Crohn's disease and ulcerative colitis are together referred to as inflammatory bowl diseases (IBD), and they affect approximately 500,000 to 2 million men and women in the United States.
Definition of Crohn’s disease
Crohn’s disease, a disease named after the physician who first described it in 1932, is a disease that is closely related to the inflammation of the digestive tract. The ulcerations seen in Crohn's disease can affect any area of digestive tract, also called the gastrointestinal tract, which runs from the mouth to the anus, but is most common in the lower part of small intestine.
The swelling associated with Crohn's disease extends deep into the lining of the affected organ and causes pain and can make the intestines empty frequently, resulting in diarrhea.
Crohn’s disease is also called colitis, granulomatous enteritis, regional enteritis, ileitis, or terminal ileitis. The disease has no medical cure and once it begins, it tends to fluctuate between periods of inactivity (remission) and activity (relapse). Crohn’s disease is closely related to irritable bowl disease and ulcerative colitis. Inflammatory bowel disease is a general name for diseases that cause swelling in the intestines.
Crohn's Disease Risk Groups: Who Is Affected?
Only in the United Stated 500,000 to 2 million men and women suffer from Crohn's disease. Both men and women are equally affected and the disease seems to run in the family: namely more than 20 percent of patients with Crohn's disease have a blood relative (most often sister, brother, or parent) with some form of inflammatory bowel disease, either Crohn's disease, irritable bowel disease or ulcerative colitis.
Statistics show that people of Ashkenazi Jewish heritage have an increased risk of developing Crohn’s disease, while African Americans are at decreased risk.
Crohn's disease occurs in all age groups — during childhood to later in life, but the first symptoms most commonly begis during adolescence and early adulthood, which is between the ages of 20 and 30.
Studies showed that the inflammation seen in the gastrointestinal tract of people suffering from Crohn’s disease involves several factors:
- the genes the patient has inherited,
- the immune system itself,
- the environment.
What causes Crohn's disease?
There are actually several theories about the potential causes of Crohn's disease, but none of them have been proven as of yet. The most popular theory about the cause of Crohn's disease claims that the body's immune system reacts abnormally and mistakes foods and other substances for harmful pathogens or foreign objects, in turn triggering a defensive mechanism that results in chronic inflammation, which is an important mechanism of defense used by the immune system.
The truth is that the cause of Crohn's disease is unknown: it may be bacteria, the body's autoimmune reaction, or even diet, although it is unlikely that diet is responsible for the disease. As stated above, genes are one of the main factors determining how the body responds to bacterial products, which means that individuals prone to mutations in this gene are more susceptible to developing Crohn's disease.
Symptoms of Crohn’s disease
Disease is not always present, but tends to fluctuate between periods of inactivity (remission) and activity (relapse). However, when disease is active, its most common symptoms are:
- abdominal pain (most often in the lower right area)
- diarrhea
- weight loss.
Less common symptoms include:
- poor appetite
- rectal bleeding and rectal pain,
- weight loss,
- arthritis,
- skin problems.
Children affected by Crohn’s disease may suffer from delayed development and stunted growth.
Up to one third of patients may suffer from following conditions involving anal area:
- swelling of the tissue of the anal sphincter, which is the muscle at the end of the colon that controls defecation.
- the development of (long) ulcers within the anal sphincter, which cause bleeding and pain with defecation.
- development of anal fistulae between the anus or rectum and the skin surrounding the anus. As a result mucous and pus may drain from the openings of the fistulae on the skin.
- development of peri-rectal abscesses, which can cause fever, pain and tenderness around the anus.
Read More: Food Digestion: Improve your Digestive System
Crohn's disease treatment
As said at the beginning of this article, there is no cure for this disease, but treatment can help control the symptoms of the disease by lowering the number of times a person experiences disease activity. Some people are free of disease for years and then it appears again. Crohn's disease behaves differently in every case.
Thus, the goal of treatment is to control or relieve symptoms, such as inflammation, abdominal pain, diarrhea and rectal bleeding. Treatment of Crohn's disease includes drugs, nutrition supplements, surgery, or a combination of these options.
Drug therapy includes anti-inflammatatory drugs (drugs containing Mesalamine, a substance that helps control inflammation — and the most commonly used one is sulfasalazine; patients that cannot tolerate sulfasalazine are put on other Mesalamine-containing drugs, generally known as 5-ASA agents). Mesalamine containing drugs have potential side effects that include nausea, vomiting, diarrhea, heartburn and headache.
Other drug therapies used to treat Crohn's disease include cortisone or steroids, drugs that suppress the immune system, antibiotics to treat and control bacterial overgrowth in the small intestine, anti-diarrheal drugs and fluid replacements.
As atreatment option, the doctor may recommend nutritional supplements, which is commonly done for children whose growth has been slowed. On the other hand, specific foods must be avoided: this is not because these foods cause Crohn's disease, but because certain foods (like hot spices, milk products, alcohol, bulky grains) may increase diarrhea, cramping or some other symptoms.
The third treatment option is surgery: actually two thirds to three quarters of patients who suffer from Crohn's disease require surgery at some point in their lives. This is either because they do not respond to medical therapy or medications cannot control the symptoms adequately, or because of certain complications.
However, surgery is not considered to eliminate the disease, which means the disease often recurs after surgery. For that reason surgery is not appropriate for everyone and people faced with decision about surgery should get as much information as possible to weight its benefits and risks compared with other treatments.
Crohn's disease is a complex condition, but it can be managed, oftentimes successfully.