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Crohn’s disease: Treatment, symptoms, advice and help

About crohn’s disease

There are two types of inflammatory bowel diseases namely crohn’s and ulcerative colitis which are both characterized by inflammation of specific parts of the digestive tract. This article is about crohn’s disease which generally involves the lower part of small intestine, also called ileum. However any part of digestive tract, which ranges from the mouth to anus, may be affected. Crohn’s disease is a lifelong problem with periods of remissions and relapses.

Crohn’s disease: Incidence, age and sex

This is a fairly common disease seen worldwide. Although it may affect any age group, it is most often diagnosed in young individuals in their 20s or 30s. The rate of prevalence is same in men and women.

Signs and symptoms of crohn’s disease: Diagnosis

The clinical features have a varied presentation and both intestinal and extra-intestinal features may be seen. The intestinal features result from swelling of intestinal wall in response to its inflammation and constitute diarrhoea and right-sided lower abdominal pain. The diarrhoea is mostly blood stained due to bleeding from terminal parts of intestines. Children affected with crohn’s disease may exhibit poor nutrition, stunted physical growth and delayed milestones. Apart from the gastro-intestinal features, other symptoms like pain in the joints or skin rashes have also been documented in many individuals. Low grade fever may or may not be encountered.

The gastroenterologist would need to take a detailed history and conduct a comprehensive physical examination before advising any tests. Standard blood tests may reveal anaemia caused by blood loss from intestines and increased white blood cell count which is an indication of the inflammation present. Other diagnostic tests include barium meal which is a contrast based x-ray study of intestines and invasive test like colonoscopy.

Causes and prevention of crohn’s disease

The exact cause of crohn’s disease is not clear and a few factors have been proposed in its causation. It is considered that family history may play a role in causing crohn’s disease. Alternatively, it may be autoimmune in nature where auto antibodies may develop against normal intestinal tissues and damage them.

Crohn’s disease: Complications

Crohn’s disease in children may result in life-threatening health concerns in the form of intestinal obstruction. This intestinal obstruction may result from increased swelling of the intestinal wall which causes obliteration of its lumen. This is an urgent situation which warrants immediate attention. Other complications include intestinal ulcers which may develop into blind ended loops called fistulas. These fistulas carry a very high risk of bacterial infection. Nutritional deficiencies are commonly seen in children with crohn’s disease.

Crohn’s disease: Treatment

Crohn’s disease is a life-long disease which has no specific treatment. Some medications like NSAIDs may be prescribed to control inflammation and thus provide symptomatic relief. Nutritional supplements are essential in a patient with crohn’s disease to prevent any malnutrition and weight loss. Surgery may be considered in occasional individuals who have persistent symptoms which are not relieved by medications. The surgical procedure includes removing a part of affected intestines and then suturing the cut ends together. This surgical may lead to improvement in some individuals. Moreover, intestinal obstruction in children may also need surgical intervention. The disease, unfortunately cannot be eliminated permanently. It has high chances of relapsing again, even after long periods of remission.