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Crohn's disease Overview
Crohn's disease (granulomatous enteritis, regional enteritis, transmural ileitis, regional-terminal ileitis) is a chronic inflammatory disease of the gastrointestinal tract, localized in all its areas, from the oral cavity to the rectum. Most often, the disease affects the terminal portion of the small intestine. Abscesses and fistulas are formed, intestinal adhesions and intestinal obstruction are possible. Basically, people aged 20-40 are susceptible to the disease, but sometimes the disease also occurs in elder people (60 years or more).
Symptoms of Crohn's Disease
Crohn's disease is difficult to diagnose due to the variety of clinical presentation. Among the most common symptoms are fever, fatigue, weakness, abdominal pain, diarrhea without blood, weight loss, bloating. In the advanced stages, long-lasting non-healing anal fissures or fistulas on the anterior abdominal wall and lateral parts of the abdomen may appear. In children, anemia, regular fever, and stunted growth can also be symptoms.
Causes of Crohn's disease
The etiology of the disease is not fully understood. Experts identify a number of reasons leading to the occurrence of Crohn's disease:
- a genetic predisposition to defects in the intestinal immune system,
- infectious factors (an experiment showed the possibility of contracting Crohn's disease through intestinal flushing),
- autoimmune cause (disorders in the immune response, patients with Crohn’s disease usually have antibodies to E. coli, cow’s milk protein and lipopolysaccharides),
- connection with the mental state of a person (depression, anxiety and psychological stress can provoke an outbreak of the disease),
- side effects of smoking,
- regular intake of certain drugs (NSAIDs, acetylsalicylic acid, ibuprofen, indomethacin).
Crohn's Disease Treatment Methods
Depending on the severity of the disease, the consulting doctor may choose various treatment methods, including surgical. In case of complications, even the removal of the affected intestines is necessary. However, in most cases, it is possible to achieve stable remission pharmacologically.
In mild forms of Crohn's disease, salicylates (5-aminosalicylic acid preparations) are used for treatment. To stop the pain and diarrhea, the doctor may prescribe loperamide and antispasmodics. In case of fistulas and fistulas, the use of antibiotics, such as ciprofloxacin, metronidazole or rifaximin, is necessary. Glucocorticoids are used for induction, antidepressants are prescribed to eliminate the psychological causes of the onset of the disease. Clinical administration of antibodies to tumor necrosis factor alpha is possible. There are studies showing positive effects of glutamine in the treatment of the active stage of the disease. In addition, experts use for the Crohn’s disease treatment probiotics and new biological products, including anti-integrins (G. R. Lichtenstein. Current Research in Crohn's Disease and Ulcerative Colitis: Highlights from the 2010 ACG Meeting. Gastroenterology & Hepatology (New York), 2010 Dec; 6(12 Suppl 17): 3–14).