The
Basics of Crohn's Disease
An estimated 500,000 Americans
have Crohn's disease, an inflammatory bowel disease (IBD) that causes
chronic inflammation of the intestinal tract. Like ulcerative colitis,
another common IBD, Crohn's disease can be both painful and debilitating
and sometimes may lead to life-threatening complications.
Crohn's disease - also called ileitis or enteritis - can affect
any area of the GI tract, from the mouth to the anus. The swelling
extends deep into the lining of the affected organ. The swelling
can cause pain and can make the intestines empty frequently, resulting
in diarrhea.
Because the symptoms of Crohn's disease are similar to other intestinal
disorders, such as irritable bowel syndrome and ulcerative colitis,
it can be difficult to diagnose. Ulcerative colitis causes inflammation
and ulcers in the top layer of the lining of the colon. In Crohn's
disease, all layers of the intestine may be involved, and normal
healthy bowel can be found between sections of diseased bowel.
Crohn's disease affects men and women equally and seems to run in
some families. About 20 percent of people with Crohn's disease have
a blood relative with some form of inflammatory bowel disease, most
often a brother or sister and sometimes a parent or child. Crohn's
disease can occur in people of all age groups, but it is more often
diagnosed in people between the ages of 20 and 30. Recent data suggests
that there is an increased risk of cancer of the small intestine
and colon in patients with long-standing Crohn's disease.
What causes Crohn's disease?
The cause of Crohn's disease is
unknown. Some scientists suspect that infection by certain bacteria
may be the cause of Crohn's disease. However, there has been no
convincing evidence that the disease is caused by infection. Crohn's
disease is not contagious. Although diet may affect the symptoms
in patients with Crohn's disease, it is unlikely that diet is responsible
for the disease. Activation of the immune system in the intestines
appears to be important in Crohn's disease. The immune system is
composed of immune cells and the proteins that these immune cells
produce. Normally, these cells and proteins defend the body against
harmful bacteria, viruses, fungi and other foreign invaders. Activation
of the immune system causes inflammation within the tissues where
the activation occurs.
What are the symptoms of Crohn's?
The most common symptoms of Crohn's disease are abdominal pain,
often in the lower right area, and diarrhea. Rectal bleeding, weight
loss, arthritis, skin problems, and fever may also occur. Bleeding
may be serious and persistent, leading to anemia. Children with
Crohn's disease may suffer delayed development and stunted growth.
The range and severity of symptoms varies.
What are the complications of Crohn's disease?
In the early stages, Crohn's disease causes small, scattered, shallow,
crater-like erosions on the inner surface of the bowel. With time,
the erosions become deeper and larger, ultimately becoming ulcers
(which are deeper than erosions) and causing scarring and stiffness
of the bowel. As the disease progresses, the bowel becomes increasingly
narrowed, and ultimately can become obstructed. Obstruction often
occurs suddenly by poorly-digestible fruit or vegetables that plug
the already-narrowed segment of the intestine. When the intestine
is obstructed, digesting food, fluid and gas from the stomach and
the small intestine cannot pass into the colon.
Deep ulcers can puncture holes in the wall of the bowel, and bacteria
from within the bowel can spread to infect adjacent organs and the
surrounding abdominal cavity.
Nutritional complications, such as deficiencies of proteins, calories,
and vitamins, are common in Crohn's disease.
Other complications associated with Crohn's disease include arthritis,
skin problems, inflammation in the eyes or mouth, kidney stones,
gallstones, or other diseases of the liver and biliary system. Some
of these problems resolve during treatment for disease in the digestive
system, but some must be treated separately.
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