Diseases

Crohn’s disease (chronic intestinal inflammation) – causes, symptoms & treatment

Crohn’s disease (chronic intestinal inflammation)

Crohn’s disease is a chronic intestinal inflammation in the gastrointestinal tract or digestive tract. This leads to typical episodes of discomfort and symptoms, such as diarrhea, painful stomach cramps and severe weight loss. However, these symptoms are initially unpsecific, so Crohn’s disease is not always diagnosed first. Therefore, if chronic intestinal inflammation is suspected, the doctor should always perform a colonoscopy, X-ray, laboratory tests and ultrasound in diagnosis and treatment.

What is Crohn’s disease?

Crohn’s disease (chronic intestinal inflammation) is, along with ulcerative colitis, one of the chronic inflammatory bowel diseases that often occurs in episodes of disease. The frequency peak is between the ages of 16 and 35. In older people over 60 years, it can come to a so-called age Crohn. There is a familial accumulation, overall the incidence of the disease is increasing.

The symptoms are often non-specific (crampsnauseaweight loss), even courses without the directional diarrhea are possible. Characteristic is the formation of granulomas in the intestinal wall. Unlike ulcerative colitis, Crohn’s disease can occur throughout the gastrointestinal tract, from the oral cavity to the rectum. Often there is a discontinuous infestation, i.e. affected sections are interrupted by healthy intestines.

Typically, however, is the involvement of the last section of the small intestine, the terminal ileum. Complaints outside the gastrointestinal tract are common, usually joint pain and joint inflammation, painful skin changes or eye symptoms. The diagnosis is made by a colonoscopy (colonoscopy) with the removal of tissue samples.

Causes

There is much speculation about the causes of Crohn’s disease (chronic intestinal inflammation), none of the theses has yet been proven. Only smoking has been identified as a risk factor. Currently, Crohn’s disease is classified as an autoimmune disease. This classification is by no means secured, only the good response to immunosuppressive therapy is based on it. It is also suspected that those affected have a barrier disorder of the intestinal wall, so that bacteria can penetrate unhindered and provoke a partially excessive defense.

A genetic component is also discussed because of the familial accumulation. It is unclear whether excessive hygiene, nutritional conditions or infections with mycobacteria play a decisive role. For a long time, Crohn’s disease was considered a psychosomatic illness. This has now been refuted as the sole cause, although a psychosomatic influence can be assumed. Thus, the severity of the disease and relapse frequency is significantly increased in stressful times.

Symptoms, complaints & signs

Crohn’s disease is characterized by long-lasting watery diarrhea and colicky pain in the right upper abdomen. As a rule, no blood or mucus is added to the stool. The symptoms occur intermittently. There may be long intervals between each flare-up. However, the symptoms can also intensify during a relapse if there are also allergies or intolerances to certain foods.

Such food allergies or food intolerances are more common in patients with chronic inflammatory bowel diseases such as Crohn’s disease. As a result of the numerous diarrhoea, further symptoms can develop, which are due to the high protein and fluid loss. It often comes to fatigue and fatigue.

Furthermore, there is loss of appetite, which in turn can lead to a strong weight loss. Due to the malabsorption of nutrients in the intestine, various deficiencies can develop. Typical is a vitamin B deficiency, which can be the cause of anemia. During a relapse, there is usually a general feeling of illness.

Thus, in addition to the symptoms of anemia, fever and an increase in white blood cells can occur. Other organs can also be affected. Among other things, symptoms of hepatitis, , joint pain, bone resorption, eye inflammation or painful skin diseases are observed in about 40 percent of patients with Crohn’s disease. Often the high disease activity causes psychological problems, which manifest themselves, among other things, in depression.

Complications

Since Crohn’s disease damages the tissue of the digestive tract in the long term through inflammation, fistulas occur. Depending on how they run and whether they cause an unintended mixture of substances in the body, they must be surgically removed. The same applies to developing ulcers.

In the worst case, these can degenerate and lead to tumor formation. The risk of tumor diseases in the area of the digestive tract is increased. An intestinal obstruction occurs at least once in up to 30 percent of those affected and represents an acute emergency. Severe narrowing of individual intestinal sections also occurs. Both entail operations.

Inflammatory abscesses in the various parts of the digestive tract – especially the intestines – also occur. They can also cause severe inflammation and lead to symptoms of poisoning if opened mechanically. In addition, the impaired absorption capacity of the intestine, in combination with the occurrence of diarrhea, often leads to deficiency symptoms and metabolic imbalances.

In addition to general exhaustion, this also leads to problems in the bone tissue (osteoporosis; also promoted by cortisone therapy of the disease) and other tissue weaknesses. Urinary stones are also common. In addition, a protein deficiency can set in, which is unfavorable for the entire cell preservation of the body.

Because people with Crohn’s disease should avoid certain foods, there is often an undersupply of certain nutrients, which must be compensated for with medication or the administration of dietary supplements.

When should you go to the doctor?

Diarrhea, pain in the stomach or intestines and unwanted heavy weight loss must be examined by a doctor. Before taking an analgesic drug, it is always advisable to consult a doctor because of the possible risks and side effects. The episodic occurrence of symptoms is characteristic of the disease.

Between the phases, the affected person experiences a period of freedom from symptoms, which in some patients can cover several months or years. Nevertheless, a doctor’s visit is necessary so that extensive medical tests can clarify the cause and thus make a diagnosis. An increase in existing irregularities during a relapse should be presented to a doctor as soon as possible, as they contribute to a severe impairment of the quality of life.

