Currently, Crohn's disease
is believed to be related to abnormalities in the response of the body's
immune system to the bowel contents. The body's immune system is composed
of cells and proteins that normally protect the body from infections or
other foreign invaders. In normal individuals, no immune response will
be directed against food, bacteria, and other substances in the intestines.
In patients with Crohn's disease, the immune system seems to react actively
to a variety of substances and/or bacteria in the intestines, causing inflammation,
bowel injury, and ulcerations. This abnormally active immune system is
believed to be genetically inherited. First degree relatives of patients
with Crohn's disease (brothers, sisters, sons and daughters) are more likely
to develop the disease. Furthermore, certain chromosome markers have been
found in patients with Crohn's disease. Chromosomes are components in the
cells where all the genetic information of the body is stored.
What are the symptoms?
The terminal ileum is commonly involved in Crohn's disease. Since the terminal ileum is located adjacent the appendix, right-sided abdominal pain and tenderness mimicking appendicitis is common. The pain of Crohn's disease can also be crampy in nature, and may reflect bowel obstruction.
Diarrhea is also common. Diarrhea may be a result of a partial bowel obstruction, excessive growth of bacteria in the small bowel, poor absorption of nutrients and bile acids and inflammation of the large intestine. The diarrhea may be bloody and associated with abdominal pain and cramps. Rectal bleeding and bloody diarrhea are common. While massive bleeding (hemorrhage) from Crohn's ulcer is rare, it can occur. In some cases, chronic constipation can also be a symptom of Crohn's.
Diseases affecting the anus
are common. Up to one third of patients with Crohn's disease may have diseases
involving the anal area. Anal diseases include tears of the anal tissue
(fissures), infections (abscesses) adjacent to the anus and draining abnormal
passages or tubes (fistulae) between the inside of the anus and the surrounding
skin.
Treating Crohn's
Symptoms and severity of the disease vary among patients. Patients with minimal disease activity with mild or no symptoms may not need treatment. Patients whose disease is in remission (where symptoms are absent) also may not need treatment. Most patients with Crohn's disease will experience periodic increases in activity of the disease when symptoms of abdominal pain, fever, diarrhea, and rectal bleeding worsen.
Medications are then used to bring the active disease into remission. Medications for the treatment of active Crohn's disease include salicylate preparations, corticosteroids, antibiotics, and medications that suppress body immunity. The decision regarding which treatments are used is based on the location and the severity of the disease. Patients with advanced disease causing persistent bowel obstruction, abscess, and fistulae may need surgery.
General measures which may
help control Crohn's disease include dietary changes and supplementation.
Since fiber is poorly digestible, it can exacerbate symptoms of partial
bowel obstruction. Hence, a low fiber diet may be recommended, especially
in those patients with small bowel disease. A liquid diet may be of benefit
when symptoms are more severe. Intravenous nutrition or TPN (total peripheral
nutrition) may be utilized when it is felt that total bowel rest is necessary.
Supplementation of calcium, folate and vitamin B12 is helpful when malabsorption
of these nutrients is apparent. The use of antidiarrheal agents and antispasmotics
can also help relieve symptoms of cramps and diarrhea.
Some info on medications
Listed below are some medications you possibly might take if diagnosed with Crohn's. To learn more about a specific drug, click on the name.
- Asacol
- Benadryl
- Biaxin
- cA2
- Levsin
- Megace
- Methotrexate
- Pentasa
- Pepcid
- Prednisone
- Prilosec
- Questran
- Remicade
- Sulfasalazine
- Tetracycline
- Zantac
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