Crohn’s Disease: Symptoms, Causes, Diagnosis & Treatments

Crohn’s disease is a chronic illness that mainly affects the digestive tract of a person. The main cause of the disease has not yet been established. It is also suspected to be caused by dietary habits of individuals but this is yet to be proven. Some bacteria like Mycobacterium are also suspected to cause the disease but it is also yet to be proven. Crohn's disease is a form of inflammatory bowel disease or (IBD). The development of Crohn's disease can lead to a number of health complications that include arthritis, painful conditions of the eye, inflammation of the spine and lower back, cancer, jaundice, hepatitis, liver cirrhosis, rupture of the intestine and megacolon.

Crohn’s disease leads to the inflammation of the bowels of a person and also the digestive tract. The inflammation of the bowels and the digestive tract resulting from the development of Crohn's disease usually spread deep into the affected organs leading to life-threatening conditions to develop. The disease is associated with symptoms such as severe diarrhea, abdominal pain, weight loss, malnutrition and general body weakness.

Crohn's disease has no known cure but it can be managed with the right treatment. Crohn's disease can affect anyone but is most prevalent to those between the ages of 15 and 35 years of age. It can affect both men and women in the same proportion and the effects can range from being mild to severe depending on the stage of the disease. Approximately more than 70,000 people are affected by the disease in the U.S and the statistics can be more or less in other countries. Lifestyle changes like consumption of a healthy diet and regular exercise can help in the treatment of Crohn's disease. There are over the counter medications such as the administration of antidiarrhetics and anti-inflammatory medications that can help in the treatment and management of the disease.

There are many illnesses with the same signs and symptoms as Crohn's disease and therefore doctors usually take a lot of caution before diagnosing a patient with the disease. The symptoms and severity of the disease mainly depend on which part of the bowel has been affected by the disease. Symptoms may also arise according to the complications of the disease, for example, those patients suffering from fistula around the rectum may experience pain and a leaking discharge in areas around the rectum.

Crohn's disease leads to the obstruction of gastrointestinal tract due to the swelling of the bowels and intestines. This can cause health problems like the perforation of a person's bowels, and abdominal distensions. The disease adversely affects the small intestines by narrowing them and blocking the flow of food inside the bowels. It can also cause the development of deep ulcers inside the small intestine.

Causes of Crohn’s Disease:

The main cause of Crohn's disease has not yet been known. The following are suspected by scientist to cause Crohn’s disease.

  • Infection from some bacteria like mycobacterium is said to be the cause of Crohn’s disease. It is not contagious and therefore cannot be spread from one person to the other. Diet can also affect the signs and symptoms of the disease but has nothing to do with its occurrence.
  • Crohn's disease is also suspected to be caused by the reaction of the immune system. This occurs when the immune system tries to defend the body against viruses, fungi, and bacteria. The immune system might react in such a way that even the normal cells of the body are destroyed by it. This can cause the destruction of the small intestines leading to the development of Crohn's disease affecting the bowels and the gastrointestinal tract.
  • Hereditary factors can lead to the development of Crohn's disease. Those people with family members that have experienced the disease are also likely to be affected by it. Even though the genetic makeup of a person plays a significant role in the development of Crohn's disease, most cases associated with it are not related to genetic factors. Most of the patients diagnosed with the disease have no family records of people having Crohn's disease in their family lineage.
  • The environment in which a person is living in also plays a role in the development of the disease. Research that was recently conducted has shown that those living in urban areas are likely to be affected by the disease than those staying in rural areas of a country. The disease is most common in the developed countries than it is in the third world countries.
  • The abnormal balance of the gut bacteria can lead to the development of Crohn's disease.
  • Smoking is also associated with the development of the disease.
  • A previous stomach bug may end up causing Crohn's disease.

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Risk Factors Related to Crohn’s Disease:

Anyone can be affected by Crohn's disease. However, some people are more likely to suffer from the condition as compared to other people. Such people include:

  • Those with some bacterial infections that are suspected to be causing the development of Crohn's disease, for example, the presence of Mycobacterium.
  • Those with auto-reactive immune systems are at great risks of being affected by Crohn's disease. This is because the immune system while fighting harmful bacteria and viruses in the body can react in such a way that normal healthy cells of the intestines are also affected. This leads to the inflammation of the bowels resulting in the development of Crohn's disease.
  • People coming from family backgrounds associated with cases of Crohn's disease are at higher risks of being affected by the illness due to genetic factors involved.
  • People living in urban areas, or developed countries are also at great risks of being affected by the illness as compared to those living in rural areas or developing countries.
  • Those who constantly experience abnormal balance of the gut bacteria can easily be affected by Crohn's disease.
  • Cigarette smokers are at a greater risk of being affected by the illness. This is due to the fact that the cigarette smoke interferes with the lining of the small intestines which may lead to an infection and inflammation of the bowels resulting in Crohn's disease.
  • Those who have had a stomach bug in previous days are also at a risk f developing the disease.
  • Crohn's disease can affect anyone. However, those of ages between 15 and 35 have high chances of developing the condition.
  • Crohn's disease can affect people from all ethnic groups. However, the whites and the Jewish have increased chances of suffering from the disease as compared to people from other ethnic backgrounds.
  • Those people who are under nonsteroidal anti-inflammatory medications are at high risks of being affected by Crohn's disease. These medications lead to the inflammation of the bowels and cause the disease. Some of these medications include diclofenac sodium, naproxen sodium, and other medications. They worsen the state of the disease in people that are already suffering from the condition.

