Crohn’s disease is an inflammatory disease that targets the entire gastrointestinal tract. It commonly targets the large and small intestine, but involvement of the mouth and esophagus is also possible. The disease is an autoimmune disease, meaning that the body’s own immune system is attacking itself and the immune system is the culprit of the disease.
It can affect both males and females, and tends to occur in the teens to twenties, or the 50s to 70s. This disease also does tend to run in families. Crohn’s affects the gastrointestinal(GI) tract by causing an inflammation reaction to occur chronically, causing long-term damage to the GI tract. The inflammation causes irritation of the GI tract, leading to its symptoms.
After a while, fat strictures form around the tract. The GI tract also begins to narrow at several areas. These strictures may narrow or even close off the GI tract, as if a person were squeezing the neck of a balloon to prevent air from coming out. The inflammation may also eat away at the GI tract and simultaneously create new fistulas in the GI tract or even to the outside skin near the anal area.
Crohns Disease Side Effects and Symptoms
The most common symptom of Crohn’s disease is abdominal pain that is very nonspecific and comes and goes. Diarrhea often accompanies the disease, with as many as fifteen bowel movements a day. Itching around the anus may occur as well. Flatulence and bloating are also common. In more severe disease, fistulas may form in the perianal area, causing fecal leakage.
Vomiting, nausea, and crampy abdominal pain may also be seen in more advanced Crohn’s disease due to intestinal blockage from strictures. The inflammation from Crohn’s disease may also affect the rest of the body as well. Eye pain, due to uveitis, is not an uncommon symptom, as well as inflammatory arthritis. Fever may also occur as well.
Oral nonhealing ulcers is also a not-so-uncommon complaint as well. Typically, the diagnosis of Crohn’s disease requires a procedure called an endoscopy, in which a camera is guided through the GI tract to visualize the disease. Often the disease is officially diagnosed in this way.
Crohn’s Disease Treatment
Since Crohn’s disease is an autoimmine disease, it can only be managed, not cured. Lifestyle changes include diet modification, hydration, and smoking cessation. Eating smaller meals may help, along with eating less fibrous foods to prevent frequent bowel movements.
It is also recommended to cease drinking milk. Smoking also worsens Crohn’s disease and makes episodes more frequent. Medication is primary used to treat flareups of Crohn’s disease. Corticosteroids and aminosalicyclates are the typical mainstays used to treat these flareups. However, corticosteroids are not recommended long-term to treat this disease. Other medications to treat this disease chronically include methotrexate and the TNF-alpha inhibitors, such as Enbrel and Humira.
In fact, the TNF-alpha inhibitors, a recent discovery, have become revolutionary in the treatment of Crohn’s disease, causing fewer flareups and easing symptoms. However, most Crohn’s disease patients will eventually require surgery to relieve intestinal blockages caused by strictures.
Unfortunately, surgical treatment to remove strictures also raises the chances of another intestinal blockage in the future, creating a vicious cycle sometimes, especially if the patient has no medical treatment.
Occasionally, portions of the small bowel may have to be removed due to the intrinsic nature of the narrowing; since the inflammation is part of the small bowel, the narrowing cannot be simply cut open. With newer advances in medical treatment of Crohn’s disease however, this is hopefully becoming a less frequent course of the disease.