Dec 25, 2008

Crohn's Disease

Crohn's Disease
Crohn's disease is a severe, chronic inflammatory bowel disease. It causes inflammation, ulcers, and bleeding in the digestive tract. Crohn's disease usually affects the small intestine, particularly the last section (called the ileum), but any part of the digestive tract can be affected from the mouth to the anus.
Small Intestine

The cause of Crohn's disease is not known. Inflammatory bowel diseases (ulcerative colitis and Crohn's disease) seem to run in some families. Some researchers think that a virus or bacteria causes the immune system to over-react and damage intestines.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
• Family members with inflammatory bowel disease
• Jewish heritage
Symptoms include:
• Diarrhea
• Abdominal cramps and pain
• Rectal bleeding
• Anemia
• Weight loss
• Fatigue, weakness
• Nausea
• Fever
• Mouth sores
• Sores, abscesses in the anal area
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
• Blood tests
• Stool examination
• Barium swallow – a series of x-rays of structures inside the throat that are taken after drinking a barium-containing liquid
• Barium enema x-ray– insertion of fluid into the rectum that makes your colon show up on an x-ray
• Flexible sigmoidoscopy– a thin, lighted tube inserted into the rectum to examine the rectum and the lower colon
• Colonoscopy – a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
• Biopsy – removal of a sample of colon tissue for testing. This may be performed as part of a flexible sigmoidoscopy or colonoscopy.
Treatment may include:
Avoiding Foods That Provoke Symptoms
These foods are different for each person. They may include:
• Dairy foods (due to lactose intolerance)
• Highly seasoned foods
• High-fiber foods
Aminosalicylate Medications
• Sulfasalazine
• Mesalamine
• Olsalazine
Anti-inflammatory Medications
• Prednisone
• Methylprednisolone
• Budesonide
Immune Modifiers
• Azathioprine
• 6-mercaptopurine
• Methotrexate
Biologic Therapy
• Infliximab
Antibiotic Medications
• Metronidazole
• Ampicillin
• Ciprofloxacin
Very severe Crohn's disease may not improve with medications. You may be advised to have the severely diseased section of your intestine removed. The two remaining healthier ends of the intestine are then joined together. However, you are still at high risk for recurrence of the disease elsewhere. Surgery may also be necessary if you have an intestinal obstruction, or if you have fistulas which need removal or repair.
Untreated Crohn's disease may lead to:
• Fistulas – abnormal connections between the intestine and other organs or tissues, such as the bladder, vagina, or skin
• Intestinal obstruction
• Arthritis
• Eye inflammation
• Liver disease
• Kidney stones
• Gallstones
• Skin rashes
• Osteoporosis
There are no guidelines for preventing Crohn's disease because the cause is not known.