Gain insights into managing Crohn's Disease for a healthier life. Meri Sehat provides expert tips and guidance for individuals with Crohn's.

Crohn's Disease

A. JABBAR DENTAL CLINIC KARACHI

Sadia Khan

Overview

Crohn&#39;s disease is a chronic, inflammatory condition of the gastrointestinal tract. 
&nbsp;

Crohn&rsquo;s disease is a type of inflammatory bowel disease that can affect anyone, irrespective of age and gender.

It usually affects people in North America and Western Europe. About 1 in 10,000 people are diagnosed every year. More than 500,000 people in the US alone have it.<a href="#accordion">[3]</a> Whereas, 10 in every 100,000 people in the UK have it.<a href="#accordion">[4]</a> 
&nbsp;

It is a lifelong condition that individuals rarely recover from after a single attack. The disease flares up at irregular intervals throughout the person&rsquo;s life, with each episode being mild, severe, brief, or prolonged.

About 10% of people with Crohn&rsquo;s disease are disabled due to the disease itself or its complications. However, most people can lead productive lives with proper treatment.<a href="#accordion">[2]</a> 
&nbsp;

There are 5 types of Crohn&rsquo;s disease, each affecting different parts of the digestive tract.<a href="#accordion">[1]</a>

<ul>
	<li>Ileocolitis: This is the most common type. It affects the end of the small intestine (ileum) and the large intestine (colon), causing symptoms such as <a href="https://merisehat.pk/disease/diarrhea">diarrhea</a>, cramping, and pain in the lower right part of the abdomen.</li>
	<li>Ileitis: This type affects only the ileum and causes significant weight loss and fistulas in the lower right section of the abdomen in addition to diarrhea, cramps, and pain in the middle or lower right part of the abdomen.</li>
	<li>Gastroduodenal Crohn&#39;s Disease: This affects the stomach and the beginning of the small intestine (duodenum), causing nausea, vomiting, loss of appetite, and weight loss.</li>
	<li>Jejunoileitis: This type involves inflammation of the middle part of the small intestine (jejunum), leading to cramps after meals, diarrhea, fistulas, and abdominal pain.</li>
	<li>Crohn&rsquo;s (Granulomatous) Colitis: This type affects the colon, causing diarrhea, joint pain, rectal bleeding, skin lesions, abscesses, fistulas, and ulcers around the anus (perianal disease). 
	&nbsp;</li>
</ul>

Note: Sometimes, Crohn&rsquo;s disease may affect multiple parts of the digestive tract simultaneously. This means people can have more than one type of Crohn&rsquo;s disease at the same time. 
&nbsp;

Sign and Symptoms

Common symptoms of Crohn&rsquo;s disease include:

<ul>
	<li>Diarrhea</li>
	<li>Abdominal pain and cramping</li>
	<li>Weight loss</li>
	<li>Fatigue</li>
	<li>Reduced appetite 
	&nbsp;</li>
</ul>

Other symptoms may include:

<ul>
	<li>Mucous and/or blood in the stools</li>
	<li>Fever</li>
	<li>Mouth ulcers</li>
	<li>Pain or swelling around the anus</li>
</ul>

Symptoms change as inflammation flares up and then eases. Also, not all people with Crohn&rsquo;s disease have the same symptoms, as it depends on the area of the gut affected. 
&nbsp;

Causes

The exact cause of Crohn&#39;s disease is unknown. However, it is an autoimmune condition, which means a dysfunction of the immune system causes the intestines to overreact to a dietary, environmental, or infectious agent. 
&nbsp;

The disease may get worse over time.<a href="#accordion">[3]</a>

<ul>
	<li>Mild &ndash; Symptoms include diarrhea</li>
	<li>Moderate To Severe &ndash; Symptoms include abdominal pain or tenderness, diarrhea, fever, noticeable weight loss, and nausea or vomiting</li>
	<li>Severe &ndash; The individual presents with infections or blockages in the intestines, symptoms that don&rsquo;t respond to treatment, or in places other than the digestive tract 
	&nbsp;</li>
</ul>

