Crohn's disease is a chronic inflammatory bowel disease (IBD) that causes inflammation or swelling of the digestive tract, also known as the gastrointestinal (GI) tract1.
Crohn's disease can affect any part of the GI tract, though it usually occurs at the end of the small intestine, also known as the ileum, and the beginning of the large intestine, also known as the colon2. Crohn's disease often is mistaken for other GI disorders that cause similar symptoms, such as ulcerative colitis, diverticulitis and irritable bowel syndrome (IBS)1.
Symptoms and potential complications of Crohn's disease
Crohn's disease symptoms may range from mild to severe and can vary widely from person to person2. Most people experience periods when they have flare ups, followed by episodes of remission when the symptoms decrease or even disappear2. Commonly reported symptoms include the following:
Persistent diarrhea
Abdominal cramps and pain
Fever
Fatigue
Rectal bleeding and loss of appetite may also occur. In addition to the effects on the gastrointestinal tract, Crohn's disease can also affect other areas of the body such as the joints, eyes, skin, and liver2.
Along with painful symptoms, Crohn's disease can lead to complications, including an obstruction of the intestine due to swelling and the formation of scar tissue1.
Other potential complications of Crohn's disease include the development of fissures (small cuts or tears in the anal canal), abscesses (localized infection or collection of pus), and fistulas (an abnormal tunnel that forms between two structures of the body)1,2.
Causes and risk factors of Crohn's disease
Not much is known about what causes Crohn's disease. What is known is that it is a chronic inflammatory disease of the digestive or gastrointestinal tract that appears to be a result of a complex interaction of factors including3:
Inherited genes
The immune system
Environmental factors
Researchers believe that once a person's immune system is "turned on" it doesn't know how to "turn off" at the right time causing inflammation that damages the intestines. This results in the pain and other symptoms of Crohn's disease2.
Though it can occur at any age, most people are diagnosed with Crohn's disease between the ages of 15 and 351. Roughly 20% of people with Crohn's disease have a sibling, parent or child with some form of IBD3. Men and women are at equal risk, while people of European heritage are more likely to develop the disease1.
Treatment options for Crohn's disease
Several types of drugs are used to treat Crohn's disease, including1,2:
Aminosalicylates: a class of anti-inflammatory drugs typically used to treat mild to moderate disease.
Corticosteroids: steroids are used typically for moderate to severe disease.
Immune modifiers: used especially for patients with moderate to severe disease and those who are steroid dependant.
Antibiotics: may be used to treat fistulas and other infectious complications of Crohn's disease.
Biologic therapy: used to treat moderate to severe disease when conventional therapy has proven ineffective.
Biologic drugs, also known as TNF (tumor necrosis factor) blockers, are a recent class of drug for the treatment of Crohn's disease. They work by neutralizing TNF, a protein in your body that in excess can cause inflammation in your gastrointestinal tract.
Biologic therapies work selectively, unlike corticosteroids which target the entire immune system.
As the location, symptoms and severity of Crohn's disease can vary greatly from person to person, finding the right treatment for you is crucial. That's why it's important to get as much information about treatment options as you can and to share it with your healthcare provider. Remember, only your doctor can determine which medications may be right for you.
References:
Mayo Foundation for Medical Education and Research. Crohn's disease. Available at: http://www.mayoclinic.com/health/crohns-disease/DS00104. Accessed December 6, 2006.
Crohn's and Colitis Foundation of America (CCFA). About Crohn's disease. Available at: http://www.ccfa.org/info/about/crohns. Accessed December 6, 2006.
National Institutes of Health (NIH). Crohn's Disease. NIH Publication No. 06-3410. February 2006
2007-04-09 02:19:17
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answer #3
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answered by Anonymous
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Crohn's Disease is 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 and ulcerative colitis are similar — so similar that they're often mistaken for one another. Both inflame the lining of your digestive tract, and both can cause severe bouts of watery or bloody diarrhea and abdominal pain. But Crohn's disease can occur anywhere in your digestive tract, often spreading deep into the layers of affected tissues. Ulcerative colitis, on the other hand, usually affects only the innermost lining of your large intestine (colon) and rectum.
