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WelchAllyn Cleaning & Disinfection Part 1.

Crohn's Disease - The Factual Information

Crohn's disease is basically a condition that causes gastrointestinal tract inflammation (gut). The gut consists of the stomach, oesophagus and small and large intestine.

It most commonly occurs at the lower end of the small intestine, also known as the ileum, it can affect any part of the gut.

Roughly one in 1,500 people in the UK suffer from this disease and the condition affects slightly more women than men. It can develop at any age, but usually starts between the ages of 15 and 40.

What are the symptoms?

The symptoms of this disease appears when the wall of the affected part of the gut becomes inflamed. The inflammation can cause one or more of the following symptoms:

• pain - each individual experiences different levels of pain. Where the pain occurs depends on which part of the gut is affected. The condition usually occurs at the lower end of the small intestine (ileum), and so the pain will often be on the lower right side of the abdomen

• ulcers - these are raw areas of the gut wall that may bleed. If ulcers do occur, this may lead to blood in the stools (faeces). Mouth ulcers are also a common symptom.

• diarrhoea - can vary from mild to severe, and may contain mucus, pus or blood. Experiencing a frequent need to go to the toilet, but a lack of anything to pass (tenesmus) is common

• feeling generally unwell - fever and extreme tiredness

• loss of appetite and weight

• anaemia - can occur if you lose a lot of blood

• anal fissures and rectal bleeding - the skin of the anus may become cracked (anal fissures), bleed and be painful

The symptoms of this disease vary depending on the part of the gut affected. For example, pain in the abdomen, with no other symptoms, may be due to a small patch of this disease in your small intestine, whereas if the condition causes severe diarrhoea and other symptoms, the large intestine may be affected.

As well as weight loss and ill-health, there are a few physical signs that may indicate that you have this disease. Sometimes, a mass can be felt in the abdomen when loops of inflamed bowels are stuck together. There may also be fatty stools. Some people with Crohn's disease experience additional symptoms.

These can include:

• skin rashes
• inflammation of the joints (arthritis),
• inflammation of the eye (uveitis),
• inflammation of the liver

The reason why these other symptoms occur is not fully understood. However, it is thought that they may be triggered by the immune system as a reaction to the inflammation of the gut.

What causes it?
The exact cause of this disease is unknown. There may be a genetic link, since some evidence has shown that it runs in families. One in ten people with the condition have a close relative who also has it.

A bacterium or virus may be a factor in the cause of this disease. It has been suggested that in people who are genetically prone to the condition, bacteria may trigger the immune system to cause inflammation in parts of the gut.

Interestingly, this disease is more common in smokers and in women who use the combined oral contraceptive pill although there is currently no scientific explanation for this link.

Diagnosis

A number of tests can be carried out to diagnose this disease, and which ones are used will depend on the part of the gut affected. Tests that can be used include:

• stool tests
• blood tests to check for anaemia and other deficiencies
• biopsy where a small sample of the lining of the gut is taken for analysis under a microscope
• sigmoidoscopy - investigation of the lower bowel using a sigmoidoscope (a short, flexible telescope)
• colonoscopy - investigation of the colon using a colonoscope (a long, flexible telescope)

If symptoms occur in the upper part of the gut, an endoscopy may be conducted. This involves an endoscope (a thin, flexible telescope) being passed down the oesophagus and into the stomach.

A barium X-ray of the large intestine (barium enema) or small intestine (barium meal) may also be used to diagnose Crohn's. Barium is usually given in liquid form and will appear white on X-rays, highlighting which parts of the gut are affected. Further tests and scans may be required if a diagnosis of this disease is in doubt, or if there are complications.

Treatment

Medicines or steroids, to reduce inflammation in the gut, are commonly used to treat this disease when it first develops. They are usually taken in oral tablet form or as an enema (a tablet inserted into your anus), if the rectum or lower part of the colon are affected. 5-aminosalicylate medicines can be used as an alternative to steroids, to treat mild to moderate symptoms of this disease. However, they do not always work and if symptoms are severe, steroids may be prescribed as an alternative.

There is some evidence that some foods, such as dairy products, may trigger the symptoms and that resting the gut may help, although the reasons behind this are not known. If symptoms are particularly bad and cannot be controlled using medicines, therefore, a strict diet may be recommended to help manage the condition. In most cases, after sticking to the diet for a few weeks, symptoms improve and a normal diet can be gradually resumed.

Anti-diarrhea medicines can be taken to firm up the stools, and painkillers may be needed at times when symptoms are particularly bad.

If other treatments do not work, surgery may be required to remove the affected part of the gut. Surgery may also be required to treat complications such as obstructions, abscesses or damage to your gut.

The future:

The development of new medications for this is ongoing, and it is likely that there will be a number of new treatment options available for the condition over the next decade.

About the Author

Kirthy Shetty, Platinum author. Get all your tips related to Crohns disease from: Crohns Disease

Find more information on: Irritable Bowel Syndrome