Crohn’s disease – symptoms, treatment, diet, prognosis

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Crohn’s disease is a disease of the intestines, stomach and esophagus. It happens, however, that it also attacks the mouth or the inside of the digestive tract walls. The main symptoms of Crohn’s disease are diarrhea, abdominal pain, and blood and mucus in the stools. The disease is recurrent and chronic, so symptoms come and go. Check what else you should know about this condition.

Crohn’s disease – characteristics

Crohn’s disease is a chronic inflammatory disease that affects the walls of the digestive tract, but also other areas from the mouth to the anus. Most often, the disease focuses on the end of the ileum. Crohn’s disease is classified as inflammatory bowel disease.

The name comes from the names of the doctors who described the symptoms of the disease for the first time, i.e. the Pole Antoni Leśniowski and the American Burrill Bernard Crohn.

Crohn’s disease is most common in industrialized countries and the tendency to contract the disease is increasing. At the same time, experts believe that the statistics are currently understated and do not include all patients. The disease affects people in adolescence and early adulthood, as well as people over 60. Currently, there are also more and more cases of the disease among children. Additionally, there is a higher number of cases among first-degree relatives people suffering from Crohn’s disease.

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Crohn’s disease – symptoms

Crohn’s disease is chronic and recurrent, which means that the patient goes through exacerbation phases when symptoms become extremely bothersome. During this period, the following symptoms appear:

1. diarrhea;
2. fever;
3. tiredness;
4. anemia;
5. abdominal pain and cramps – often on the right side;
6. blood in the stool;
7. mouth ulcers and aphthas;
8. lack of appetite and weight loss;
9. malnutrition;
10. pain and discomfort around the anus which may be a consequence of fissures, abscesses and fistulas.

Severe cases of Crohn’s disease may also be related to:

1. inflammation of the skin, eyes and joints;
2. inflammation of the liver or bile ducts.

It should also be remembered that the symptoms of Crohn’s disease are not specific and may be related to other conditions. We should also remember that the clinical picture of the lesions is closely related to their location lesions caused by Crohn’s disease:

1. classic form of Crohn’s disease with involvement of the terminal ileum – in this form, the disease develops in secret, and the first symptom may be anemia or an unreasonably elevated temperature. The most common symptoms are acute abdominal pain and diarrhea. About 1/3 of patients also feel a tumor in the lower abdomen. Additionally, fatty diarrhea occurs as a result of extensive involvement of the small intestine, which causes malabsorption syndrome. In addition, there is anemia, hypoproteinaemia, avitaminosis and electrolyte disturbances. After some time, malnutrition and exhaustion of the body also appear;
2. changes in the large intestine – changes in the large intestine caused by Crohn’s disease resemble the symptoms of ulcerative colitis. The most common symptoms are diarrhea, but also abdominal pain resulting from the involvement of the caecum and ileum;
3. anal lesions – lesions around the anus caused by Crohn’s disease include skin growths, ulcers, fissures, abscesses and fistulas. These changes concern about 50-80 percent. patients with colon involvement, while in 27 percent. it may be the first sign of a disease;
4. extraintestinal complications – these changes appear in some patients and affect the skin, joints, eyes and bile ducts, e.g. erythema nodosum or urinary tract.

If you notice any problems with your gastrointestinal tract, check what may be causing it. Perform preventive examinations as soon as possible, eg. A test package for digestive system diseases, which you can buy on Medonet Market.

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Crohn’s disease – diagnosis

Diagnostics of Crohn’s disease it is very complex. Any methods that allow you to assess the condition of the small intestine are helpful, as it is a difficult section to examine. It is necessary to evaluate the results of physical and physical examinations, conduct additional examinations and, above all, endoscopic evaluation of the intestines condition and take samples for examination. The diagnosis of Crohn’s disease includes:

1. medical interview – the doctor asks, among others o a family history of inflammatory bowel disease;
2. laboratory tests – CRP and blood counts can help differentiate inflammatory from functional diseases;
3. endoscopic examinations of the digestive system – crucial for a correct diagnosis, as it is necessary to take specimens for histopathological examination;
4. histopathological examinations of samples taken from the digestive system;
5. imaging tests – computed tomography is helpful. If on examination the doctor can find thickening of the intestinal wall limited to the right side of the large intestine, fibrous mesenteric hyperplasia and the presence of abscesses in the abdominal cavity.

Unfortunately, it should be remembered that in the case of the large intestine, it is not always possible to distinguish Crohn’s disease from ulcerative colitis, which is why some patients receive a diagnosis of indeterminate colitis.

In order to diagnose Crohn’s disease, it is worth performing a shipment test for the concentration of calprotectin in the feces. Too high levels of calprotectin may indicate the presence of inflammation in the intestines.

