Crohn’s disease is an ongoing disorder that causes inflammation of the digestive tract. Crohn’s disease can affect any area of the GI tract, from the mouth to the anus, but it most commonly affects the lower part of the small intestine, called the ileum.
Crohn’s disease is closely related to another condition of inflammation of the intestines called ulcerative colitis. Together, they are frequently referred to as inflammatory bowel disease (IBD). Ulcerative colitis and Crohn’s diseases are chronic conditions that can last years to decades.
Crohn’s disease affects men and women equally and seems to run in some families. About 20 percent of people with Crohn’s disease have a blood relative with some form of inflammatory bowel disease, most often a brother or sister and sometimes a parent or child. Crohn’s disease can occur in people of all age groups, but it is more often diagnosed in people between the ages of 20 and 30. People of Jewish heritage have an increased risk of developing Crohn’s disease, and African Americans are at decreased risk for developing Crohn’s disease.
No one knows what causes crohn’s disease. The theories suggest various intrinsic and extrinsic factors responsible for crohn’s disease.
Intrinsic or internal factors include: –
Hereditary factors/genetic factors- it is seen that if there is immediate family member having crohn’s disease, then your chances of having the disease increases.
Faulty immune-system– it is believed that it is responsible for the inflammation of the GI tract.
The disturbance is thought to be either of two: –
Allergy: studies suggest that crohn’s disease is a form of increased allergic response to certain food or to the presence of some microorganisms in the GI tract.
Autoimmunity: Most recent research indicates that crohn’s disease can be a form of autoimmune disease in which body’s defense system starts attacking body’s own organs and tissues.
Extrinsic or external factors/ triggering factors include: –
Diet– certain foods items are known to trigger crohn’s disease like junk food, dairy products etc.
Infection– studies suggest that certain bacterial and viral infections like mycobacterium are known to trigger CD.
Drugs– recent research shows that certain drugs like antibiotics, aspirin, contraceptive pills; NSAID’s are known to flare up CD.
Stress- Recent studies has accepted the fact that any kind of emotional stress has definite detrimental effect on the immune system and hence can be the root cause of chronic disease like crohn’s disease.
In the early stages, Crohn’s disease causes small, scattered, shallow, crater-like areas (erosions) on the inner surface of the bowel. These erosions are called aphthous ulcers. With time, the erosions become deeper and larger, ultimately becoming true ulcers (which are deeper than erosions) and causing scarring and stiffness of the bowel. As the disease progresses, the bowel becomes increasingly narrowed, and ultimately can become obstructed. Deep ulcers can puncture holes in the wall of the bowel, and bacteria from within the bowel can spread to infect adjacent organs and the surrounding abdominal cavity.
The most common symptoms of Crohn’s disease are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, arthritis, skin problems, and fever may also occur. Bleeding may be serious and persistent, leading to anemia. Children with Crohn’s disease may suffer delayed development and stunted growth. The range and severity of symptoms varies.
Crohn’s disease may lead to one or more of the following complications:
Intestinal complications
People who have had Crohn’s disease for several years are at increased risk of developing cancer in the inflamed part of their bowel. Screening for colon cancer may be beneficial in this group.
Extra-intestinal complications
When Crohn’s disease causes a flare-up of gastrointestinal symptoms, the person may also experience inflammation of the joints (arthritis), inflammation of the whites of the eyes (episcleritis), mouth sores (aphthous stomatitis), inflamed skin nodules on the arms and legs (erythema nodosum), and blue-red skin sores containing pus (pyoderma gangrenosum). Even when Crohn’s disease is not causing a flare-up of gastrointestinal symptoms, the person still may experience pyoderma gangrenosum, while inflammation of the spine (ankylosing spondylitis), inflammation of the pelvic joints (sacroiliitis), inflammation inside the eye (uveitis), or inflammation of the bile ducts (primary sclerosing cholangitis) are liable to occur entirely without relation to the clinical activity of the bowel disease.
The doctor will take a history and perform a thorough physical examination. Slow growth may be a key feature in making a diagnosis, particularly of Crohn’s disease, in children.
Several laboratory tests may be performed:
Standard Endoscopic Procedures: Flexible sigmoidoscopy and colonoscopy are procedures that involve snaking a fiberoptic tube called an endoscope through the rectum to view the lining of the colon. The doctor can also insert instruments through it to remove tissue samples.
DIETS ADVISED- It is important to self- manage crohn’s disease with healthy lifestyle habits and a nutrient-rich diet. Paying attention to your nutrition is especially important with GI diseases because the symptoms of diarrhea and bleeding can lead to dehydration, electrolyte imbalance, and loss of essential nutrients. That can lead to a host of problems such as fatigue, weakness, and anemia.
If you are a vegetarian with crohn’s disease, dairy products and plant proteins — such as soy products — can provide the nutritional elements found in meat, fish, and poultry.
Food items to be avoided-Learning to avoid food triggers may give you better control of your disease and allow you greater freedom to enjoy an active life. Despite the fact there is no scientific proof; many people with crohn’s disease have found that one or more of the following foods can trigger their GI symptoms: