Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract and belongs to the group of Inflammatory Bowel Diseases (IBD). It is named after Dr. Burrill B. Crohn, who first described the disease in 1932.While it primarily causes ulcerations in the small and large intestines, it can affect any part of the digestive system, from the mouth to the anus.What differentiate it from ulcerative colitis is that Crohn’s disease can affect any part of the digestive tract.Ulcerative colitis is limited to the colon, also called the large intestine.
Types and Symptoms
This is the most common form of Crohn’s. ileocolitis affects the ileum(the end of the small intestine) and the colon (large intestine). Symptoms: Diarrhea , cramping in the right lower part or middle of the abdomen, weight loss.
This type affects only the ileum. Symptoms :same as ileocolitis. but in severe cases, complications may also include fistulas in right lower quadrant of abdomen.
Gastroduodenal Crohn’s disease
This type affects the stomach and the duodenum(the beginning of the small intestine). Symptoms: loss of appetite, weight loss, nausea and vomiting.
This type is characterized by patchy areas of inflammation in the jejunum(the upper half of the small intestine ). Symptoms: mild to intense abdominal pain and cramps following meals, diarrhea. In severe cases, fistulas may be formed.
Crohn’s (granulomatous) colitis
This type affects the colon only. Symptoms: diarrhea, rectal bleeding, and disease around the anus like abscess, fistulas and ulcers, skin lesions and joint pains.
Also Crohn’s disease can be classified on the basis of the nature of disease as follows.
- Inflammatory in nature, it results in small erosions and breakdown of the lining of the bowel wall.
- Fibrostenotic, scar tissue forming. The inflammation is healed by the body but the resulting scar tissue can cause obstructive types of symptoms where the bowel is not moving properly.
- Penetrating type, the inflammation goes through the wall of the bowel and has a tendency to form connections between loops of bowel or connections between the bowel and other organs or the skin.
It’s important to diagnose Crohn’s disease early because Crohn’s disease is a progressive disease. And in some people the Crohn’s disease can progress very rapidly to complications such as narrowing of the small intestine leading to blockages, or perforation of the small intestine requiring surgery.
- To determine whether you have Crohn’s (to obtain or disprove a Crohn’s disease diagnosis)
- To re-evaluate your Crohn’s disease — something your gastroenterologist will probably want to do on an ongoing, regular basis
Common tests for Crohn’s disease are
Blood Tests.Although blood tests alone cannot diagnose Crohn’s disease, they’re an important tool in diagnosis and monitoring of this disease. Several different kinds of blood tests are used.
- Routine blood testsThese are used to detect infection, anemia, indicators of inflammation, and to identify deficiencies of vitamins or minerals.
- Fecal blood test
- Antibody blood tests
These are tests that take pictures of different parts of your body to provide a clearer picture of your condition. They show your doctor areas of disease activity and identify possible complications. These are only some of the imaging tests used for Crohn’s—there are others your doctor may recommend.
- Conventional X-rays
A standard X-ray of your abdominal area can show narrowing of the intestines or an intestinal blockage, possibly from inflammation or scarring. It may also be done to rule out certain Crohn’s complications.
- Contrast X-rays
- Computerized tomography (CT scan)
- Leukocyte scintigraphy (white blood cell scan)
- Endoscopy (includes colonoscopy)
- Endoscopic ultrasound
- Magnetic resonance imaging (MRI)
Crohn’s is a chronic, life-long disease that requires constant treatment. Even though there is no cure for Crohn’s, there are many different medications available to treat it.The following are the categories of drugs prescribed to treat Crohn’s:
- Antibiotics :Antibiotics may be used when infections occur, or to treat complications of Crohn’s disease.
- Aminosalicylates (5-ASAs):To decrease inflammation in the lining of the intestines and are usually used to treat mild to moderate Crohn’s symptoms.
- Corticosteroids (Steroids):To reduce inflammation by suppressing the immune system and are usually given to help with moderate to severe Crohn’s symptoms.
- Immune modifiers (Immunomodulators):To suppress the body’s immune response so that it cannot cause ongoing inflammation.
- Biologic therapies (Biologics):To uppress the immune system to reduce inflammation by targeting a specific pathway, and is usually given to people who have not responded to conventional therapy.
Regarding pregnancy,most women who have Crohn’s disease can have a normal pregnancy and healthy baby.However, some Crohn’s disease medicines can harm an unborn baby, so you should speak to your doctor if you are planning pregnancy.Women may also find it harder to get pregnant during a flare-up.Possible complications of the disease are
- damage to your bowel that may require surgery
- difficulty absorbing nutrients from food leading to problems like osteoporosis or anaemia.
- bowel cancer :regular cancer screening is needed to check this.
So adequate screening and diagnosis is required for handling the disease and to prevent severe complications.
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