Diagnoses of Crohn’s Disease:

There is no specific way of diagnosing Crohn's disease. A number of tests have to be done to correctly diagnose it. These tests include:

  • A blood test can be conducted in the lab to determine the number of white blood cells in the blood. Sedimentation rate can also be determined by the blood test. If the white blood cells are elevated and there is the presence of abnormal elevation, then there is the presence of inflammation. Further tests can be done on the blood and a record of a low amount of blood, which may be caused by anemia, is noted. Presence of chronic diarrhea is also confirmed by the low amount of proteins and mineral levels in the body. Blood test together with the determination of the history of the patient during a physical test can help in the diagnosis of Crohn's disease.
  • In order to determine the nature and distribution of the disease, Barium-X rays studies are used. The severity of the disease is also determined using the same mechanism. Barium can be ingested orally or administered through the rectum. Oral ingestion of barium enables pictures of the small intestine and the whole stomach to be taken. Administration of barium through the colon allows pictures of the colon and the terminal ileum to be taken. The pictures are helpful in determining the presence of Crohn's disease. The test is important since it enables the doctors to be able to see the presence of ulcers in the stomach, narrowing of the small intestines and fistulae.
  • In cases where Barium-x rays have failed to give accurate results, a colonoscopy test is carried out. The test helps doctors in the direct observation of the large intestines and the rectum. It is accurate in determining even the presence of small inflammations of the intestine or ulcers in the stomach. Samples of the tissues in the digestive tracts can also be taken through this method and sent to the lab for further tests.
  • Scanning can also be helpful in the diagnosis process. This is made possible by using computerized axial tomography or CAT. It allows clear imaging of the whole pelvis and abdomen at a glance. CT and MRI enterography can also be used in the scanning process.
  • Video capsule endoscopy or VCE can also be of help in the diagnosis of the disease.

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Differential Diagnosis of Crohn’s Disease:

During the differential diagnosis of Crohn's disease ulcerative colitis is mostly considered. Both diseases involve the inflammation of the colon and the rectum. Ulcerative colitis is singled out and differentiated from Crohn's disease because the inflammations only involve two parts of the digestive tract, that is the colon and the rectum. However, with Crohn's disease, various parts of the digestive tract can be inflamed including the colon, rectum, mouth, stomach and the esophagus.

Treatment of Crohn’s Disease

Crohn's disease has no known cure. It is associated with periods of relapses, where the symptoms are severe and the inflammation worsens, and periods of remission where the symptoms become acute and the inflammation lessen. These periods occur naturally. The main aim of treatment is to reduce the relapses, increase the remissions and maintain the remissions. This is done through the administration of anti-inflammatory medications such as 5 aminosalicylic acid (5-ASA) compounds, antibiotics and corticosteroids to decrease inflammation, sulfasalazine, mesalamine, dipentum, and metronidazole or Flagyl. Immuno-modulator drugs can also be administered to patients with Crohn's disease.

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Myths Related to Crohn’s  Disease

Like any other medical condition, there are various myths that are associated with the development of Crohn's disease and its medication. Some of these myths include the following:

Myth #1: Surgery Cures Crohn’s Disease

As earlier stated, Crohn's disease has no cure. Even if surgery is done and the infected parts are removed, the other remaining parts of the digestive tract will still develop the condition. If a person suffering from Crohn's disease undergoes surgery, it will mainly be to treat some conditions like fistulae of the colon or to remove the dead segments of the small intestine.

Myth #2: Crohn’s disease can be brought about by diet

This is false. The only relationship between Crohn's disease and diet is that some diet tends to worsen the condition.

Frequently Asked Questions (FAQs)

1) Is there a vaccine against the condition?

Ans: There is no vaccination that directly prevents the development of Crohn's disease. However, a person may be given various vaccinations that help prevent some illnesses that may increase chances of developing Crohn's disease. Vaccination can be performed against diseases such as pneumonia, influenza, hepatitis A and hepatitis B vaccines should also be administered to patients suffering from Crohn's disease. There are other diseases that may increase the risk factors for developing the disease and their vaccinations should also be considered.

2) Which Diet Can Supplement the Treatment of Crohn’s Disease?

Ans: Diets such as intravenous nutrition can be applied, a patient is also advised to include a lot of water in their diets. The diet may also consist of low fiber since the digestion of fiber is hard, it can worsen the Crohn’s condition.

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Last updated on : 24-12-2018

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