What
is Crohn's disease?
Crohn's Disease (CD) is an inflammatory disease of the gastrointestinal
(GI) tract. It affects the ileum (small intestine) and the
colon (large intestine) in most cases, but can occur in any
section of the GI tract from the mouth to the anus. Areas
of inflamed tissue are often separated by areas of normal
tissue. The large intestine is inflamed in 65% of the people
who have Crohn's disease. The small intestine is inflamed
in 35% of people with the disease. Crohn's disease generally
occurs in young adults.
How
does it occur?
The cause of Crohn's disease is unknown. In Crohn's disease,
the inflammation occurs in all the layers of the small or
large intestine as well as nearby tissues and lymph nodes.
The sores and swollen areas may thicken and eventually block
the intestines. The inflammation can cause holes and sores
in the bowel walls. Because the inflammation also affects
the outer intestinal walls, the loops of bowel may attach
to each other.
What
are the symptoms?
Symptoms of Crohn's disease include:
- abdominal
pain or cramping
- diarrhea
- fever
- fatigue
- weight
loss
- rectal
fistula (abnormal opening at or near the anus)
- rectal
fissure (a painful crack in the mucous membrane of the anus)
- skin
lesions
- joint
pain
How
is it diagnosed?
To diagnose Crohn's disease, your doctor will review your
symptoms and examine you. The exam usually includes a sigmoidoscopy
or colonoscopy (a procedure in which the doctor uses a scope
to look at the inside of your intestine or colon). Often the
doctor will take a small piece of bowel tissue for testing.
The doctor may also want a sample of your stool (bowel movement)
for testing. Other tests may include a blood test and a barium
x-ray study to examine the colon and small bowel (particularly
the end section of the bowel).
How
is it treated?
There is no cure for Crohn's disease. [SCD Editors' note:
wake up and check out the SCD] The best treatment is frequent
checkups with your doctor to control the disease. The doctor
will probably prescribe one or more medications for you to
take. If you have diarrhea, avoid certain foods that have
a laxative effect, such as raw fruits and vegetables and concentrated
fruit juices. You can rest your bowel by not eating solid
foods for a while. Drink just clear fluids frequently during
the day (electrolyte or rehydrating fluids are best). It is
important to drink often so that you do not become dehydrated.
When an attack of diarrhea is over, eat small frequent meals.
Return to your normal diet gradually. Limit or avoid food
additives and stimulants such as caffeine (in coffee, tea,
or chocolate). Avoid eating or drinking milk products. Enzyme
supplements may help if you develop an intolerance to lactose
(a sugar in dairy products). Ask your doctor if you should
reduce the amount of roughage in your diet. If you have cramps
or abdominal pain, it may help to put a hot water bottle or
electric heating pad (set on low) on your abdomen. If your
condition is more serious, hospital treatment may include:
- intravenous
feeding (into a vein) to replace lost nutrients and fluids
- blood
transfusions to restore lost blood
- use
of medications such as antibiotics and steroids to reduce
inflammation
- nasogastric
suction (through a tube passed through the nose to the stomach)
to drain out acidic digestive juices.
If the
disease is not kept under control you may get sores, tears,
or abnormal openings in and around your intestines. In this
case you may need surgery.
How
can I take care of myself?
It is important to follow your doctor's instructions. If your
symptoms persist or if you develop new symptoms, tell your
doctor. In addition, you can:
- Be
aware of the possibility of the symptoms coming back. Otherwise
a recurrence may make you feel discouraged, anxious, fearful,
or tense.
- Keep
a healthy, positive attitude.
- Learn
to use relaxation techniques such as mental imaging, muscle
relaxation exercises, and deep breathing.
- Talk
with a mental health professional about how to manage events
in your life that trigger anxiety.
- Develop
a positive support system (family, friends) for talking
about the normal stresses of daily life.
- Follow
a balanced, nutritious diet, but avoid raw fruits and vegetables
and milk products during a flare-up.
- Exercise
20 minutes at least three times a week.
- Get
enough rest even if you cannot sleep.
- Allow
time each week for play and recreation.
- Take
the full course of treatment your doctor prescribes.
For more
information you may also want to write or call:
Crohn's and Colitis Foundation of America 444 Park Avenue
South
New York, New York 10016 Phone: (212) 685-3440
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Crohn's
disease involves inflammation in the gastrointestinal tract.
Most cases involve the small intestine or the colon. The patient
has recurrent flare-ups and remissions. It is almost always
a lifelong illness. The cause is unknown.
Early
signs include chronic diarrhea, abdominal pain, fever, weight
loss, and loss of appetite. The first sign for some patients
is an "acute abdomen" resembling appendicitis. Usually there
is one or more of the following clinical situations:
- inflammation
of intestines,
- blockage
of intestines,
- bloating
and constipation,
- abnormal
intestinal connections, or
- anal
fissure or abscess.
There
may be problems outside of the intestinal tract. These include
arthritis, kidney stones, malabsorption, or inflammation of
the spinal vertebrae.
There
is no cure for Crohn's disease. Treatments work to control
the disease and relieve symptoms. People receive anti-inflammatory
drugs, such as steroids or drugs that suppress the immune
system. Patients should eat a well-balanced diet. Unless there
is an obstruction, people benefit from supplemental fiber.
During extreme flare-ups, the person may require intravenous
feeding.
Over half
of all people with Crohn's disease eventually need at least
one surgical procedure. Removal or bypass of the affected
section of the intestine often results in relief for 5 to
15 years. With proper medical and surgical treatment, most
people are able to cope with Crohn's disease and lead productive
lives.
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