Crohn

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Crohns disease - A Review of Symptoms and
Treatment
Brian Nguyen University of California - Irvine
Medical Center, Orange, CA
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Background

• Inflammatory bowel disease in large intestine and
  rectum
• May occur in any part of GI tract
• Chronic condition
• Onset occurs 16-40 yrs old
• Exact cause unknown
• Genetic risk factors

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Background

• Autoimmune disorder
• Immune system attacks normal microbes
• White blood cells rush lining
• Chronic inflammation
• Similar symptoms to ulcerative colitis
• UC affects superficial layers and colon only
• CD affects all layers and GI tract

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Usually found in ileocecal region (small
intestine to large intestine)
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Normal colon
Colon with Crohns disease
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Symptoms

• Periods of flare ups
• Abdominal pain
• Diarrhea
• Fever
• Weight loss
• Anal pain

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Complications

• Obstruction of bowel
• Swelling or scar tissue
• Ulcers in tract
• Can result in fistulas (30)
• Abscess
• Malnutrition
• Inadequate intake and absorption

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Diagnosis

• Colonoscopy (70 effective)
• Visualization of colon and terminal ileum
• Radiological studies
• Can help see remainder of small intestine
• Highlights inflammation
• Blood tests
• Anemia indication for Crohns

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Treatment

• No cure only symptom relief
• Medication
• Cortisteroids or anti-inflammatory agents
• Immunosuppressive drugs
• Surgery
• Remove diseased portion of intestine
• Anastomosis connects remaining bowel
• 50 patients have recurrence within 5 years

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Surgery
Total proctocolectomy with ileostomy
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Surgery
Total colectomy with ileorectal anastomosis
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Prognosis

• No cure
• Higher risk for colon cancer
• Long periods of remission