In Crohn’s disease, the digestive tract of a person gets inflamed, which causes malnutrition, weight loss, fatigue, diarrhea, and abdominal pain. The location inflammation varies from person to person. It mostly affects deep layers of the large intestine.
Signs and symptoms (1)
The inflammation can target both the small and large intestine whether in continuous manners or segments. Some patients get this inflammation only in the colon (part of the large intestine). A patient can experience mild to severe signs and symptoms. Exposure to symptoms can be abrupt or gradual. A patient may undergo a remission period in which he experiences no signs.
Following signs and symptoms can be seen in the active phase of the disease.
- Blood in stool
- Abdominal pain
- Cramping in abdomen
- Mouth sores
- Loss of appetite
- Weight loss
- Damage or pain sensations near the anus due to fistula inflammation.
When the disease progresses, then symptoms become more severe. Such as,
- Ulcers anywhere in the gastrointestinaltract
- A perianal fistula leads to the drainage and pain near the anus
- Inflammation of skin, joints, liver, and eyes
- Shortness of breath
- Anemia (iron deficiency)
- Reduced exercising ability due to anemia
- Kidney stones
- Delayed growth in children
Causes of Crohn’s disease
The underlying cause of Crohn’s disease is still a mystery. At first, stress and diet were thought to be the causesbut later both were considered as aggravating factors of Crohn’s disease. Two factors likely play a role in disease development.
- Immune system
Chances of getting Crohn’s disease due to a bacterium or virus are possible. However, those specific bacteria and viruses are yet not identified. When a foreign microorganism attacks the body, the immune system activates and fights with that microorganism. Any abnormality in the immune response can cause the immune system to attack the digestive tract. This leads to the inflammation of cells of the digestive tract.
Crohn’s disease runs in a family. A person is vulnerable to disease if any of his family members is suffering from that disease. But its onset does not necessarily depend upon the family history. A person with no family history of Crohn’s disease can also get affected but the incidence rate is relatively less.
Crohn’s disease is not exactly age-dependent. But most cases are reported in young ones when they are around 30 years of their age.
People of any ethnic group can be affected by Crohn’s disease. But white people have the highest risk, particularly Eastern European Jewish Descendants. However, this disease is also spreading among Blacks of the United Kingdom and North America.
- Family history
According to Crohn’s and colitis foundation, about 20% of people suffering from Crohn’s disease have a sibling, parents, or a child with this disease.
- Cigarette smoking
Cigarette smoking is one of the chief risk factors for Crohn’s disease. It is a main yet controllable risk factor. It enhances the severity of the disease and eventually makes surgery the only way of treatment.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
NSAIDs worsen Crohn’s disease by increasing the inflammation of the bowel. These include ibuprofen, diclofenac sodium, naproxen sodium and more.
A general physician makes the differential diagnosis by ruling out other conditions that may cause similar symptoms. No particular test is designed to diagnose Crohn’s disease.
- Blood test
A blood test is performed to determine anemia. Anemia is a condition in which blood cellsare not enough to take adequate oxygen to tissues. It is a common condition that occurs during Crohn’s disease.
- Stool test
The patient gives the sample of stool and the doctor checks for the presence of any parasites or hidden blood clots in the sample.
Several imaging procedures are performed to diagnose Crohn’s disease.
- Computerized tomography (CT).
This scan provides higher definition results than the normal X-ray. It examines the complete bowel from the inside as well as the outside. To examine the small intestine, CT enterography (special CT scan) better serves the purpose.
It is a complete examination of the entire colon. The expected purpose is achieved by sending a flexible, lighted, thin tube in the body. The tube has a camera on its terminal that helps to show the inside scenario of the colon. A doctor may do a biopsy during this procedure. Samples are then sent to the laboratory and the presence of granulomas (clusters of inflamed cells) is checked to confirm the diagnosis.
- MRI (Magnetic Resonance Imaging)
An MRI scanner generates a highly defined image of tissues or organs by using radio waves and a magnetic field. Two types of MRI are done in Crohn’s disease.
- MR enterography; evaluation of small intestine
- Pelvic MRI; evaluation of fistula near the anus
- Capsule endoscopy
A capsule having a camera is engulfed by the patient. The camera takes images of the site of infection. Recorder on the patient’s belt records the images. A computer downloads images, the monitor displays them on-screen, and the doctor checks for any signs of the disease.
These are the first-line treatment for Crohn’s disease.
Budesonide and prednisone reduce the inflammation of the bowel.
- Oral 5-aminosalicylates
Drugs such as sulfasalazine were widely used to treat Crohn’s disease. But its use has been limited now.
Immune system suppressant
- Azathioprine and mercaptopurine
Both are extensively used immunosuppressants for treating Crohn’s disease. Due to several side effects, a close follow-up is required while having this treatment.
This is a drug of choice for those patients who do not respond to other medications.
This drug inhibits the binding of integrin with the intestinal cells. This inhibition slows the attack of the immune system to the target site.
It is also called a TNF inhibitor. It inhibits TNF (tumor necrosis factor) protein and treats Crohn’s disease.
In the body, there is a protein known as interleukin that causes inflammation. Ustekinumabinterferes with that protein and reduces inflammation.
Some anti-diarrheal, pain killers and supplements help to reduce the symptoms of Crohn’s disease.