Crohn’s Disease (Regional Enteritis)

What is Crohn’s Disease (Regional Enteritis)?

Crohn’s disease is a condition which causes chronic inflammation of the gastrointestinal tract, or the digestive tract as it is commonly called, and may affect any part from the mouth to the anus. It is also known as the Regional Enteritis. It mostly affects the lower portion of the intestines, generally the ileum. It also causes ulcerations in the intestinal regions. This condition can be very painful at times, and may also spread deep into the layers of the bowel tissues. It may lead to certain complications which may be life threatening.

There is a close relation between this disease and another disease called ulcerative colitis, as this also an inflammatory condition.  Crohn’s disease is a communicable disease, and the relatives of patients of this disease are more prone to this disease than the others. It affects men and women in almost equal ratio.

Crohn’s Disease Symptoms

This disease manifests itself through a number of common symptoms.  There are a number of common symptoms of this disease. Some of the signs of this disease are Diarrhea, abdominal pain, weight loss, fever, rectal pains, night sweats, and bleeding from the rectal region. There are certain patients who develop certain disease outside the digestive tract. These patients may also show symptoms of arthritis and skin rash, and sometimes even inflammation of the iris of the eye. These patients are also prone to certain diseases like small bowel bacterial overgrowth.

Some of the painful symptoms of this disease are:

  • Painful eye conditions like episcleritis and uveitis
  • There may be potentially life-threatening complications such as massive dilation of the colon, and the intestine may rupture.
  • There may be some extra complications in the skin, joints, spine, liver and bile ducts.
  • A condition known as Sacroiliac joint Arthritis may crop up, which causes inflammation of the low back. Stiffness of the spine, or Ankylosing as it scientifically called, may also occur.
  • Hepatitis, i.e. inflammation of the liver may also occur.
  • There may be certain symptoms like primary sclerosing cholangitis which causes narrowing and obstruction of the bile duct that drains the liver, which may also cause jaundice.

The other symptoms may be categorized into different groups, such as systemic symptoms and extraintestinal symptoms.

Extraintestinal Symptoms

Crohn’s disease affects certain organs of the body. This condition affects the organ system of the body. It is known to cause many diseases in the intestinal tract. It causes very many diseases. Some of the commonly occurring diseases are:

  • Seronegative Spondyloarthropathy – It is a rheumatic disease.
  • Enthesitis – Muscle insertions
  • Sacrolitis
  • Stiff joints
  • Ptyoderma gangrenosum
  • Eruthema Nodusum – A condition that presents red nodules appearing on the shins.

Systemic Symptoms

Crohn’s disease is a cause of many inflammatory diseases in adults as well as in children. There is a very harmful consequence of crohn’s disease in children. It causes growth failure in children.  In fact since the children are unable to grow further, they are opting for diagnosis, and then crohn’s disease comes out as the result.  This disease may also cause retardation of growth.  There are certain other symptoms that occur, such as fever, small intestine disease such as malabsorptoin of lipids and carbohydrates and weight loss.

Crohns Disease Causes

The exact cause of this disease is not known. Different people have put forward different causes for the occurrence of this disease. It is often considered to be a combination of genetic and environmental factors. Crohn’s disease is not a contagious disease. The probable causes of this disease can be classified under the following heads:

Genetic Factors

Crohn’s disease is often said to have been caused due to genetic predisposition. There is a genetic condition, called Mutations in the CARD15. This is often associated with the crohn’s disease. Since it is a genetically transmitted disease, it is common in those patients who have it in his genes. Apart from mutations, it is also caused due to anomalies in the XBPI.

Immune System

If the immune system of an individual is not good, or if he has certain abnormalities in it, then it may be a strong reason for this disease to occur.  It is an autoimmune disease since it is caused by the inflammation of Th1 cytokine response.

Diet

There is a close relation between the occurrence of this disease and the diet that a person takes in.  As the intake of animal protein increase in a person’s diet, the incidence of this disease increases.  Not only animal protein. Intake of omega-3 and Omega-6 polyunsaturated fatty acids is also detected as a causative agent. But if a person consumes vegetable protein, then there is a decline in the incidence of this disease.