In case of fatigue, fatigue, loss of appetite and internal weakness, a doctor’s visit should be made. If there are intolerance reactions of the organism during food intake or if inflammation occurs, a doctor’s visit is advisable. In the case of joint pain, eye complaints, kidney stones or hepatitis, Crohn’s disease may be the cause. Therefore, a doctor is needed to order further examinations. Irritability, inner restlessness and psychological abnormalities are also signs of an existing health disorder. A visit to the doctor is recommended as soon as the symptoms persist for several days or weeks.

Treatment & Therapy

In the acute phase of Crohn’s disease , the intestine is relieved by parenteral nutrition. The use of Cortisone is medicinal in the first place.

This can be used either systemically or, in the case of deep infestation, as an enema or rectal foam. Alleviation of the symptoms is the rule, often even a reduction in the symptoms of the disease can be achieved. Salazosulfapyridine and mesalazine can also be used, but their effectiveness is relatively low.

Immunosuppressants and TNF-alpha blockers are used for remission therapy (i.e. to prevent new flare-ups). A maintenance dose of cortisone is often unavoidable.

Surgical therapy should be as economical as possible and usually limited to the treatment of complications. Indications are, for example, narrowing of the intestine (stenoses) to the point of intestinal obstruction, breaking through the intestinal wall (perforation), tunnel formation between intestinal loops, to other organs or to the skin surface (fistulas), inflammatory melting (conglomerate tumor) and abscesses.

Psychological, stress management and body perception therapy is also recommended.

Outlook & Forecast

Crohn’s disease has very individual prognoses, but is always a lifelong condition for all those affected. With increasing age, it is the case for many people that complaints and relapses become rarer. About a third of those affected experience Crohn’s disease as a relapsing ailment with intervening freedom from symptoms. This freedom from symptoms can sometimes last for months. In about one fifth of all those affected, however, chronic intestinal inflammation manifests itself as a permanent condition without phases of improvement.

It has been shown that about half of patients with Crohn’s disease experience at least one severe flare-up within a year. Within two years, it is up to 70 percent. Important factors regarding a possible resurgence are diet and lifestyle habits. Cigarettes and alcohol usually aggravate inflammatory symptoms. A specific diet is not currently recommended. However, deficiency symptoms can occur due to the weak intestine and should be compensated for a better prognosis.

Necessary operations worsen the quality of life for some sufferers. Likewise, about one third of sufferers develop inflammation in other parts of the body, such as the eyes or bones.

Lifelong therapy as well as possible stress on the body through surgery and frequent inflammation slightly reduce the life expectancy of Crohn’s disease patients.

Prevention

Since no cause for Crohn’s disease has been confirmed to date, specific prevention is not possible. Only risk factors can be avoided (especially smoking).

Complications can be avoided or delayed by early diagnosis and subsequent adequate therapy. The prevention of deficiency symptoms as a result of impaired absorption from the intestine (e.g. deficiency of fat-soluble ,osteoporosis due to calcium deficiency, massive weight loss due to fat loss via the intestine) is one of the building blocks in the treatment of Crohn’s disease.

Aftercare

In Crohn’s disease, follow-up examinations and treatments are extremely important components of the course of the disease. They essentially contribute to dealing with and living with the disease. Due to the chronic course, the disease can spread and affect other regions of the gastrointestinal tract. Through follow-up examinations, foci of inflammation can be localized at an early stage.

Furthermore, the follow-up examinations also serve colorectal cancer screening. An endoscopy of the intestine can thus detect changes and diseases in the large intestine and at the end of the small intestine. In this way, the attending physician always keeps an eye on the patient’s risk of developing colorectal cancer. Patients with Chron’s disease are usually involved in appropriate therapy programs.

This includes ongoing advice on nutrition and a healthy lifestyle. Thus, a balanced, healthy and individually tailored diet can be sustainably helpful. Sports activities and dealing with stressful situations also play a decisive role for patients with Chron’s disease in coping with everyday life.

The aim of the follow-up treatment is to achieve a remission phase that lasts as long as possible, in which the patient is doing well as far as possible. Talking to a psychotherapist about the illness is also helpful. The exchange with other Crohn’s disease patients in the context of self-help would also be advantageous.

What you can do yourself

Adhering to the treatment plan prescribed by the doctor is extremely important in the treatment of Crohn’s disease. To avoid complications, the dosage of the medication must not be changed arbitrarily, even if the symptoms improve.

Stress can worsen the symptoms, so there should be room for regular breaks in everyday life. Learning relaxation techniques and exercising while taking your own performance into account can also contribute to an increase in well-being. Tuxedo has a negative effect on the course of the disease and should be avoided.

Eating habits play a major role: it is advisable to keep a food diary to identify intolerable foods – these must be consistently eliminated from the menu. Occasionally, a change in the way of preparation helps to improve tolerance: raw vegetables, for example, trigger symptoms much more often than cooked ones. Particular attention should be paid to adequate nutrient intake, as these are difficult to absorb from food due to chronic intestinal inflammation. Some Vitamin and minerals , including calcium and vitamin D , which are important for bone health, may need to be taken in the form of an appropriate dietary supplement after consultation with the doctor treating you.

Detailed information about the disease and the limitations and opportunities associated with it can help to accept the disease more easily – exchange in a self-help group often contributes to this.

 

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.