Crohn’s disease (regional enteritis) is a type of inflammatory bowel disease (IBD) marked by inflammatory changes in the lining of the digestive tract. Any part of the digestive tract starting from mouth to anus may be affected by Crohn’s disease. The other type of IBD, ulcerative colitis, is limited to the colon of the colon of the large intestine and the rectum.
The common symptoms are bloody diarrhea with abdominal pain. It can also present with symptoms affecting other organs outside of the digestive tract. A complex interplay between environmental factors, bacteria and individual’s immune system is the most common cause of Crohn’s disease. Currently Crohn’s disease is incurable. Various drugs and surgery are the options to relief symptoms and prevent relapses.
The terminal part of the small bowel and colon of the large intestine are the most commonly affected part of the gut in Crohn’s disease. Inflammatory changes due to the disease may remain confined to the bowel wall, may cause narrowing of the lumen (stenosis) or perforate the bowel wall (fistula). There are usually disease-free intervals (remission) in between periods of aggravation of symptoms.
Symptoms can be classified by the location of the pathology – intestinal, outside of the gut (extra-intestinal) and general.
- Diarrhea with or without blood
- Pain in the abdomen
- Ulcer development
- Skin tags around the anal orifice, anal fissures and/or abscess in the anal region
- Eye: pain, light intolerance (photophobia) due uveitis, scleritis
- Bone and joints: knee and shoulder inflammation and pain (arthritis), low back pain (sacroilitis), bone weakness, increased fracture
- Skin: red lesion (erythema nodosum), painful ulcers (pyoderma gangrenosum)
- Increased chance of blood clotting leading to painful leg swelling (deep vein thrombosis)
- Mouth sores
- Nervous system: depression, headache, stroke
- Weight loss
- Malaise during attacks
- Loss of appetite
The exact causative factor of Crohn’s disease is still not known. Commonly associated factors include :
- Environmental: consumption of increased amount of animal and milk protein, smoking are associated with Crohn’s disease.
- Bacterial: infection with certain bacteria in a patient of weak immune system may trigger Crohn’s disease.
- Genetic: Crohn’s disease may run in families, although many patients lack family history.
- Weak immune system.
- Age: people of any age group can be affected but young people are at more risk.
- Family history.
- Inhabitants of industrialized areas.
At present there is no permanent cure available for Crohn’s disease. The goal of treatment is :
- Relief of symptoms.
- Prevention of relapse.
- Prevention of complications of Crohn’s disease.
Anti inflammatory drugs:
Other drugs to relieve symptoms :
- Stool softener
- Iron and vitamin supplements
Certain foods may trigger acute attacks or exacerbate the existing symptoms of Crohn’s disease. Although there are some common foods that may affect most Crohn’s disease patients, there are often individual items unique to each case. Patients are advised to keep a food diary to note trigger foods and exacerbating items.
Surgery is required if drugs are not sufficient alone. The diseased portion is removed and healthy portions of the two ends are connected. Usually 3 out of 4 patients with Crohn’s disease require surgery at least once. In most of these cases, recurrence occurs after surgery at different regions of the bowel.