Although Crohn's disease
is a permanent condition,
with the right therapy
most people can lead
a functional and fulfilled life.
Crohn’s disease can significantly affect your health and life satisfaction, often on a daily basis. Since it is a lifelong condition, it is important that you are well informed about Crohn’s disease. This includes, above all, knowledge of what it is caused by, what worsens it and how it can be treated with the ultimate goal of preserving your health and improving the quality of your life.
In short — what is Crohn’s disease?
Crohn’s disease is, in addition to ulcerative colitis, the most common form of an inflammatory bowel diseas. Typically, it is an inflammation of the intestinal wall, but it can affect various parts of the digestive system, from the mouth to the anus. Men and women are both at risk, and it is most often diagnosed in adolescents and young people below the age of 30.
What causes Crohn’s disease?
Although the specific cause of Crohn’s disease is still unknown, it is likely that there is a correlation between several factors such as genes, the environment and the immune system. Stress and certain diets can contribute to the aggravation of the disease. Studies also indicate that smoking significantly increases the risk of getting Crohn’s disease.
It is possible that viruses and bacteria cause an inappropriate reaction of the immune system, which mistakenly attacks the cells of the digestive system.
In addition, genetic factors also seem to play a role. If you have Crohn’s disease, this means that your close relatives have a slightly higher risk of getting the same disease. Ethnically, people of European origin are at a higher risk of getting Crohn's disease, while its prevalence is highest among Jews.
What are signs and symptoms?
The specific symptoms of Crohn’s disease depend on the part of your digestive system that is affected. Symptoms can therefore vary on a case-by-case basis:
Sometimes Crohn’s disease has other symptoms outside the digestive system such as rashes, redness of the eyes and mouth sores.
If you have these symptoms, you should contact your doctor. Timely reaction is especially important if your child has symptoms because Crohn’s disease can cause low growth and a delay a child’s development.
How does Crohn’s disease affect you?
Crohn’s disease causes inflammation that can affect the entire intestinal wall. Although it may affect any part of your digestive system, inflammation is most often affected by the small and/or large intestine. In case of inflammation, there are also manifestations of the symptoms of the disease.
The stages of the duration of the inflammation are called aggravations of the disease, while the phases when the inflammation with symptoms recedes are called remissions.
Alternations of aggravations and remissions is a typical dynamic of Crohn’s disease.
There are multiple types of Crohn’s disease depending on the part of the intestine affected by inflammation. For example, the most common type of ileocolitis is the one in which inflammation affects the large intestine and the back of the small intestine. Granulomatous colitis is the inflammation of the large intestine only, and ileitis is the inflammation of the end of the small intestine only.
There is no way to determine directly whether you have Crohn’s disease. As a result, the examinations seek to exclude other options that may cause the same symptoms. Tests will typically include a physical examination and a laboratory analysis of your blood and stool. Further examinations may include colonoscopy, endoscopy, magnetic resonance imaging and CT.
Treatment of Crohn’s disease
Although the “drug” for Crohn’s disease still does not exist, there is an increasing number of medication treatments that can relieve inflammation and associated symptoms. The types of drugs used are antibiotics, anti-inflammatory drugs, so-called biological drugs and corticosteroids which are avoided whenever possible due to side effects.
In addition to symptom relief, medication treatment aims to maintain a long-term remission and prevent the occurrence of health complications.
In short, the purpose of medical therapy is to preserve your health and quality of life as much as possible, and ultimately to avoid the need for surgery as a last resort in the treatment of Crohn’s disease.
Another important element in the treatment of Crohn’s disease is your diet.
There is no ideal diet for this disease. Through consultation with a doctor and dietitian, you need to determine what is the best approach for your individual case. Some foods may need to be avoided if they are shown to worsen the symptoms of the disease.
It is also important to make sure that you make up for a possible shortage of nutrients such as iron and vitamin D, which is typical of Crohn’s disease.
In order for your digestive system to be able to recover from inflammation and to get the necessary nutrients, one of the options is nutritional therapy where liquid nutrients are introduced into your body through a probe (enteral nutrition) or infusion (parenteral nutrition).
If medications and dietary changes do not achieve the desired results and if you develop fistulas and strictures (narrowing of the intestine), you might require surgical procedures. Today, it is less likely that you will need a major surgery than it was the case with people suffering from this disease in the past.
However, at least 50 % of people with Crohn’s disease will still need at least one procedure.
Resection is a major surgical procedure in which the surgeon removes the part of the intestine damaged by Crohn’s disease and connects the healthy parts of the intestine. If it is necessary to remove a major part of the large or small intestine, an ostomy will be performed, which is a surgical procedure of forming an opening on the surface of the abdomen for the purpose of emptying digested materials.
Depending on the part of the intestine, your surgeon can form a colostomy (for the large intestine) or an ileostomy (for the small intestine).
It is important to point out that, although it can improve your health and contribute to the quality of your life, a surgery still cannot cure Crohn’s disease and the symptoms may come back years after the surgery.
Finally, one of the reasons your doctor may suggest a surgical procedure is the risk of colorectal cancer, which may be increased by a long-term inflammation of the intestine.
Life with Crohn’s disease can be very demanding and can negatively affect your physical and psychological health. However, it is also important to know that most people with this disease, can lead a functional and fulfilling life if given the right therapy. It is certainly encouraging that significant progress has been made in developing medicines and treatments to treat Crohn’s disease over the past few decades.
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