Medical researchers and professionals have not pinpointed the precise
cause of Crohn's disease. The common gist of their studies is that Crohn's
disease is a yet undefined interaction of factors: the genes of the patient,
the immune system and environmental factors.
Crohn's disease has been found to run in families. An individual with
a sibling suffering from Crohn's disease has about 30 times more risk
of getting the disease than those without close relatives suffering from
Crohn?s. The disease is also prevalent among whites and northern Europeans.
Researchers also found that Asians, Africans and southern Europeans not
affected by Crohn's disease later developed the disease after migrating
to industrialized areas in the West.
Individuals react to a diagnosis of Crohn's disease in various emotions.
Some are relieved that they have a name for what has been ailing them
for so long and could already start taking treatments. Some are angry
and question why they have been chosen to have Crohn's disease among millions.
Others accept their diagnosis stoically, silently thinking of ways to
deal with the disease.
Any individual diagnosed with Crohn's disease could not be blamed for
any emotional outburst upon diagnosis. But as days go by, the individual
should learn to deal with the disease as he goes through initial and further
treatments. As body and mind are intertwined, the earlier one's attitude
is towards hope and healing, the earlier Crohn's disease symptoms are
controlled.
Many individuals suffering from Crohn's disease are interested in trying
nontraditional treatments because of the inability of many standard Crohn's
therapies to improve their medical conditions. The adverse effects of
most of the Crohn's drugs are also increasingly frustrating them. Studies
have shown that more than half of patients with Crohn's disease and ulcerative
colitis have tried at least one kind of alternative or complementary therapy.
Most of these alternative treatments have not been tested by clinical
trials and are not regulated by the Food and Drug Administration (FDA).
Crohn?s disease sufferers should talk with their doctors first before
trying alternative therapies. Herbs and other alternative substances are
mistakenly perceived as safe natural medicinals. In reality, these have
also side effects and may cause fatal interactions.
Crohn's disease and ulcerative colitis are the two most common inflammatory
bowel diseases (IBD). It is estimated that about one million Americans
are afflicted with IBD, with half of them suffering from Crohn's disease
and the other half suffering from ulcerative colitis.
These two IBD conditions have similar symptoms, as they both involve the
colon. But they have a lot of differences in how they affect the digestive
tract. Medical professionals differentiate between the two because the
course and progression of the diseases are different.
The most commonly mentioned differences between the two are location of
the disease in the intestines, distribution of inflammation and the degrees
of involvement of the ileum, colon, rectum and anus. Crohn's disease usually
involves the ileum, colon and anus but not the rectum. Ulcerative colitis
always involves the colon, usually involves the rectum, but seldom involves
the ileum and the anus.
If left untreated, Crohn's disease may progress to one or more complications.
These complications may be within the intestine, may be in organs or tissues
surrounding the intestine, may be in other areas of the body that do not
directly relate to the intestine or may be nutrition-related.
The intestinal complications include ulcers, fistulas and sores. Extra-intestinal
complications include eye inflammation, arthritis, skin lesions and mouth
sores. Nutritional complications include deficiencies in calories, proteins
and vitamins.
The most common Crohn's disease complication is blockage or obstruction
of the intestine. As the inflammation worsens, the intestinal wall thickens
and makes the intestinal passage narrower and narrower. These narrowed
portions are called strictures. Symptoms of strictures are abdominal pain
often accompanied by bloating and vomiting.
Crohn's disease can be manifested outside the gastrointestinal tract
in about 25 percent of Crohn's disease sufferers, according to inflammatory
bowel disease (IBD) studies.
Extraintestinal manifestations are more common in cases of Crohn's diseases
which involve the colon. The most common organs affected by Crohn's disease
are the joints, skin, eyes and liver.
Crohn's disease is linked to a type of rheumatologic disease called seronegative
spondyloarthropathy. This disease involves inflammation of one or more
joints or muscle entheses. Inflammation of the joints is popularly known
as arthritis and muscle insertion inflammation is called enthesitis.
Arthritis can affect bigger joints such as the shoulder or the knee or
smaller joints such as those of the hand and feet. Arthritis can also
affect the spine, causing ankylosing spondylitis or sacroiliitis. Arthritis
symptoms include stiff joints, loss of joint mobility and functions and
painful joints.
The most common gastrointestinal symptom
of Crohn's disease is abdominal pain. The pain is typically
described as cramping, aching and initially intermittent. When the pain
becomes dull and steady, it is not relieved by bowel movement. Most often,
the pain is in the lower right side of the abdomen. This is because most
Crohn?s disease cases involve the ileum, the part where the large intestine
meets the small intestine.
If the inflammation is in the lower part of the small intestine and in
the colon, the cramping pain after meals is caused by partial obstruction
of the small bowel. Excessive gas in the alimentary canal also causes
a feeling of bloating and discomfort.
Studies have found that more and more children are being diagnosed with
Crohn's disease since the late 20th century. About one-third of Crohn's
disease sufferers develop their symptoms before their 20th year. In the
U.S., about a hundred thousand children and teens suffer from Crohn's
disease.
Crohn's disease
is especially difficult for children and teens since childhood and adolescence
are periods of many physical and psychological changes that often overwhelm
and confuse them. Crohn's symptoms such as pain and diarrhea may prevent
them from enjoying normal childhood activities. These children need kindness,
patience and understanding from their families, friends and doctors in
order for them to grow and be able to pursue their goals later in life.
Diagnosis of late-onset Crohn's
disease is much less common than diagnosis of Crohn's in
young adults aged 15 to 35. Studies show that Crohn's disease is generally
a disease of young adults between the ages of 15 to 35. However, as diagnostic
methods improve, about 15 to 25 percent of new cases have been diagnosed
in patients over the age of 60.
Studies in Canada, which is considered to have one of the highest incidences
of ulcerative colitis and Crohn?s disease in the world, about four percent
of people with Crohn's disease develop symptoms when they are over 60
with incidence.
Crohn's disease
in older persons is similar in most aspects to that in younger
adults. However, they differ in some ways in diagnosis and in treatment.
The standard Crohn's disease treatment model is called step-up therapy.
Crohn's patients are first treated with drugs that have milder side effects
and later treated with stronger drugs but with potentially more toxic
effects. The model starts with milder drugs such as aminosalicylates and
antibiotics, to moderate drugs such as budesonide, prednisone and other
drugs, and then to very powerful drugs such as anti-tumor necrosis factor.
The process at the top of the model is surgery.
5-aminosalicylates (5-ASA) are drugs used to treat Crohn's disease in
the mild to moderate stage. These target the gastrointestinal tract and
provide an anti-inflammatory effect. Sulfasalazine, the first 5-aminosalicylate,
has been used to treat inflammatory bowel disease (IBD) for years.