 |
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
|
|
 |
Crohn’s Disease Description
Crohn's disease is a chronic inflammatory condition the intestinal tract, and can occur from the mouth to the rectum. The large intestine is involved in 65% of the people who have Crohn's disease. The small intestine is involved in 35% of people with the disease. Crohn's disease typically occurs in young adults. The cause of Crohn's disease is unknown, but autoimmune and infectious factors are believed to play a role.
In Crohn's disease, the hallmark of inflammation is an ulcer, and it can occurs in all the layers of the intestinal tract, which is one distinguishing feature from another form of inflammatory bowel disease called ulcerative colitis. Typically, there are areas of the intestine that are not involved ("skip areas"). The ulcers may cause thickening of the intestine, with eventual blockage. The inflammation can cause holes bowel walls, called perforations, and lead to other organs, called fistulas. Because the inflammation also affects the outer intestinal walls, the loops of bowel may attach to each other.
Symptoms of Crohn's disease include:
• abdominal pain or cramping
• diarrhea
• fever
• fatigue
• weight loss
• rectal fistula (abnormal opening at or near the anus)
• rectal fissure (a painful crack in the mucous membrane of the anus).
Diagnosis
To diagnose Crohn's disease, your doctor will review your symptoms and examine you. The exam usually includes a colonoscopy (a procedure in which the doctor uses a scope to look at the inside of your large intestine or colon). Often the doctor will take a small piece of bowel tissue for testing, called a biopsy. Certain features of the biopsy can be diagnostic of Crohn’s disease. Since the colon is involved 65-70% of the time, this is often the first test done.
Another important test is the barium small bowel series, an x-ray study where you drink barium and the radiologist takes pictures of the small intestine to see if the disease has affected this part of the intestine. This can help make the diagnosis, and detect fistulas. CT scans may also be done to look for collections of infection in the abdomen (called an abscess).
Treatment
There is no cure for Crohn's disease. The best treatment is frequent checkups with your doctor to control the disease. The doctor will probably prescribe one or more medications for you to take.
Anti-inflammatory medications are often used, but are a specific type. Steroids, such as prednisone, is used for severe disease. Milder forms may be controlled by a non-steroid medication called mesalamine (5-ASA), which comes in several brand names. Antiobiotics are often used, and occassionally your doctor will put you on intravenous nutrition (bowel rest) to allow the inflamed intestine to heal properly.
If the disease does not respond, or recurs after stopping prednisone, other medications called biological response modifiers may be used. These include the immunosuppressive drug called Imuran (azathioprine, 6-MP) and a newer medication called Infliximab (Remicade). Your doctor can explain the risks and benefits of these medications with you.
In sever cases, the intestine may be so badly damaged or so severely blocked off that surgery is necessary.
Dietary Considerations
If you have diarrhea, avoid certain foods that have a laxative effect, such as raw fruits and vegetables and concentrated fruit juices. You can rest your bowel by not eating solid foods for a while. Drink just clear fluids frequently during the day (electrolyte or rehydrating fluids are best). It is important to drink often so that you do not become dehydrated. When an attack of diarrhea is over, eat small frequent meals. Sometimes anti-diarrheals are prescribed.
Limit or avoid food additives and stimulants such as caffeine (in coffee, tea, or chocolate). Avoid eating or drinking milk products. Enzyme supplements may help if you develop an intolerance to lactose (a sugar in dairy products). Ask your doctor if you should reduce the amount of roughage in your diet.
If you have cramps or abdominal pain, it may help to put a hot water bottle or electric heating pad (set on low) on your abdomen.
Crohn’s disease is a chronic condition which tends to come back if not treated appropriately. You should follow up with your doctor regularly, and pay careful attention to the treatment planned as outlined.
For more information you may also want to write or call:
Crohn's and Colitis Foundation of America
444 Park Avenue South
New York, New York 10016
Phone: (212) 685-3440
TOP
Please note: We do not answer questions regarding individual medical problems on this website. We advise you to contact your physician for your specific health related concerns.
©2007 Syracuse Gastroenterological Associates, P.C.
Site designed and hosted by Internet Host Services