There is no specific screening test for Crohn&#39;s disease. 
&nbsp;

Diagnosis

There is no single test to confirm the diagnosis. Doctors ask about the patient&rsquo;s medical history and perform a physical exam, including checking for abdominal bloating, tenderness, and pain. 
&nbsp;

Additionally, they may use a combination of the following tests to diagnose it:

<ul>
	<li>Endoscopy &ndash; Upper or lower endoscopy and a biopsy for microscopic examination&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</li>
	<li>Imaging Tests &ndash; A CT scan or MRI of the abdomen to provide detailed images of the digestive system; recurring episodes may require upper gastrointestinal series, video capsule endoscopy, CT enterography, or magnetic resonance enterography</li>
	<li>Blood Tests &ndash; To check for anemia and other indications of inflammation</li>
	<li>Stool Tests &ndash; To rule out infection and fecal calprotectin 
	&nbsp;</li>
</ul>

Treatment

Sometimes, symptoms of Crohn&rsquo;s disease may resolve on their own. Treatment is usually aimed at relieving inflammation and other symptoms.<a href="#accordion">[2]</a>

<ul>
	<li>Medications, including aminosalicylates, antidiarrheals, corticosteroids, immunomodulators, biologic agents, and broad-spectrum antibiotics and probiotics.</li>
	<li>Around 66-75% of patients need surgical interventions, such as ileostomy and resection, to remove diseased sections of the intestine.<a href="#accordion">[3]</a></li>
	<li>Patients with severe symptoms are hospitalized. They may need intravenous fluids, blood transfusions, or iron supplements. Doctors also encourage smoking cessation, given how smoking increases the risk of recurrence, especially in women. 
	&nbsp;</li>
</ul>

In cases where flare-ups are severe or frequent, Crohn&rsquo;s disease may lead to:

<ul>
	<li>Stricture</li>
	<li>Fistula</li>
	<li>Abscess</li>
	<li>Malabsorption and malnutrition</li>
	<li>Colon cancer</li>
</ul>

Some individuals may present with systemic complications, i.e., complications that affect the whole body. The disease may affect the joints, skin, eyes, kidneys, and liver. It may even cause physical development problems like delayed puberty in children with Crohn&rsquo;s disease or other issues during pregnancy.

The complications of Crohn&rsquo;s disease may also increase the risk of early death.<a href="#accordion">[3]</a> 
&nbsp;

These include:

<ul>
	<li>Genetics; 3 in 20 people have a close relative with Crohn&#39;s disease.<a href="#accordion">[4]</a></li>
	<li>Age, with those aged 15-35 being especially vulnerable.</li>
	<li>Ethnicity, white or of Eastern European Jewish background.</li>
	<li>Smoking</li>
	<li>Other factors, such as air pollution, previous infections or surgeries, certain medications, a diet high in refined foods and sugar, and stress. 
	&nbsp;</li>
</ul>

It is not possible to prevent Crohn&rsquo;s disease itself. However, the following lifestyle changes may help manage symptoms and prevent complications:

<ul>
	<li>Quitting smoking</li>
	<li>Avoiding medications and foods that trigger unwanted symptoms</li>
	<li>Eating several small meals and drinking plenty of water</li>
	<li>Exercising regularly and practicing relaxation techniques 
	&nbsp;</li>
</ul>

Key Points

<ul>
	<li>Crohn&#39;s disease is a chronic, inflammatory condition of the gastrointestinal tract.</li>
	<li>The exact cause is unknown, but genetics, age, ethnicity, and smoking are major risk factors.</li>
	<li>Diagnosis involves endoscopy, imaging studies, and laboratory tests.</li>
	<li>Treatment includes medications, surgical interventions, and lifestyle modifications.</li>
	<li>Preventive measures help manage the symptoms and reduce the risk of developing complications.</li>
</ul>