What is Crohn’s Disease?
Crohn’s disease, also known as Crohn syndrome and Regional enteritis, is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus, especially the colon and ileum, associated with ulcers and fistulae.
Crohn’s disease can be both painful and debilitating, and sometimes may lead to life-threatening complications.
Causes of Crohn’s disease
The exact cause of Crohn’s disease remains unknown. Previously, diet and stress were suspected, but now doctors know that these factors may aggravate but don’t cause Crohn’s disease.
A number of factors, such as heredity and a malfunctioning immune system, likely play a role in its development.
Immune system -Usually, cells of the immune system defend the body from harmful microbes — bacteria, viruses, fungi, and other foreign substances — that have entered it. Many microbes are helpful, especially for digestion. And so the immune system leaves them alone.
If there is an invader that needs to be eliminated, your body’s defense reaction begins. This immune system response causes inflammation. Immune system cells, chemicals, and fluids flood to the site to overcome the offending substance. After the substance has been disabled or removed, the immune response ends. Inflammation subsides.
For some reason, though, people with Crohn’s disease have an immune system that reacts inappropriately. The immune system may be defending the body against helpful microbes by mistake. Or, for some other reason, the inflammatory response simply will not stop. Either way, over time, this chronic inflammation in the digestive system can result in ulcers and other injuries to the intestines.
Hereditary: -Crohn’s has a genetic component. Because of this, siblings of known people with Crohn’s are 30 times more likely to develop Crohn’s than the general population.
Environmental factors may contribute to Crohn’s disease in one of these two ways:
- They may trigger an immune system response. Once started, the response cannot stop.
- They may directly damage the lining of the intestines. This may cause Crohn’s disease to begin or to speed up.
Crohn’s is associated with an increased intake of animal protein, milk protein and an increased ratio of omega-6 to omega-3 polyunsaturated fatty acids. Those who consume vegetable proteins appear to have a lower incidence of Crohn’s disease. Stress is sometimes claimed to exacerbate Crohn’s disease
Symptoms of Crohn’s Disease
Signs and symptoms of Crohn’s disease can range from mild to severe. They usually develop gradually, but sometimes will come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (remission).
The main symptoms of Crohn’s disease include:
- Belly pain. The pain often is described as cramping and intermittent, and the belly may be sore when touched. Belly pain may turn to a dull, constant ache as the condition gets worse.
- Diarrhea. Some people may have diarrhea 10 to 20 times a day. They may wake up at night and need to go to the bathroom.
- Blood in your stools Crohn’s disease may cause blood in stools, but not always. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. You can also have bleeding you don’t see (occult blood).
- Loss of appetite. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
- Mouth ulcers
- Fever. In severe cases, fever or other symptoms that affect the entire body may develop likely due to inflammation or infection. You may also feel tired or have low energy.
- Weight loss.
- Anaemia Some people with Crohn’s disease develop anemia because of low iron levels caused by bloody stools or the intestinal inflammation itself.
- Small tears in the anus (anal fissures)
People with severe Crohn’s disease may also experience:
- Inflammation of skin, eyes and joints
- Inflammation of the liver or bile ducts
- Delayed growth or sexual development, in children
Complications of Crohn’s disease
Crohn’s disease may lead to one or more of the following complications:
- Scarring and narrowing (stenosis), or may spread through the bowel wall (fistula).
- Bowel obstruction.Crohn’s disease affects the thickness of the intestinal wall. Over time, parts of the bowel can thicken and narrow, which may block the flow of digestive contents.
- Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).
- Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind.
- Anal fissure.This is a small tear in the tissue that lines the anus or in the skin around the anus where infections can occur and cause painful bowel movement.
- Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished.
- Colon cancer.Having Crohn’s disease that affects your colon increases your risk of colon cancer.
- Other health problems.Among these problems is anemia, osteoporosis, and gallbladder or liver disease.
