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Crohn’s Disease Treatment

Crohn’s Disease: Symptoms, Diagnosis, Treatment, and FAQs

Overview

Crohn’s disease affects approximately 4 to 10 individuals per 100,000 people annually. It requires specialized medical guidance and consistent patient compliance. The condition involves deep inflammation in the gastrointestinal (GI) tract, potentially affecting any area from the mouth to the anus. Most commonly, it affects the ileum (the last part of the small intestine). The inflammation is often patchy, with normal segments between inflamed sections.

Symptoms of Crohn’s Disease

  • Diarrhea: Inflammation causes the bowel to contract faster.
  • Bleeding in stool
  • Weight loss
  • Bone pain
  • Skin problems
  • Anal fissures
  • Fever
  • Abdominal pain
  • Mouth sores

In children, malabsorption due to digestive issues can lead to delayed growth and development. The disease has a relapsing-remitting course, with multiple flare-ups throughout life.

Complications

  • Strictures: Scar tissue narrows the bowel lumen, risking obstruction.
  • Fistulae: Abnormal tunnels between bowel and skin or other organs.
  • Fissures: Painful deep cracks in the lining of the bowel.

Diagnosis of Crohn’s Disease

A thorough physical examination and a series of diagnostic tests are required:

  • Blood tests: To detect anemia, inflammation, and immune markers.
  • Stool test: Detects inflammation and bleeding.
  • Barium meal X-rays: Helps locate upper GI tract inflammation.
  • Endoscopy: Visual inspection of GI tract and tissue biopsy.
  • Imaging: CT, MRI, and other scans to assess disease extent.

Treatment of Crohn’s Disease

Medications

  • Anti-inflammatory agents: Mesalamine
  • Steroids: Prednisone
  • Immune suppressants: 6-mercaptopurine, azathioprine
  • Biologics: Infliximab (anti-TNF?)

Supportive Treatments

  • Fluid replacement: For dehydration due to diarrhea
  • Nutritional supplements: Especially in children and nutrient-deficient individuals

Surgical Options

  • Indicated when:
    • Medical therapy fails
    • Complications arise (e.g., strictures, perforation)
  • Types:
    • Partial or complete removal of affected bowel
    • Multiple surgeries may be required over a patient’s lifetime

Important Notes

  • Crohn’s cannot be cured, but flare-ups can be managed.
  • Treatment may differ between episodes.
  • Nutritional therapy helps manage deficiencies based on disease extent.

Frequently Asked Questions

Q: What are the causes of Crohn’s Disease?

A:

  • Immune response: Abnormal attack on the GI tract during infections
  • Genetics: Family history can increase the likelihood, although it is rare

Q: What are the risk factors of Crohn’s Disease?

A:

  1. Age: Most common under 30
  2. Family history
  3. Smoking
  4. NSAIDs: Medications like ibuprofen may increase risk
  5. Lifestyle: High-fat diets, sedentary living, and urban environments

Q: What are the complications of Crohn’s Disease?

A:

  1. Strictures and infections
  2. Bowel obstruction
  3. Fistulas (especially anal)
  4. Anal fissures
  5. Malnutrition
  6. Colon cancer (especially with long-term colonic involvement)
  7. Other risks: Liver disease, osteoporosis, anemia, and potential medication-related cancers
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