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Crohn’s disease is a chronic disease resulting in inflammation of the gastrointestinal tract. Usually, Crohn’s disease disturbs the small intestine as well as the starting portion of the large intestine, but it can also disturb any part of the gastrointestinal tract ranging from the mouth to the anus. Most commonly, the disease starts with less severity but with the passage of time, it becomes more serious. People in the age range of 20 to 29 years have more chances of developing the disease. Nearly 25% of new cases of Crohn’s disease are found in people younger than 20 years of age (National Human Genome Research Institute, 2011). Many patients may also face the periods of remission, when there are no symptoms of the disease for weeks or even years (NIH, 2014).
Causes of Crohn’s disease
Autoimmune reaction, genes, and environment are some of the factors that are thought to play an important role in the development of disease, but further studies are required in finding the exact cause. Autoimmune reaction refers to the attack of the body’s own immune system on healthy cells of the body. Usually, the immunity protects the body from attacks of microorganisms and certain other potentially dangerous substances from outside the body. However, in case of autoimmune reaction, some organisms or substances disturb the functioning of the system, and it starts affecting the inner lining of the intestines, thereby causing inflammation and development of symptoms of Crohn’s disease. Research also shows that Crohn’s disease often develops in particular families, i.e. people having relatives, who have already developed Crohn’s disease, have more chances of developing the disease, i.e. about 20% of people having Crohn’s disease have a blood relative having some inflammatory bowel disease (National Human Genome Research Institute, 2011). On the other hand, research also shows that certain substances from the environment can increase the chances of getting the disease, although the overall chances are less. For example, antibiotics, nonsteroidal anti-inflammatory drugs, and oral contraceptives can increase the chances of getting the disease. Similarly, high-fat diet, smoking cigarettes, living in an industrialized country, and low exposure to sunlight can also increase the chances of developing the disease (NIH, 2014; University of Maryland Medical System, 2015).
Signs and Symptoms of Crohn’s disease
The most commonly encountered signs and symptoms of the disease include diarrhea, weight loss, and abdominal cramps and pain. Among other signs and symptoms are tired feelings, nausea, fever, loss of appetite, floating stools, and anemia. Some other signs and symptoms, which are not directly related to intestines, may include eye irritation, joint pain and/or soreness, and skin changes involving red, tender bumps appearing under the skin. Moreover, symptoms of the disease may change depending on the severity of the inflammation or swelling, and its location (NIH, 2014; University of Maryland Medical System, 2015).
Diagnosis of Crohn’s disease
Crohn’s disease can be diagnosed by examining family history, by physical examination, by using a series of lab tests, and by using devices such as computerized tomography (CT) scan and intestinal endoscopy. Various medical tests are performed to confirm the presence of Crohn’s disease as several other disorders such as ulcerative colitis, irritable bowel syndrome, and celiac disease may also show similar problems (NIH, 2014).
One of the first things in the diagnosis of disease is to check the family history. After asking about the family history of developing the disease, physical examination helps in checking some signs of the disease such as the presence of abdominal distention or swelling and the presence of pain or tenderness. In order to confirm the presence of the disease, lab tests are performed such as blood tests and stool tests. In the blood test, blood sample of a person is analyzed for red blood cells and white blood cells. Fewer number of red blood cells or smaller than normal size of red blood cells may show the presence of anemia, and higher number of white blood cells may show the presence of infection or inflammation in the body of the patient. In the stool tests, stool is analyzed to check for other causes of gastrointestinal diseases (NIH, 2014).
Fluoroscopy can also help in the diagnosis of upper gastrointestinal portions. This method does not require the use of anesthesia. The patient is also prohibited to eat or drink before the procedure. In the method, patients are told to drink barium, which is in the form of chalky liquid, and sit or stand in front of the x-ray machine. This barium coats the different portions of the gastrointestinal tract. Then a radiologist checks the shape of the organs with the help of x-rays. Patient may feel nausea and/or bloating for some time after the test. For some days after the test, barium liquid in the body causes light-colored or white-colored stools (NIH, 2014).
CT scan takes the help of both x-rays and computer technology to develop images of the internal parts of the body. In this method, the patient is provided with a liquid to drink and an injection of a dye referred to as contrast medium. Then the patient lies on a table and images are taken with x-rays. This procedure can help in the diagnosis of Crohn’s disease and other complications associated with the disease (NIH, 2014).
Intestinal endoscopies are among the most accurate methods to diagnose Crohn’s disease. In this method, a small flexible tube is inserted to directly check the lining of the gastrointestinal tract (University of Maryland Medical System, 2015).
Treatment of Crohn’s disease
Crohn’s disease can be treated with medicines, bowel rest, and/or surgery. Type of treatment for a patient depends on the severity of the disease. In order to induce remission and improve the quality of life of patient, corticosteroids such as hydrocortisone and prednisone; aminosalicylates such as mesalamine and sulfasalazine, and immunomodulators such as azathioprine and methotrexate can be prescribed. Bowel rest includes the resting of bowel of the patient for a few days to many weeks. In this method, patients are told to drink only clear liquids or their oral intake is reduced, i.e. intravenous (IV) nutrition is used. In some cases, patients may also need surgery to treat complications and to improve the conditions. Different kinds of operations such as subtotal colectomy, small bowel resection, and protocolectomy and ileostomy can be performed for the treatment of Crohn’s disease. General anesthesia is used in surgeries, and many patients stay in the hospital for 3 days to a week after the surgery. Full recovery can occur within 6 weeks (NIH, 2014).
Concluding Remarks
Crohn’s disease is a chronic problem of the gastrointestinal tract. Several factors ranging from autoimmune reactions to genes and environment have been studied, but further studies are still required to find the exact cause of the disease. Signs and symptoms of the disease include abdominal cramping, diarrhea, and pain, and they may help in the diagnosis of disease, but further researches are required to improve the physical and lab testing of the disease as these procedures would be easy to perform and would also be cheap, so that patients would never stop to go for a diagnosis. Treatment of the drug may include the use of medications, bowel rest, and/or surgery. Moreover, some dietary changes can also help the patient to improve his or her quality of life. It is also important to change the lifestyle as, for example, more exercise and decreased smoking can help in reducing the severity of the problem or chances of getting the problem.
References
National Human Genome Research Institute. (2011). Learning About Crohn's Disease. Retrieved from https://www.genome.gov/25521854
NIH. (2014). Crohn's Disease. Retrieved from http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/facts.aspx
