Crohn’s Disease, or inflammatory bowel disease, is a chronic, progressive, relapsing disease, characterized by inflamed intestines, that usually strikes between the ages of 15 and 30. Because it resembles many other gastrointestinal problems, Crohn’s disease is very hard to diagnose and treat.

 

Causes

Although the exact cause of Crohn’s disease is unclear, research has shown that a combination of genetics, environment and ineffective immune system all play a part in the development of the disease. Some believe that bacterial infections lead to a weakened bowel wall, which then leads to inflammation and GI breakdown. Others believe a lack of protective enzymes and/or mucus cause irritation and inflammation. Because 10% of patients have a first degree relative with Crohn’s disease, the disease appears to have a strong genetic link.

Symptoms

Crohn’s disease is characterized by deep lesions that develop discontinuously throughout the entire bowel. These lesions may be accompanied by enlarged intestinal lymph nodes.  Symptoms include rectal bleeding, abdominal pain, cramping, diarrhea, vomiting, loss of appetite, weight loss, fever, dehydration, malnutrition, fatigue, increased bowel sounds, hemorrhoids, and anemia. Patients may also develop kidney stones, hydronephrosis, stomatitis, arthritis and/or ulcers of the skin.

Because a person with Crohn’s disease will have an impaired bowel, he or she will not be able to absorb the nutrients that they eat very well. This often leads to calorie and vitamin deficits. If serious deficiencies develop, decreased immunity, slower wound healing and worsened anemia may result.

Treatments

Because Crohn’s disease involves intense inflammation of the bowel, anti-inflammatory drugs, including steroids, are most useful. Patients may also receive anti-diarrheals, and pain medications. The lesions in Crohn’s disease are often deep, penetrating throughout multiple layers of the bowel wall, so therapy is often long-term.  Patients experiencing malnourishment, anemia and/or dehydration are given fluids, electrolytes and blood to restore proper balance. After the initial restoration of vitamin, fluid and calorie balance, patients are encouraged to eat a diet high in calories and protein, with a multivitamin. In addition, physical activity should be decreased to keep intestinal motility to a minimum. Patients are often put on bed rest to limit the amount of movement the bowel can perform.

Because there is no cure, and because this disease is so debilitating, depression often results. Stress management, therapeutic counseling and relaxation techniques may prove helpful in relieving symptoms.