Crohns Disease Fast Facts! • Crohns disease is a chronic inflammatory disease of the intestines. • The cause of Crohns disease is unknown. • Crohns disease can cause ulcers in the small intestine, colon, or both. • Abdominal pain, diarrhea, vomiting, fever, and weight loss are symptoms of Crohns disease. • Crohns disease of the small intestine may cause obstruction of the intestine. • Crohns disease can be associated with reddish, tender skin nodules, and inflammation of the joints, spine, eyes, and liver. • The diagnosis of Crohns disease is made by barium enema, barium X-ray of the small bowel, and colonoscopy. • The choice of treatment for Crohns disease depends on the location and severity of the disease. What is Crohns disease? Crohns disease (also spelled Crohn disease) is a chronic inflammatory disease of the intestines. It primarily causes ulcerations (breaks in the lining) of the small and large intestines, but can affect the digestive system anywhere from the mouth to the anus. It is named after the physician who described the disease in 1932. It also is called granulomatous enteritis or colitis, regional enteritis, ileitis, or terminal ileitis. Crohns disease is related closely to another chronic inflammatory condition that involves only the colon called ulcerative colitis. Together, Crohns disease and ulcerative colitis are frequently referred to as inflammatory bowel disease (IBD). Ulcerative colitis and Crohns disease have no medical cure. Once the diseases begin, they tend to fluctuate between periods of inactivity (remission) and activity (relapse). What causes Crohns disease? The cause of Crohns disease is unknown. Some scientists suspect that infection by certain bacteria, such as strains of mycobacterium, may be the cause of Crohns disease. To date, however, there has been no convincing evidence that the disease is caused by infection per se. Crohns disease is not contagious. Although diet may affect the symptoms in patients with Crohns disease, it is unlikely that diet is responsible for the disease. Activation of the immune system in the intestines appears to be important in IBD. The immune system is composed of immune cells and the proteins that these immune cells produce. Normally, these cells and proteins defend the body against harmful bacteria, viruses, fungi, and other foreign invaders. Activation of the immune system causes inflammation within the tissues where the activation occurs. (Inflammation is an important mechanism of defense used by the immune system.) Normally, the immune system is activated only when the body is exposed to harmful invaders. In individuals with IBD, however, the immune system is abnormally and chronically activated in the absence of any known invader. The continued abnormal activation of the immune system results in chronic inflammation and ulceration. The susceptibility to abnormal activation of the immune system is genetically inherited. Thus, first degree relatives (brothers, sisters, children, and parents) of people with IBD are more likely to develop these diseases. Recently a gene called NOD2 has been identified as being associated with Crohns disease. This gene is important in determining how the body responds to some bacterial products. Individuals with mutations in this gene are more susceptible to developing Crohns disease. Other genes are still being discovered and studied which are important in understanding the pathogenesis of Crohns disease including autophagy related 16-like 1 gene (ATG 16L1) and IRGM, which both contribute to macrophage defects and have been identified with the Genome-Wide Association study2. In this regard, there have also been studies which show that in the intestines of individuals with Crohns disease, there are higher levels of a certain type of bacterium, E. coli, which might play a role in the pathogenesis1. One postulated mechanism by which this could occur is though a genetically determined1 defect in elimination of the E. coli, by intestinal mucosal macrophages. The exact roles that these various factors play in the development of this disease remain unclear. What are the symptoms of Crohns disease? Common symptoms of Crohns disease include abdominal pain, diarrhea, and weight loss. Less common symptoms include poor appetite, fever, night sweats, rectal pain, and occasionally rectal bleeding. The symptoms of Crohns disease are dependent on the location, the extent, and the severity of the inflammation. The different subtypes of Crohns disease and their symptoms are: Crohns colitis is inflammation that is confined to the colon. Abdominal pain and bloody diarrhea are the common symptoms. Anal fistulae and peri-rectal abscesses also can occur. Crohns enteritis refers to inflammation confined to the small intestine (the first part, called the jejunum or the second part, called the ileum). Involvement of the ileum alone is referred to as Crohns ileitis. Abdominal pain and diarrhea are the common symptoms. Obstruction of the small intestine also can occur. Crohns terminal ileitis is inflammation that affects only the very end of the small intestine (terminal ileum), the part of the small intestine closest to the colon. Abdominal pain and diarrhea are the common symptoms. Small intestinal obstruction also can occur. Crohns entero-colitis and ileo-colitis are terms to describe inflammation that involve both the small intestine and the colon. Bloody diarrhea and abdominal pain are the common symptoms. Small intestinal obstruction also can occur. Crohns terminal ileitis and ileo-colitis are the most common types of Crohns disease. (Ulcerative colitis frequently involves only the rectum or rectum and sigmoid colon at the distal end of the colon. These are called ulcerative proctitis and procto-sigmoiditis, respectively.) Up to one-third of patients with Crohns disease may have one or more of the following conditions involving the anal area: Swelling of the tissue of the anal sphincter, the muscle at the end of the colon that controls defecation. Development of ulcers and fissures (long ulcers) within the anal sphincter. These ulcers and fissures can cause bleeding and pain with defecation. Development of anal fistulae (abnormal tunnels) between the anus or rectum and the skin surrounding the anus). Mucous and pus may drain from the openings of the fistulae on the skin. Development of peri-rectal abscesses (collections of pus in the anal and rectal area). Peri-rectal abscesses can cause fever, pain and tenderness around the anus.
Posted on: Wed, 16 Jul 2014 11:59:02 +0000
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