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About 60 to 70 million Americans suffer from digestive disease.
*Source: National Institutes of Health
 

Crohn's Disease

Crohn's disease is an inflammatory bowel disease (IBD) that causes inflammation of the lining of the intestine, usually the small intestine, leading to abdominal pain, severe diarrhea, and possibly malnutrition. It can be debilitating and has life-threatening complications. There is no known cure, but treatments can alleviate the symptoms, allowing patients to live normally.


Symptoms

Symptoms of Crohn's disease may be mild or severe, may develop gradually or suddenly, and may fall into remission. They include:


  • Ongoing diarrhea, caused by the inflamed areas of your intestine's secreting too much water and salt for the large intestine to reabsorb.
  • Abdominal pain and cramping. The inflammation causes swelling and buildup of scar tissue, hindering the normal movement of material through the digestive tract.
  • Nausea and vomiting may result from abdominal cramps in severe cases.
  • Blood in your stool as the inflamed bowel bleeds.
  • Ulcers that may penetrate the intestinal wall, as well as in your rmouth.
  • Reduced appetite and weight loss as you lose both your desire for and ability to digest food.
  • Fever
  • Fatigue
  • Arthritis
  • Eye inflammation
  • Skin disorders
  • Stunted growth in children

You should see your WellStar physician if you have any of these symptoms, or an unexplained fever lasting more than a couple of days.


Causes and Prevention

Although the cause of Crohn's disease is unknown, researchers believe that heredity and an abnormal immune reaction to an infection may lead to the condition. Risk factors include:


  • Age 20 to 30
  • Being white, especially of Ashkenazi Jewish descent
  • Family history
  • Smoking is the only controllable risk factor for Crohn's disease.
  • Living in an urban area and/or in a northern climate, perhaps because of a high fat diet
  • Possibly use of Accutane®, an acne medication
  • Non-steroidal anti-inflammatory drugs (NSAIDs) [link] can worsen Crohn's disease.

Complications of Crohn's disease include:


  • Stricture - abnormal narrowing of the intestine
  • Fistula - an abnormal connection between two parts of the intestine

Diagnosis

Crohn's disease is usually diagnosed only after eliminating other conditions that can result in the same symptoms, like diverticulitis, irritable bowel syndrome, and colon cancer. Tests for Crohn's disease include:


  • Blood tests to check for anemia and infection
  • Fecal occult blood test (FOBT) for blood in the stool
  • Colonoscopy - a thin, flexible tube with a camera is inserted to examine the colon and possibly take a biopsy
  • Barium enema - the colon is coated with a dye to make it visible on an X-ray
  • Small intestine imaging - you drink a dye that coats the small intestine, making it visible to X-ray, computerized tomography (CT) scan, and magnetic resonance imaging (MRI). This helps locate narrowing and inflammation.
  • Computerized tomography (CT) scan of the entire bowel area
  • Capsule endoscopy, a camera pill that sends thousands of images to a recorder on your belt

Treatment

Although Crohn's disease cannot be cured, its symptoms can be mitigated, leading in some cases to long-term remission.


Certain foods aggravate may the symptoms of Crohn's disease, and should be avoided during flare-ups. Suspect foods include:


  • Dairy products
  • High-fat foods: Crohn's disease inhibits the digestion of fats
  • High-fiber foods may aggravate diarrhea, cramps, and gas
  • Gassy foods
  • Citrus
  • Alcoholic and caffeinated beverages can stimulate your intestines.
  • Carbonated drinks can produce gas.

You may feel better if you eat more, smaller meals. Try to drink plenty of fluids, especially water, and consider nutritional supplements with your WellStar physician and dietitian.


Stress also aggravates the Crohn's symptoms, and may be managed with exercise, biofeedback, and relaxation exercises.


In addition to lifestyle changes, there are drugs that treat the symptoms of Crohn's disease. Those that work well for some people do not work for others, and some have serious side effects. Your WellStar physician will help you evaluate the risks and potential benefits of your treatment options. Some types of drugs used are anti-inflammatories, immune system suppressors, antibiotics, anti-diarrheals, laxatives, and nutritional supplements.


If these treatments fail to relieve your symptom, surgery to remove a damaged portion of your intestine, close fistulas, and drain abscesses, may be indicated. At best, this provides temporary relief. Nearly 75 percent of people with Crohn's disease eventually require surgery, and about half of these will need a second procedure.

 
 
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