Wednesday, April 1, 2009

Explaining Crohn's Disease

NB: This is an article I wrote for Helium several years ago and thought it would be a good first post here. 

Explaining Crohn's Disease

Crohn's Disease, a type of Inflammatory Bowel Disease (IBD), is a disease of the gastrointestinal system that can affect any part of the digestive tract from the mouth to the anus, but most commonly occurs in the small intestine, terminal ileum and/or large intestine.

It was named after Burrill Bernard Crohn, an American gastroenterologist, who discovered the disease in 1932.

While it can affect people of any age, gender or ethnicity, onset is usually late teens to early adulthood. It affects men and women equally and is more common among people living in developed countries.

The exact cause of Crohn's disease is currently unknown. It is believed that the disease results when the immune system attacks the body, causing inflammation and other symptoms. Some believe that the disease may be caused by strains of mycobacterium, which has been found to be present in many people with Crohn's disease, but not present in those with Ulcerative Colitis (another form of IBD) however researchers are unable to confirm this as the cause.

Heredity is thought to play a role as approximately 1 in 5 people with Crohn's disease have a relative with the disease. More recently a gene called NOD2/CARD15 has been associated with Crohn's disease. Mutations in this gene have been linked to high rate of relapse post surgery and the early onset of symptoms.

The symptoms of Crohn's disease are wide and varied, depending on which area of the body is affected, however the most common symptoms include abdominal pain/cramping, diarrhea, blood in stools, ulcers, fissures, weight loss, loss of appetite, nausea, fatigue, fever and sometimes constipation.

There is currently no cure for Crohn's disease. Treatment is typically via medications that aim to induce the remission of symptoms. Corticosteroids are one of the most common and widely used drugs. They are effective in suppressing the inflammation in the intestine and other associated symptoms however they have a number of significant side effects. Sulfasalazine is an older drug, which was one of the first alternatives to corticosteroids, however it too has a number of side effects and is not suitable for people with an allergy or intolerance to sulfa. 5-ASA drugs have fewer side effects and are site specific, depending on where the active disease is located will depend on the type of 5-ASA. Immunomodulators aim to suppress the immune system, specifically the CD4 cells and are generally prescribed to steroid dependant people.

While diet does not cause Crohn's disease, some food and beverages can certainly aggravate the symptoms. It is generally thought that foods high in fat, fiber, caffeine or lactose can increase the occurrence of symptoms, particularly during a flare up. Many people find that a low-residue and/or gluten free diet are gentler on the body and tend to trigger flare-ups less.


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