Crohn’s disease – treatment

Nistety nie ma an effective drug for Crohn’s disease. The implemented treatment aims to:

1. bringing the disease into remission;
2. preservation of the state of remission as long as possible;
3. relieving the side effects of treatment;
4. taking care of the patients’ quality of life.

choosing a form of treatment for Crohn’s disease, the doctor always takes into account the stage of the disease and the location of the changes caused by the disease. In the treatment of the disease, the following are used:

1. drugs affecting the immune system – 5-aminosalicylic acid derivatives, steroids, purine analogues, methotrexate and biological drugs that inhibit inflammatory reactions;
2. surgical treatment – the operation concerns approx. 70% of patients at different stages of the disease. The reasons for the operation are abscesses, fistulas, strictures and partial intestinal obstruction, and the suspicion of neoplastic changes.

Diet plays a very important role in the treatment of Crohn’s disease.

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Crohn’s disease – recommendations

After diagnosis, the patient should start implementing the list of recommendations:

1. quitting smoking and avoiding secondhand smoke – smoking is important risk factor for the development of Crohn’s disease. Additionally, it can make treatment of the disease difficult;
2. avoiding the use of NSAIDs, i.e. non-steroidal anti-inflammatory drugs, which contribute to exacerbation of the disease;
3. avoiding stress;
4. avoiding infection;
5. supplementing nutritional deficiencies, i.e. dehydration, electrolyte disorders, iron deficiency, vitamin B12;
6. the use of supplements with calcium and vitamin D, because patients are much more likely to develop osteoporosis.

After the end of treatment, i.e. after the symptoms have subsided, the patient should not stop taking the medications on his own. It is necessary to contact a doctor regularly, follow the recommendations and perform checkups. Keep in mind that the disease is associated with an increased risk of developing colorectal cancer. Therefore, regular colonoscopy every 2 years is recommended.

Unfortunately, Crohn’s disease is a chronic disease of unknown cause, therefore prevention and complete recovery is not possible. However, it is very important to follow the doctor’s instructions, which allows the periods of remission to be extended by months or even years.

In order to monitor the course of the disease, you can use the mail-order test of calprotectin, which is a marker of inflammation of the intestine, available at Medonet Market.

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Crohn’s disease – diet

The diet for Crohn’s disease is not clearly defined, which means that patients do not receive a clear-cut list of recommendations. Doctors recommend a healthy diet (the same as for the rest of the population) for people in remission, as long as they are not struggling with various nutritional problems.

However, it is important to remember that the drugs used can lead to a significant shortage of certain nutrients, so it is worth taking care of their appropriate amount in the diet. In addition, patients with intestinal strictures should eat fewer foods with a high dietary fiber content, and properly prepare food before consumption. This means that they should peel vegetables and fruits, then crush them and cook them longer. Foods rich in fiber should also not be eaten during the exacerbation of the disease, so as not to aggravate diarrhea. The diet during this period is often supplemented with parenteral nutrition.

Crohn’s disease – pregnancy

It is worth remembering that women struggling with Crohn’s disease have a chance of becoming pregnant. The chances are much higher if the pregnancy occurs in remission of the disease. Unfortunately, when Crohn’s disease is active it can cause:

1. impaired fertility;
2. increase the risk of premature birth;
3. increase the risk of low birth weight in your baby.

Additionally, some of the drugs used during treatment may impair fertility and the further development of pregnancy and the fetus. Some medications should not be used while trying for a baby and during pregnancy. Some of the medications may also affect a woman’s fertility.

For this reason, it is advisable to consult your doctor before becoming pregnant. Thanks to this, it will be possible to change the drugs used, supplement any nutritional deficiencies, perform tests and necessary surgical procedures. The doctor will have time to eliminate all factors that may potentially threaten the course of pregnancy and the development of the fetus. In some situations, the patient’s condition is an indication for a caesarean section.

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Crohn’s disease – children and teenagers

There is a high risk that the disease will be inherited by children if one of the parents has the disease. The risk is approx. 9%. However, when both parents suffer from Crohn’s disease, about 1/3 of children develop the disease.

Unfortunately, the disease in children and adolescents carries a much greater risk. The disease symptoms also include the risk of:

1. slowing growth;
2. bone weakness;
3. later sexual maturation.

However, we should remember that if children and adolescents are properly treated, they can function normally, go to school and even play sports. A healthy lifestyle plays an important role in this age group.

Crohn’s disease – causes

The cause of Crohn’s disease has not been known so far. Doctors suspect that the development of the disease is influenced by:

1. genetic factors;
2. environmental factors, i.e. bacteria of the intestinal flora;
3. immunological factors.

Some researchers believe Crohn’s disease is caused by a bacterial infection. In addition, it is worth remembering that the cause of the disease is not stress or an inadequate diet. However, these factors may exacerbate the course of the disease.

Inflammation of the intestine – genetic testing of the NOD2 gene will help to exclude or confirm the genetic predisposition for the disease.

Crohn’s disease – prognosis and complications

Crohn’s disease is a chronic disease. The available drugs make it possible to control the disease. Unfortunately, a drug that removes the cause of the disease has not yet been developed. For many people, surgery is a chance to improve the quality of life, but it is associated with the risk of relapse.

The disease can have very serious complications. The most serious consequence of the disease is disability. In addition, the disease is associated with:

1. anemia;
2. skin diseases;
3. osteoporosis;
4. arthritis;
5. liver disease;
6. colorectal cancer.

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