Description of Crohn’s disease
Crohn’s disease is a chronic inflammation of the digestive tract, typically the small intestine (50%), less frequently colon (30%) and more rarely the esophagus and oral cavity (5%).
This disease arises from immune process and genetic predisposition. The triggering factors can sometimes be a bacterial or viral infection. Effect is usually between 20th to 40th year.Occurrence was demonstrated more in women than in men and demonstrates considerable geographic differences. Particularly in the industrialized countries of the northern hemisphere as Crohn’s disease significantly more frequent. In recent years, undoubtedly increasing in our country of 100,000 inhabitants had become ill about 20 people.
Prevention and risk factors for Crohn’s disease
Against this disease unfortunately there is no guaranteed prevention.
It is considering the harmful effects of the diet with excess refined sugars and lack of soluble fiber, which could thus disrupt the natural composition of the intestinal flora.
A similar effect has frequent use of antibiotics.
Acute worsening or exacerbation of diseases caused by smoking, the use of NSAIDs (Brufen, Aspirin, diclofenac, …) and hormonal contraceptives.
People whose families are Crohn’s disease occurs, should be monitored for gastroenterological workplaces that any outbreak of the disease caught early. They have a much higher risk of the disease. The only way to prevent more severe disease course, is to notice the early symptoms and do not underestimate them. Plenty of patients had come to the doctor after several years when no treatment can develop complications.
Signs and symptoms of Crohn’s disease
The disease is usually chronic, with alternating periods of flare periods when the patient without difficulty.
Most patients with ignition period characterized by mild to moderate disease activity. Patients haveabdominal pain, protracted diarrhea, mild temperatures, they feel more tired and lose weight. It can appear vomiting, convulsions, respiratory arrest gases and rarely blood in the stool, that is typical rather for others, although very similar pelvic inflammatory disease – ulcerative colitis.
If these problems for some time, repeated several times, is not a good attribute is an error in catering or worse digestion. I prefer to see your doctor and he will recommend some tests. Better to come early disease and begin to treat it or eliminate it and thus unnecessarily torment.
In some patients, symptoms dominate in other areas of the body. It can be a pain in the joints,kidney and gallstones, inflammation of the iris of the eye and the supporting apparatus or askin condition called erythema nodosum.
Examination of Crohn’s disease
The task of the physician in the diagnosis will differentiate this disease from ulcerative colitis,which looks very similar and assumes her and a similar mechanism of formation. Ulcerative colitis never affects the small intestine.
Diagnosis is determined primarily on the basis of clinical symptoms, colonoscopy and X-ray. In rare cases (5-10%), disability colon fails to determine with certainty which of these two diseases it actually is. Crohn’s disease may be acute, in its early days appear as appendicitis, which, however, easily distinguish.
Treatment of Crohn’s Disease
What entails the treatment of Crohn’s disease? Above all, it is a long term, as well as the period improvement of the condition requiring maintenance doses. Selecting therapeutic strategy depends on the localization process, the extent of involvement and disease activity.
It is generally recommended sparing regimen physical activity by individually assessed by the overall condition. It does not mean that you will permanently bedridden, but that you need to avoid sports and physically demanding activities. Sometimes you because the disease will require a change of employment.
Furthermore, it is appropriate diet represented by all the nutrients and energy proportionate to restrict physical activity. In severe cases of outbreaks of illness serves chemically defined food probe directly into the small intestine, so as not to burden the mechanical processing. Extreme option is to parenteral nutrition, which is completely bypasses the digestive tract and the patient gets all the nutrients, vitamins and minerals into the venous system.
For those forms of the disease, which means inflammation of the digestive tract narrows, you must be careful to coarse indigestible food residues (eg. The pulp of oranges, grains, husk). It’s also a good idea to track which foods can aggravate the problem and those to avoid. The positive effect may be contrary unsaturated fatty acids contained in fish.
The doctor prescribes usually mesalazine (asacol, Pentasa, Salofalk) which is 5-aminosalicylic acid, which has anti-inflammatory effect, and thus interferes with the immune processes responsible for causing the disease. They act mainly locally, so the physician chooses a form of the drug, so that the active substance is released only at the site where the localized inflammatory process.They can be therefore suppositories and enemas, but more frequent administration of tablets.Mesalazine is used in lower doses and in the retreat of disease activity.
Some doctors prescribe sulfasalazine (Salazopyrin, sulfasalazine), but this drug is a rather past as an increased incidence of adverse reactions.
In severe disease progression are administered corticosteroids (e.g. prednisone) of the impingement higher dose, which is gradually reduced. Given the wide range of side effects they are not suitable for maintenance treatment. They can add to them immunosuppressants(azathioprine, cyclosporine, …), thanks to which dose corticosteroids reduced. Their effect will be seen after 6-8 weeks of therapy, it should be borne in mind that we did not expect an immediate therapeutic effect and remain patient.
For maintenance therapy, your doctor may prescribe probiotics also (Mutaflor, Santax S, Enterol).They are live microorganisms acting favorably on human health, and recently also showed a positive effect in the treatment of intestinal inflammations.
If problems arise (blockage of the intestine, inflammation spreading through the fistula to other organs, etc.) or other treatment does not help, you need to undergo surgery. The surgeon removes the affected part of the intestine, which sometimes requires Bringing the end of a healthy intestine through the abdominal wall with the introduction of the stoma, but unfortunately even that does not guarantee a cure. Operation over the years, eventually undergo about half of patients.
The prognosis of Crohn’s disease is therefore quite unpredictable. The disease can deteriorate over the years, or remained stable with mild activity. Sometimes it can lead to full recovery, sometimes the disease reappears. It is important to respect medical measures.
Future treatment and prevention of Crohn’s disease
Regarding the development of new drugs, the future belongs to the biological treatment. Its first promising candidate to become anti-tumor necrosis factor (anti-TNF-alpha) – Ramicade or Humira which have helped a number of patients whose other drugs worked. Yet it remains 10-20% of patients who neither this treatment would not improve.
When it is not possible to achieve control over the treatment of these diseases, there is a tendency to deal with the prevention and eliminate any risk factors. Attention has recently focused next treatment therefore on research extrinsic factors such as smoking, which recent studies worsening of disease severity and related to its higher activity.
Examines the effect of preservatives in foods, the effect of insecticides, pesticides and industrial pollution, frequent use of antibiotics, microclimate. The results of these studies are not yet clear.
Other Names: Crohn’s disease, ileitis terminalis, terminal ileitis, Crohn’s disease, chronic inflammatory bowel disease, enteritis regionalis, regional enteritis, ileokolitida, Crohn’s colitis, inflammatory bowel disease, Crohn’s disease
