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Causes
of Crohn's Disease:
What
causes Crohn’s disease is currently unknown. Crohn’s
symptoms are thought to originate as a result of
problems in the immune system. The immune system is
present all over the body and is responsible for
battling against infections and diseases. The immune
system of Crohn’s sufferers is overactive and attacks
healthy tissue in the body and this is most evident in
the digestive system. This is the physical cause of many
of the symptoms.
It is not known exactly what causes certain people to
develop Crohn’s disease, but people with a family
history of the disease are more likely to develop it.
Smokers and certain ethnic groups are also at greater
risk of developing the disease. While the disease can
develop at any age it is most likely to develop between
a person’s teenage years and their mid thirties.
What to expect
Sufferers experience Crohn’s disease differently,
depending on the affected portion of the digestive
system.
Common
symptoms in Crohn's are:
-
Tenesmus (the feeling of constantly needing to pass
stools, often with pain).
-
Ulcers in the mouth and on the skin.
-
Liquid diarrhoea.
-
Tiredness/lack of energy.
-
Stomach cramps.
-
High temperature.
-
Joint
pain.
Crohn’s symptoms come and go which means that the
disease can either be described as in a ‘flare up’, when
symptoms are present, or in ‘remission’, when there are
no symptoms.
Testing
for Crohn's Disease
There are
a number of ways to test for Crohn’s disease. During a
colonoscopy a small camera is inserted in to the rectum
so that a doctor or nurse can see the lower part of the
digestive system, or ‘colon’.
A patient suspected of having Crohn’s disease might also
be asked to have a barium enema. During a barium enema
liquid is passed in to the lower bowel through a
patient’s anus. This liquid shows up well on X-Ray
scans, so that the doctors can better see what the
inside of the colon looks like.
Magnetic Resonance Imaging (MRI) is another way of
viewing the small bowel and may sometimes be used.
Medical Treatments
Certain medical therapies are used to treat and reduce
the severity of flare-ups and bring patients back in to
remission (quiescent disease state). Others are used to
try to reduce the number of flares suffered by a patient
by keeping them in remission using ‘maintenance
therapies’. Therapies include:
-
5-aminosalicylic
acid (also known as mesalazine or mesalamine)
administered either as tablets or directly in to the
back passage (rectum) as an enema, if the Crohn’s
disease is located there.
-
Corticosteroids
like prednisolone administered as tablets or as an
enema.
-
Immunosuppressants
like azathioprine and 6-mercaptopurnine.
-
Biologicals such as Infliximab, which is injected
directly in to the blood stream, for patients whose
disease is not controlled by other medicines.
While
these treatments can end a flare-up or maintain a
patient in remission, there is still no known cure for
Crohn’s disease.
Surgery
is sometimes used to remove parts of the digestive tract
in patients who do not respond to treatment with
medicines. This is called a bowel resection. There are
certain circumstances when surgery is needed, these
include when the disease causes fistulas (unwanted
connections between tissues) obstructions in the bowel
due to scarring or internal bleeding.
Lifestyle suggestions and support
Some
Crohn’s sufferers find that there are foods or liquids
that can make their symptoms worse, particularly
diarrhoea. There isn’t a hard and fast rule on which
foods to eat or avoid, but Crohn’s sufferers often work
this out through a process of trial and error. Sufferers
tend to find that it helps if they eat and drink little
but often, rather than eating the traditional three
meals a day.
Some sufferers
find the disruptive symptoms of Crohn’s distressing and
embarrassing. Many hospitals have specialist nurses to
advise sufferers. There are also charities to assist and
support Crohn’s sufferers:
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