Crohn’s Disease affects approximately 700,000 people in the United States. While it is most common in people ages 15-35, anyone at any age can show symptoms. Men are also just as likely to have the disease as women are. If someone, such as a parent, have the disease you are more likely to show symptoms. The risk is also higher if the person is Jewish or African American. The causes of this disease are not clear but some think that genetics, diet, smoking and stress play a role in the irritation. The person’s environment seems to also play a role. For example, people who live in northern climates are more likely to have the disease as well as people in underdeveloped countries as opposed to the more developed ones.
Crohn’s is one of the many diseases that fit into the Inflammatory Bowel Disease category. This disease is many times confused with ulcerative colitis. While their symptoms may be very similar, the thing that sets them apart is the part of the gastrointestinal tract that they affect.
Crohn’s can affect the large intestine, the end of the small bowel, and the thickness of the bowel wall. Symptoms include persistent diarrhea, rectal bleeding, constipation, and abdominal cramps. If symptoms are not treated the disease can also lead to fatigue and weight loss. Crohn’s is also considered to be a chronic disease meaning that the person can experience periods of remission followed by flare ups. Only in the most severe cases does the disease cause fissures, or tears in the lining of the anus, and fistulas, hollow passages from one part of the intestine to another or in some cases to other organs, to develop.
In a normal person’s gastrointestinal tract there are tons of bacteria that help digest the food, but in the case of a person with Crohn’s their immune system attacks these bacteria that are normally left alone. For some reason the immune system mistakes these “good” bacteria for being dangerous ones that don’t belong in the body. As a response to the attack, cells travel from the blood stream into the intestine which causes the inflammation and the walls of the intestine to thicken. At the point when the intestinal wall starts to thicken is when the person usually starts to notice the symptoms.
Unfortunately Crohn’s cannot be diagnosed in one test; it takes many to rule out other things such as a bacterial infection. When a patient first shows symptoms, their doctor may do things such as ask them about their family history and diet. After that their doctor may take blood tests, examine stool matter, and do x-rays on the patient’s gastrointestinal tract.
If the patient shows sign of Crohn’s in the x-ray, their doctor may then do things such as a biopsy, an endoscopy, or a chromoendoscopy. During a chromoendoscopy, the doctor sprays the intestine walls with a blue substance in order to find polyps that may be growing in the intestine.
Since Crohn’s is a chronic disease, there is no definite cure and there is not just one way to manage symptoms that work for every patient. Common treatment options are surgery, diet changes and medication.
If medication is the route the patient takes, they could be prescribed one of six different options depending on the severity of the symptoms and what part if the gastrointestinal tract is affected. All medications are designed to suppress the immune system so that it can no longer attack the bacteria in the gastrointestinal tract and allow the walls of the intestine to heal.
One group that a patient may be prescribed is Aminosalicylates. These work only if the colon is affected. This group also works well for patients with mild symptoms by decreasing inflammation or ones that are in remission.
The second group is called Corticosteroids. These suppress the immune response and work best for treating moderate to severe symptoms. This group however is only used as a short-term treatment and because of the side effects is never used as a maintenance drug.
The next group of medication that a patient could be prescribed is Immunomodulators, Like the other medications, this one suppresses the immune response so that the inflammation can be stopped. This medication is used only as a backup plan when the first two groups don’t work or the patient has very little response or remission.
The fourth group is antibiotics which are generally just for treating bacterial infections that can be caused by Crohn’s. They are not used as a maintenance drug or to help relieve symptoms. They are strictly used for getting rid of infections.
The last group that a patient could receive is biologic therapies also known as anti-TNF agents. TNF is the chemical in our bodies that is responsible for causing inflammation. These work for patients with moderate to severe symptoms and work by producing antibodies that attach to and destroy the chemical causing inflammation to be reduced.
Another alternative to treating the disease is changing the patient’s lifestyle. Stress is one factor that is said to make symptoms worse so the patient may look into relaxation techniques such as yoga or meditation in order to relieve any anxiety. Adding in exercise has also been shown to help with symptoms. Another thing a patient’s doctor may suggest is watching what they eat. Foods that are high in fiber or spicy tend to cause more irritation and flare ups then bland foods. A person with Crohn’s that is experiencing diarrhea should drink more water and eat foods high in protein, vitamins and minerals since their body’s ability to absorb these is compromised.
A third alternative to managing symptoms is surgery. Approximately 70% of people that suffer from the disease will eventually require some sort of surgery. Surgery is only necessary if a fistula, fissure or other obstruction forms in the gastrointestinal tract. Again, since Crohn’s is a chronic disease, surgery is by no means a cure and in fact patients may be in remission for years after their surgery but then can easily have a flare up.
Along with the normal symptoms of Crohn’s, patients can also experience other painful complications. One example is painful red bumps on the patient’s legs. Other examples are visual difficulties, arthritis, lower back pain caused from inflammation and inflammation of the liver.