Environmental Factors

Smoking increases the rate of this disease. Apart from this, any sort of hormonal stimulative that a person takes increases the rate f this disease. Isotretinoin is also one of the major causes of this disease.

Microbes

There is a wide range of pathogenic bacteria that cause this disease. Some of the causative agents are Mycobacterium avium subspecies paratuberculosis (MAP), Blastocytis and psychrotropic bacteria.  These bacteria produce certain infection in the body that lead to the occurrence of this disease.

Crohn’s Disease Nutrition

Proper and adequate nutrition is very essential for maintenance of good health. If a person follows a proper diet, then he can be spared from this disease. But if a person is already suffering from this disease, then he may face several nutritional problems.  Since the small intestines get inflamed, it does not perform its job in a proper manner. This can lead to malabsorption. The amount of malabsorption depends on the extent to which the intestine is inflamed. Diarrhea also depletes the nutrient content of the body. If the calorie intake of the person is insufficient, then it can also lead to crohn’s disease.

Crohn’s Disease Diagnosis

It is very difficult to diagnose this disease. It requires a number of tests to be performed. But even then one cannot be sure that the test will be successful in detecting this disease. There are some methods of diagnosing this condition:

Endoscopy

This is a very effective method for taking the diagnosis of the crohn’s disease.  This technique allows almost direct visualization of the colon region. It also allows direct vision of the terminal ileum which helps considerably in identification of the pattern in which the disease is involved.

Radiologic Tests

A rather useful method for the diagnosis of this condition is a small bowel follow – through.  It is a useful method, especially when the disease involves the small intestine. The other methods cannot be used for the evaluation of the small intestine. Therefore it is a very important technique. 21certain CT and MRI scans are also used for the evaluation of small bowel with the help of enteroclysis protocols. Magnetic Resonance Imaging is a good option for the imaging of small intestine since it looks for all the possible complications.

Nuclear Scans and Imaging

There are a variety of white blood cell scans. These scans help in the detection of the various location of the crohn’s disease.  It is also very useful for those patients who suffer from mild phase of this disease. The procedure is of a nuclear type. The white blood cells are removed from the patients and then tagged with a radioisotope, which is then injected to the patients and finally scanned at definite intervals so as to test whether there is any abnormal accumulation of the white blood cells.

Blood Tests

There are several diseases that may be revealed through these tests. It there is a complete blood count, it may show anemia.  There are certain antibodies which differentiate crohn’s disease from the other similar conditions.

Crohn’s Disease Treatment

The treatment of this disease involves treatment of its chronic symptoms first, and then treating its other symptoms. Although at present, there are no treatments fort this disease, yet the symptoms can be controlled and the relapse can be prevented through the use of medications, changes in the lifestyle and surgery in extreme cases.

Medications

The common treatment for this disease involves use of appropriate medications that are helpful in eliminating infections. These medications involve use of antibiotics, especially aminosalicylate and the anti-inflammatory drugs, and other corticosteroids.

Changes in lifestyle

If a person follows certain changes in his lifestyle, he may be able to reduce the symptoms of this condition. Smoking should be completely ceased. The diet that a person is taking should be an elementary one, and he should take in enough water so as to allow hydration of his body. The patients should increase dietary fibers in his diet, as this helps to reduce the symptoms.

Surgery

If medications are unsuccessful in treating the symptoms, then surgery is the last resort. If the remission is induced, then the treatment goal is only maintenance of remission, and thereby the return of the flares is reduced. Although this disease cannot be completely cured by surgery, yet its chronic symptoms can be brought under control. Surgery is generally followed when the intestine is blocked either partially, or completely.

 

Crohn’s Disease Prognosis

Currently there is no cure for this disease.  This condition shows periods when the symptoms of this fare up at one point, and then there is some improvement at the other point. If proper treatment is taken, then there are chances of achieving a proper and healthy weight. The mortality rate of this disease is not quite high. But this disease shows an increased risk of small bowel and carcinoma, and also of bowel cancer.

Crohn’s Disease Epidemiology

Crohn’s disease has a sort of bimodal distribution; this disease affects the teenagers and the people in the age of 20s more than the others. The reports of this disease being diagnosed in the childhood are very rare. It is more common in women than in men. Since it is transferable genetically, therefore those children who have it in their genes are more prone to this disease as compared to others.

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