Diagnosis:-A variety of diagnostic procedures and lab tests are used to distinguish Crohn’s disease from other inflammatory gastrointestinal conditions –
- Colonoscopy or sigmoidoscopy to obtain bowel tissue for analysis.
- Blood tests, including blood counts (often high white blood cell counts — a sign of inflammation — and low red blood counts — a sign of anemia from blood loss — are present).
- Stool samples to rule out infections as the cause of diarrhea.
- Imaging techniques (such as a CT scan or MRI) of both the upper and lower gastrointestinal tract may be ordered as well to confirm the location of the inflammation.
Treatment of Crohn’s disease
The main treatment for Crohn’s disease is medicine to stop the inflammation in the intestine and medicine to prevent flare-ups and keep you in remission. A few people have severe, long-lasting symptoms or complications that may require a stronger medicine, a combination of medicines, or surgery. The type of treatment you need depends on the type of symptoms you have and how bad they are.
Aminosalicylates (asa):-e.g. sulfasalazine.they work at the level of gastrointestinal lining and reduce inflammation.
Corticosteroids:- they nonspecifically suppress the immune system and used to treat moderate to severe episodes.
Antibiotics:-antibiotics may be used when infections—such as abscesses—occur in Crohn’s disease. They can also be helpful with fistulas around the anal canal and vagina.
Immunomodulators:-This class of medications modulates or suppresses the body’s immune system response so it cannot cause ongoing inflammation. Immunomodulators may take several months to begin working.
Surgery for Crohn’s disease
- Proctocolectomy and ileostomy
- Bowel resection
- Intestinal transplant.
Homoeopathy Medicines for Crohn’s Disease
- Stomach: Incessant, green, bilious vomiting. Epigastrium very sensitive.
- Abdomen: Bruised sensation; cecal region and transverse colon painful. Bloated; very painful to least touch.
- Stool: Dysentery; tenesmus, not relieved by stool; incessant. Stool hot, bloody, slimy, and offensive, with cutting pains and shreds of mucous membrane.
- Stomach: Nausea and faintness when rising up. Abnormal hunger, loss of taste. Thirst for large draughts. Vomiting of bile and water immediately after eating. Worse, warm drinks, which are vomited. Stomach sensitive to touch. Pressure in stomach after eating, as of a stone. Soreness in stomach when coughing. Dyspeptic ailments during summer heat. Sensitiveness of epigastrium to touch.
- Abdomen: Burning pain, stitches; worse, pressure, coughing, breathing. Tenderness of abdominal walls.
- Stool: Constipation; stools hard, dry, as if burnt; seem too large. Stools brown, thick, bloody; worse in morning, from moving, in hot weather, after being heated, from cold drinks, every spell of hot weather.
- It affects chiefly the duodenum, small intestines, liver, and rectum. Gastro-enteritis with colicky pain and bilious vomiting. Stool is watery with jelly-like mucus, painless, profuse. Gushing and offensive.
- Stomach: Hot, sour belching; nausea and vomiting. Thirst for large quantities of cold water. Vomiting of hot, frothy mucus. Heartburn; gagging or empty retching. Vomiting of milk.
- Abdomen: Distended; heat and emptiness. Sensation of weakness or sinking. Can lie comfortably only on stomach. . Rumbling and shifting of flatus in ascending colon.
- Rectum: Diarrhea of long standing; early in morning;, with hot, glowing cheeks while being bathed or washed; in hot weather after acid fruits. Morning, painless diarrhea when not due to venous stasis or intestinal ulceration. Green, watery, fetid, profuse, gushing. Prolapse of rectum before or with stool. Constipation; clay-colored, hard, dry, difficult. Constipation alternating with diarrhea. Internal and external piles.
Prognosis of Crohn’s disease
Crohn’s disease can range from being benign or it can be very severe. At the extreme end, some patients may experience only one episode and others suffer continuously.
Although recurrences tend to be the norm, disease-free periods can last for years or decades in some patients. Although Crohn’s disease cannot be cured even with surgery, treatments are now available that can offer significant help to most patients.