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Crohn s Disease Crohns disease is named after the physician who described the disease in a paper written in 1972. It is also called Morbus Crohns, Granulomatous enteritis, Regional enteritis, or Terminal ileitis. The disease is usually chronic, with recurrent periods, and also periods of remission. The spread of Crohn s disease into the world is getting worse, and there is still no cure or prevention known to the disease. Crohns disease is an inflammatory bowel disease, IBD, the general name for diseases that cause inflammation in the intestines. Crohns disease can be difficult to diagnose because its symptoms are similar to other intestinal disorders such as irritable bowel syndrome and to another type of IBD called ulcerative colitis.
Crohns disease may also be called ileitis or enteritis. Ulcerative colitis causes inflammation and ulcers in the top layer of the lining of the large intestine. Crohns disease affects men and women equally and seems to run in some families. About 20 percent of people with Crohns disease have a blood relative with some form of IBD, most often a brother or sister and sometimes a parent or child.
The most common complication is blockage of the intestine. Blockage occurs because the disease tends to thicken the intestinal wall with swelling and scar tissue, narrowing the passage. Crohns disease may also cause sores, or ulcers, that tunnel through the affected area into surrounding tissues such as the bladder, vagina, or skin. The areas around the anus and rectum are often involved.
The disease can be aggravated by a bacterial infection. It begins with the development of patches of inflammation on the intestinal wall, which can spread from one part of the digestive tract to another. The cause of Crohns disease is unknown. It can affect the digestive system anywhere between the mouth and the anus, but usually affects the final section of the small intestine, the ileum. Ulcerative Colitis causes inflammation of the inner lining of the colon and rectum, while Crohns disease is an inflammation that extends into the deeper layers of the intestinal wall. Crohns disease can also affect the also affect the colon, the regional lymph nodes, and the mesentery, which is the outside covering of the intestines.
The symptoms of Crohns disease sometimes act like an appendicitis attack. The ileum is usually involved in Crohns disease, and is located next to the appendix. Some side effects of Crohn s disease include abdominal right-sided tenderness and pain, appetite and weight loss, possible diarrhea, bloody stools, fever, abdominal distention, nausea, vomiting, and a general sick feeling. Crohns disease also can cause growth retardation in children. Crohns disease can also appear as periodic cramps with diarrhea, and may or may not involve the obstruction of the bowel. Poorly digestible fruits and vegetables can plug the already narrowed segment of the intestine and cause an obstruction.
Diarrhea may be the result from the obstruction because of poor absorption of nutrients, excessive growth of bacteria in the small bowel, or inflammation of the large intestine. The result of this could be blood in the stools, or rectal bleeding. Hemorrhages from Crohns disease are rare, but they do occur. Complications of the disease may occur in areas related to the intestinal disease.
Complications may occur in areas not related to the intestines which include the tender, raised, reddish shin nodules; inflammation in the joints, spine, the eyes, the liver, and the bile ducts that drain the liver. In one-fourth of all reported cases, the symptoms appear only once or twice, and the disease does not come back. If they recur, they will come back every few months or every few years for the rest of your life, with periods of remission. If Crohns disease continues for years, it will gradually deteriorate the bowel functioning, there will be a risk of poor absorption of nutrients, severe bleeding could cause iron-deficiency, or it could possibly increase your risk of cancer of the intestine. If you have chronic abdominal pain, with the mentioned symptoms, your doctor will check you for Crohns disease.
This involves a series of tests starting with a blood test for anemia, which could indicate bleeding in the intestines. Another test is called a colonoscopy, which is when a flexible, lighted tube linked to a computer and TV monitor, called an endoscope, is inserted through the anus. Later, the doctor may run upper gastrointestinal series, a small intestinal study, and a barium enema intestinal x-ray to determine the extent of the disease. If you have Crohns disease your doctor will want to give you regular check-ups to diagnose your condition, and you may be a candidate for surgery. The fact that Crohn s disease often recurs makes it very important for the patient and doctor to consider carefully the benefits and risks of surgery, compared to other treatments.
