Crohn’s disease: The Inflammatory Gut

Crohn’s disease vs ulcerative colitis 

Crohn’s disease is not the same as ulcerative colitis. In Crohn’s disease the inflammation can occur anywhere along the GI tract, and the inflammation can be patchy. The inflammation can also be perforating, and affects all layers of the walls of the GI tract, whereas ulcerative colitis only affects the innermost lining of the large bowel. 

Crohn’s disease: Causes and risk factors

Crohn’s disease does not have a known cause, however, there are risk factors that may be involved: 

• Autoimmune diseases 
• Family history
• Smoking 
• Medication history: Such as NSAID use 
• A high-fat and low-fibre diet 

Crohn’s disease: Signs and symptoms 

Crohn’s disease develops gradually, so the symptoms may also present gradually, and certain symptoms may worsen over time:

• Diarrhea, with or without presentation of blood 
• Abdominal cramps 
• Fever
• Fatigue
• Weight loss 
• Loss of appetite 
• Frequent and urgent need for defecation 
• Feeling as if bowels are not yet empty after defecation
• Perianal fistulas
• Ulcers anywhere from mouth to anus 
• Joint inflammation 
• Irregular periods
• Anemia
• Fertility issues 
• Dyspareunia: Pain during sex
• Eye inflammation
• Skin lesions

Crohn’s disease: Diagnosis

• Blood test: to check for anaemia or signs of infection
• Stool studies: to check for hidden blood or organism in your stool
• Computerized tomography (CT) scan: it can provide better images of the small bowel
• Colonoscopy: a thin, flexible, lighted tube with a camera at the end will be used to view your entire colon. A small sample of tissue (biopsy) may also be taken for laboratory analysis
• Gastroscopy

Crohn’s disease: Treatment 

Pharmacological treatments: 

• Corticosteroids for reducing inflammation: Budesonide, prednisolone,, methylprednisolone, and hydrocortisone. They are available in an enema, foam, suppository, or oral form.
• Immunosuppressants: Azathioprine, methotrexate, 6 mercaptopurine, and cyclosporin
• Biologic agents: Infliximab, certolizumab, adalimumab, vedolizumab, and natalizumab,
• Antimicrobials: Metronidazole, and ciprofloxacin 

Crohn’s disease patients require surgical intervention sometimes:

• Proctocolectomy: Removal of the whole colon 
• Colectomy to remove precancerous lesions or growths that may turn into colorectal cancer. 
• Correction of complications: Such as fistulas 
• Strictureplasty: To widen and shorten the intestines in order to reduce damage to the tissue
• Bowel resection: Damaged portions of the intestines and removed, and the intestine is reformed by stitching the healthy parts together 
• Ostomy: to create a hole through which the body can eliminate waste. This can be temporary or permanent. 

Crohn’s disease: Prevention

Crohn’s disease cannot be prevented, but flare-ups can be managed and minimized: 

• Smoking cessation 
• Healthy diet: Low fat and high fiber 
• Exercise 
• Manage stress

Crohn’s disease: Complications

Crohn’s disease may lead to the following: 

• Bowel obstruction
• Fistulas
• Ulcers
• Anal fissure
• Malnutrition 
• Colorectal cancer 
• Pulmonary embolism
• Deep vein thrombosis
• Anemia
• Skin disorders
• Osteoporosis 
• Arthritis 
• Gallbladder disease
• Liver disease