Crohn’s Disease
Crohn’s disease is one among many digestive disorders in which the lining becomes inflamed. That inflammation produces ulcers (lesions or open sores in the lining) that produce abdominal pain and diarrhea. It is often progressive and leads to even more serious health consequences.
The cause(s) of the disease are not known, but an abnormal immune system response to a bacterium (known as MAP or Mycobacterium avium subspecies paratuberculosis) is suspected. Despite the lack of a clear cut culprit several risk factors are known. Diet and stress can affect the course and impact of the disease but have been ruled out as causes.
Genetics is near the top of the list, not surprisingly given the immune system response aspect of the disease. Roughly 20% of those with Crohn’s have a parent or close relative similarly afflicted. Those with an affected sibling are 30 times more likely to develop Crohn’s than the general population. Unlike many diseases, Crohn’s tends to occur in younger people, usually between the ages of 20-30.
The intestinal inflammation of the disease produces diarrhea by causing cells to secrete large amounts of salt and water. The colon is unable to absorb all this fluid (part of its natural role in the digestive system). The result is diarrhea.
One effect is swelling of the intestinal tissue and scaring as the ulcers heal. That results in less efficient movement of the chyme (the semi-fluid mass of digested food) through the colon. The effects are felt as cramping and abdominal pain. In more advanced or severe cases nausea and vomiting are common. Bloody stool is common, as well, as moving chyme causes inflamed tissue to rupture, allowing blood to flow into the colon. The ulcers can become enlarged, moving deep into intestinal tissue, worsening the problem.
The net result, apart from the pain, is often reduced appetite and unhealthy weight loss. The symptoms lead to a desire not to eat, but the weight loss is exacerbated by less efficient digestion of food. In extreme circumstances such low intake and absorption of calories and nutrients leads to many secondary consequences.
Diagnosis is fairly straightforward. Blood tests check for anemia and during a colonoscopy a physician can see the distinctive signs directly. A biopsy (tissue samples that can be removed during the procedure) are used to confirm the presence of Crohn’s.
A less invasive procedure known as a flexible sigmoidoscopy uses a lighted tube to examine only the lower two feet of the colon and rectum while a colonoscopy involves inserting a tube all the way into the intestine. It takes only a few minutes to complete.
A physician may recommend a barium enema as well. A safe, mildly radioactive barium fluid is introduced into the colon where it provides a contrast dye for an X-ray. The fluid coats the lining of the intestine to create a silhouette of the colon and rectum. In a variation, X-rays can also be taken if the patient ingests the barium fluid.
A more modern diagnostic procedure, known as capsule endoscopy, involves swallowing a tiny camera in the form of a pill, which makes its way down the digestive tract. It takes photos along the way, which the physician examines.
Unfortunately, there is no cure known for Crohn’s disease as yet, but drug therapy to reduce inflammation is a common treatment. Surgery has helped many afflicted by removing ulcerated tissue (sometimes sections of the bowel), reducing symptoms. Unlike ulcerative colitis, Crohn’s infected tissue may occur in spots with healthy tissue in between, not throughout an entire length. That allows for a more targeted repair of affected tissue.
