravenously or given a liquid diet.

There are several medications available to help treat Crohn's Disease.  They fall into different categories, depending on the type of medication and the way in which it is applied:

There are many side-effects associated with these medications.  Each medication will have a different set of side-effects.  Here are some of the most common:

Another type of treatment is surgery.  Surgery is most often used in cases where the patient is not responding to medication or the condition has become so advanced that surgery is the only option.  Such situations include:

Patients undergoing surgery can expect to be symptom free for a period of time, often years.  However, the disease often returns (relapse), and inflammation begins around the same area as before.  There are some medications such as Pentasa that have been helpful in reducing the chances of relapse.