Crohns Disease

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• Crohns Disease

What is Crohn's disease? Currently affecting an
estimated 500,000 people in the United States,
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) tract.
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 colon. Crohn's disease often is mistaken for
other GI disorders that cause similar symptoms,
such as ulcerative colitis, diverticulitis and
irritable bowel syndrome (IBS).
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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 person.
  Most people experience periods when they have
  flare ups, followed by episodes of remission when
  the symptoms decrease or even disappear. 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 liver.
• 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 tissue.
• 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).

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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
  including
• 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 disease.
• Though it can occur at any age, most people are
  diagnosed with Crohn's disease between the ages
  of 15 and 35. Roughly 20 of people with Crohn's
  disease have a sibling, parent or child with some
  form of IBD. Men and women are at equal risk,
  while people of European heritage are more likely
  to develop the disease.

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Treatment options for Crohn's disease

• Several types of drugs are used to treat Crohn's
  disease, including
• 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.

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Treatment options for Crohn's disease

• 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.

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Putting It All Together
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Putting All Together

• Here is a summary of the important facts and
  information related to Crohn's disease.
• Crohn's disease is a chronic, inflammatory
  condition that can affect any part of the
  digestive tract, from the mouth to the anus. The
  majority of cases of Crohn's disease involve the
  terminal ileum, the place in the body where the
  small intestine meets the large intestine.
• Crohn's disease is characterized by periods of
  active inflammation, called flare-ups, and
  periods of reduced or absent symptoms, called
  remission .
• Crohn's disease has a genetic component. People
  from families in which another member has Crohn's
  disease or ulcerative colitis, an inflammatory
  condition of the colon, are statistically more
  likely to be affected.

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Putting It All Together

• Together, Crohn's disease and ulcerative colitis
  are known as inflammatory bowel disease .
• Common symptoms of Crohn's disease include
  chronic diarrhea, abdominal pain, and fever.
  Weight loss and nutritional deficiencies may also
  occur.
• To accurately diagnose Crohn's disease, a
  physician will order a number of laboratory tests
  and at least one imaging examination
  sigmoidoscopy , colonoscopy , or barium enema .

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Putting It All Together

• Flare-ups are typically treated with steroids ,
  immunosuppressive drugs, 5-ASA compounds,
  anti-TNF agents, or antibiotics, or a combination
  thereof. In addition, a pharmaceutical regimen is
  often followed to maintain remission once it is
  achieved.
• The presence of active Crohn's disease may affect
  fertility in both men and women, due to the
  effects of fever, nutritional deficiency, and
  infection.
• Some drugs used to treat the disease may affect
  fertility and/or may cause birth defects, while
  others are considered to be safe. Appropriate
  treatment during efforts to conceive and
  pregnancy should be discussed with an
  individual's health care providers.

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glossary.html
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Putting It All Together

• People with Crohn's disease have a statistically
  slightly higher risk of developing colon cancer,
  so they should begin regular screening eight to
  twelve years after the initial diagnosis,
  depending on their particular disease history.
• Researchers are actively pursuing new therapies
  and improving traditional treatments as their
  understanding of Crohn's disease improves.

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glossary.html
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What Is The Outlook For People With Crohn's
Disease?

• Every day, scientists are gaining a better
  understanding of Crohn's disease its genetic
  aspects, how the immune system comes to
  malfunction, and the mechanisms of the
  relationship between infection and chronic
  inflammatory disease.
• New medical compounds are being tested in
  clinical trials and promise to provide greater
  relief with fewer side effects. Surgical
  techniques continue to be refined, and novel
  therapies continue to be explored.

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What Is The Outlook For People With Crohn's
Disease?

• For example, a group of researchers has suggested
  that the eradication (through modern sanitation)
  of a group of parasites called helminths (worms
  that live in the intestinal tract) might have led
  to a situation in which the immune system does
  not have anything to "practice" on, and so
  attacks its own bodily organs.

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What Is The Outlook For People With Crohn's
Disease?

• These researchers fed a group of six individuals
  suffering from flare-ups of Crohn's disease a
  formula made up of helminths that breed in pig
  intestines. Five people went into remission , the
  sixth experienced significant reduction of
  symptoms. Since these helminths do not breed in
  the human gut, the researchers could easily
  determine when the helminths had all been passed
  from the test subjects' bodies by checking their
  stool samples. After the worms were gone, all of
  the test subjects experienced recurrence of their
  symptoms.
• The researchers hope to study groups of
  individuals who suffer from autoimmune
  conditions, such as rheumatoid arthritis and
  lupus, to see if a similar improvement in
  condition occurs with the helminth treatment