There's no known medical cure for Crohn's disease. However, therapies are available that may greatly reduce the signs and symptoms of Crohn's disease and even bring about a long-term remission.
S/S can be diarrhea, abdominal pain and cramping; blood in stools, ulcers on the surface of the intestines or intestinal walls; reduced appetite and wt loss.
Causes
heredity, environmental, diet high in fat or refined foods.
Risk factors may include:
Age. Crohn's disease can strike at any age, but you're likely to develop the condition when you're young. Most people are diagnosed with Crohn's between the ages of 15 and 35.
Ethnicity. Although whites have the highest risk of the disease, it can strike any ethnic group. If you're Jewish and of European descent, you're four to five times as likely as other people are to have Crohn's disease.
Family history. You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. If a brother or sister has Crohn's disease, your risk of developing the disease is 30 times as high as the general population's risk.
Where you live. If you live in an urban area or in an industrialized country, you're more likely to develop Crohn's disease. People living in Northern climates also seem to have a greater risk of the disease.
Crohn's disease may lead to one or more of the complications:
Obstruction, ulcers, fistulas, anal fissures, and malnutrition. and colon cancers.
The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohn's disease usually involves drug therapy or, in certain cases, surgery.
Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you. In addition, because some drugs have serious side effects, you'll need to weigh the benefits and risks of any treatment.
There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up in your condition. It's a good idea to try eliminating from your diet anything that seems to make your signs and symptoms worse. Here are some suggestions that may help:
Limit dairy products. Like many people with inflammatory bowel disease, you may find that problems such as diarrhea, abdominal pain and gas improve when you limit or eliminate diary products. You may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods. If so, try substituting yogurt or low-lactose cheeses, such as Swiss and cheddar, for milk. Or use an enzyme product such as Lactaid to help break down lactose. In some cases, though, you may need to eliminate dairy foods completely. If you need help, a registered dietitian can help you design a healthy diet that's low in lactose.
Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat. Instead, fat passes through your intestine, making your diarrhea worse. Foods that may be especially troublesome include butter, margarine, peanut butter, nuts, mayonnaise, avocados, cream, ice cream, fried foods, chocolate and red meat.
Experiment with fiber. For most people, high-fiber foods such as fresh fruits and vegetables and whole grains are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. You may also find that you can tolerate some fruits and vegetables, but not others. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and with very crunchy foods such as raw apples and carrots.
Avoid problem foods. Eliminate any other foods that seem to make your symptoms worse. These may include "gassy" foods such as beans, cabbage and broccoli, raw fruit juices and fruits — especially citrus fruits — spicy food, popcorn, alcohol, caffeine, and foods and drinks that contain caffeine such as chocolate and soda.
Eat small meals. You may find you feel better eating five or six small meals rather than two or three larger ones.
Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
Consider multivitamins. Because Crohn's disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful.
Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Stress
Although stress doesn't cause Crohn's disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a move, job loss or the death of a loved one.
When you're under stress, your normal digestive process changes. Your stomach empties more slowly and secretes more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.
Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:
Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.
Regular exercise, yoga, massage or meditation. These can all be effective ways to relieve stress. You can take classes in yoga and meditation or practice at home using books or tapes.
Progressive relaxation exercises. These help you relax the muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all the tension go. Next, tighten and relax your calves. Continue until every muscle in your body, including those in your eyes and scalp, is completely relaxed.
Deep breathing. Most adults breathe from their chests. But you become calmer when you breathe from your diaphragm — the muscle that separates your chest from your abdomen. When you inhale, allow your belly to expand with air; when you exhale, your abdomen naturally contracts. Deep breathing can also help relax your abdominal muscles, which may lead to more normal bowel activity.
Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you as you imagine your intestinal muscles becoming smooth and calm.
Other techniques. Set aside at least 20 minutes a day for any activity you find relaxing — listening to music, reading, playing
computer games or simply relaxing in a warm bath.
2007-04-09 02:23:29
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answer #5
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answered by rosieC 7
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