Crohns disease cannot be cured by surgery, but it can be helped. The inflammation tends to return in areas of the intestine, next to where the area has been removed. The reason many patients of Crohn s disease require surgery is to relieve chronic symptoms of active diseases that does not respond to medical therapy. Some patients require surgery to correct complications such as intestinal blockage or bleeding. Drainage or removals of a section of a bowel, due to blockage are common surgical practices. When the diseased section of the bowel is removed, the bowel is cut above and below the diseased area and reconnected.
After surgery, the majority of patients live a normal, healthy life with an ostomy. The doctor may recommend nutritional supplements, especially for children whose growth has been slowed. Special high-calorie liquid formulas are sometimes used for this purpose. A small number of patients may need periods of feeding by vein. This can help patients who need extra nutrition temporarily, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food. Epidemiology studies of Crohns disease have been conducted in many countries.
They yield some important insights into the disease. There is strong evidence that Crohns disease is caused by an environmental agent. Studies have shown that the incidence of Crohns disease is increasing in most parts of Europe and North America. Studies have also shown that Crohns disease is beginning to make an appearance in parts of the world that have not experienced it before. The cause of Crohns disease is unknown, although there is a genetic tendency to develop this disease and environmental factors are also thought to play a part.
Crohns disease may occur at any age but is most common in young adults, with most people first affected during their teens or twenties. Small amounts of patients contract the disease after they are 50. Crohns disease is found mainly in Europe, North America, and Australia. Individual studies on the epidemiology of Crohns disease have been conducted, mostly confined to one city, country or region of a country. Only three countries have conducted national surveys on the prevalence and incidence of Crohns disease. These are Japan, Slovakia and Yugoslavia.
There is insufficient data to develop a complete picture of the global prevalence or incidence of Crohns disease. Several studies studied ethnic subgroups of many different populated areas. In these studies, the country of origin where people have a lower or zero prevalence of Crohns disease, have a much higher prevalence of the disease when they migrate to a country that has high prevalence of the disease. This provides strong evidence that a factor in the environment is involved in causing Crohns disease.
Further evidence that an environmental factor is involved, provided by studies that show that the pattern of relapse of Crohns disease changes through the year. In a study, it was found that there was a higher rate of reoccurrence in the fall and winter months. Studies show that the annual incidence of the disease has increased. Annual growth rates between 2 - 14 percent have been recorded. In some cases these growth trends have been maintained for periods of up to fifty years. Historically, Crohns disease has been pictured as a disease that affects mostly white populations.
However, non-white migrants to Europe and North America are at a much greater risk of developing the disease than they are in their country of origin. Also, the disease is beginning to make itself known in populations where it has never been seen before, such as in Chinese people in Hong Kong, Chinese people in Singapore and Arab people in Kuwait. A recent study in Japan found a link between the growth in incidence of Crohns disease and the increasing consumption of animal proteins, with the highest linkage figure being associated with increased consumption of milk. Crohns disease is on the rise in children. One study, in South Glamorgan, Wales, found that the annual incidence of Crohns disease in children was increasing by over nine percent per year. This has also been reported in southwest Sweden.
Crohn s disease has spread throughout the world in the past years. Although many people are not familiar with the disease, the disease is out there. The increase in reported cases has increased dramatically, which shows something must be done, before the disease eats our society and us. Bibliography Crohns Disease, Health Library. web Crohns Disease, National Digestive Diseases Information Clearinghouse. web Medical Sciences Bulletin.
web Welcome to the Crohns Disease Site. web Crohns Disease, Microsoft Encarta 98 Encyclopedia. 1993 - 1997 Microsoft Corporation. The Epidemiology of Crohns Disease, Alan Kennedy. web alan/CROHNS/eminem. htm
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