Crohn’s disease: causes, symptoms, treatment, prognosis

Crohn’s disease is a chronic inflammation of the intestine. The disease usually starts during adolescence and continues to recur. What are the causes and symptoms of Crohn’s disease, how can the disease be treated and what is the prognosis? What are the differences between Crohn’s disease and ulcerative colitis?

Article content

  • Digestive tract
  • Crohn’s disease
  • Causes of Crohn’s disease
  • Symptoms of Crohn’s disease
  • Complications of Crohn’s disease
  • Diagnosis of Crohn’s disease
  • Treatment of Crohn’s disease
  • Crohn’s disease prognosis
  • Differences between Crohn’s disease and ulcerative colitis

 

Digestive tract

The digestive tract is the route that food takes from the mouth to the anus. Parts of the digestive tract: mouth, throat, esophagus, stomach, small intestine, large intestine, rectum. Muscles contract and propel the food, this is also called peristalsis. The food can only go in one direction, sphincter muscles ensure that it does not go in the other direction. Sphincter muscles are located at the bottom of the esophagus, at the exit of the stomach, at the end of the small intestine and at the anus.

Crohn’s disease

The name of the disease, Crohn, comes from BB Crohn, an American physician (1884). It is a chronic inflammation of the intestine. The last part of the small intestine and most of the large intestine are usually affected. You often see inflammation in several places and the parts in between are not affected or are only slightly affected. In the past, the disease was thought to only occur in the last part of the small intestine and the name ileitis terminalis was used. Later it turned out that it could also occur in other parts and it became enteritis regionalis. The disease usually starts between the ages of fourteen and thirty and sometimes runs in families. Gender is not a significant factor, but the disease is often more severe in women.

Causes of Crohn’s disease

It is not known what exactly causes Crohn’s disease. Hereditary factors appear to have an influence; approximately one in ten people with Crohn’s disease have one or more people in the family with the same condition or another disease with inflammation in the digestive tract. As a result of a disturbed immune system, inflammation can occur in the intestines. Furthermore, it appears that certain bacteria play a role in the development of Crohn’s disease. Smoking is a risk factor: the condition is approximately three times more common in smokers than in people who do not smoke. Finally, stress can play a role, not as a cause, but stress can negatively influence the complaints.

Symptoms of Crohn’s disease

The complaints can vary greatly from person to person. Someone often suffers from it all their life, but there are periods of little to no complaints. An attack can be very intense and can last a few weeks to months.

Complaints:

  • Diarrhea;
  • There may be blood or mucus in the stool;
  • An increased body temperature;
  • Loss of weight;
  • Pain, cramps in the abdomen;
  • A tired feeling;
  • General malaise.

In about one in ten people, Crohn’s disease is accompanied by other conditions related to the disease. These may include: arthritis, eye disorders, gallstones, kidney stones, liver diseases and skin rashes. During flare-ups of Crohn’s disease, the symptoms outside the gastrointestinal tract can also become worse.

Complications of Crohn’s disease

  • Perianal abscess: an inflammation in the anal area.
  • An intestinal blockage can occur due to thickening of the wall of the intestine.
  • If the small intestine is damaged, nutrients can be difficult to absorb, which can lead to anemia or a vitamin deficiency.
  • If there is persistent damage to the colon, you may be more likely to develop colon cancer

 

Diagnosis of Crohn’s disease

If Crohn’s disease is suspected, an endoscopy of the intestine can be performed. Samples may be taken from the tissue of the wall of the intestine. If there is an affected small intestine, contrast X-rays can be taken.

Treatment of Crohn’s disease

If it is a mild attack, medication is usually given for the pain and something for the loose stools. If there is a sudden attack, corticosteroids can be prescribed; the dose will be reduced if the symptoms diminish. If severe symptoms require admission to hospital, corticosteroids can then be given intravenously. In severe attacks, food can be given through a tube. Many people with Crohn’s disease eventually require surgery. In this operation, the affected part of the intestine is removed and the healthy ends are joined together. An operation is performed if there is no other solution, because the part that remains can also be affected by Crohn’s disease. A number of people will need to have a stoma placed (temporarily). This is an artificial intestinal outlet on the abdominal wall.

Crohn’s disease prognosis

Crohn’s disease keeps popping up. About seven out of ten people with Crohn’s disease ultimately undergo surgery. The expected average length of life can be shortened slightly due to complications and operations. Regular monitoring (endoscopy) may be necessary to ensure that colon cancer is not developing.

Differences between Crohn’s disease and ulcerative colitis

  • The colon is also inflamed in ulcerative colitis. The conditions differ from each other because in Crohn’s disease the inflammation can pass through all layers of the intestine . This can cause deep ulcers (fistulas), while ulcerative colitis only causes inflammation on the surface.
  • Crohn’s disease can occur in the entire digestive tract, with ulcerative colitis only in the colon and rectum. Crohn’s disease may also affect organs outside the digestive tract, such as eyes and joints.
  • In Crohn’s disease, healthy parts may alternate with areas that are inflamed, in ulcerative colitis the intestine is contiguously inflamed.
  • Crohn’s disease can cause strictures in the intestine, but this is almost never the case with ulcerative colitis.
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