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Crohn’s disease is a type of inflammatory bowel disease, other type being ulcerative colitis. Crohn’s disease causes inflammation and irritation in the digestive system and lasts lifelong; however it may have weeks or even years of calm periods. It may affect any part of the digestive system, from mouth to anus. However, most commonly affected sections are the end of small intestines and start of large intestine (colon). Disease progression is generally slow and it may worsen over time.
Symptoms of Crohn’s disease can be confused with ulcerative colitis rather frequently. These two diseases have very similar symptoms; however, there are three main differentiating characteristics.
Experts are yet to find the exact cause of Crohn’s disease. However, many factors are believed to play a role in the development of the disease.
Crohn’s disease is not thought to be caused by any nutrient or stress.
Symptoms may vary depending on the location and severity of the inflammation. Development of Crohn’s disease in children can be slower.
Diagnosis of Crohn’s disease can be difficult sometimes as it may have similar symptoms with other diseases. If physical examination and laboratory tests (blood, urine and stool) indicate a suspected Crohn’s disease, doctors may refer their patients to a gastroenterology specialist for definitive diagnosis.
There is no definitive treatment for it, however, there are treatment options that can control or reduce the symptoms. Treatment is planned depending on the severity and symptoms of the disease. Main treatment options are:
Drugs that suppress the inflammation in the bowel mucosa are generally used. One or multiple drugs may be prescribed depending on the severity of the disease. Patients may need to use these drugs for a long time.
These drugs are used for the treatment of mild symptoms. Long-term use may be required. Aminosalicylates may have side effects like diarrhea, headache, heartburn, nausea and vomiting, and abdominal pain.
Steroids help reducing the immune system activity and inflammation. They are prescribed for patients with moderate and severe symptoms. They must be used with caution due to their side effects. Its side effects include weight gain, indigestion, sleep problems; slow development in children, bone mass loss, acne, high blood sugar, high blood pressure, infection possibility, and complicated state of mind. Doses may be increased in periods of exacerbation.
These drugs reduce the immune system activity and leads to lesser inflammation in your digestive system. They are prescribed to help improving the symptoms or when the patient is not responsive to other treatment options. This group of drugs may cause serious side effects due to their strong immune system suppression.
They may have side effects like higher infection risk, fatigue, complicated state of mind, getting or feeling sick, nausea and vomiting, pancreas inflammation and liver problems. Therefore, decision to use these drugs must be taken cautiously.
If other drugs cannot help, more powerful medication called biological drugs may be necessary. Biological drugs are proteins that prevent the inflammation in the body. Generally they are injected intravenously once in every two to eight weeks. They may side effects like itchiness, joint pain, high fever, and high infection and tuberculosis risk. In some cases, such as treatment of abscess around rectum and fistula, antibiotics may be prescribed.
If the symptoms of Crohn’s disease are severe, it must be necessary to rest intestines for a few days to weeks. There are three approaches for this method:
Enteral nutrition (liquid diet) is the nutrient intake instead of a normal diet through a special liquid that contains all necessary nutrients. Patient is fed this way for a several weeks. This method can be helpful in for reducing the symptoms of Crohn’s disease in children and young adults, and prevents development risk that may arise in case of steroid use.
Surgical intervention may be required for Crohn’s patients in some cases. Those cases are:
Main operation used for Crohn’s disease is called resection. Resection is the removal of the diseased part of an organ. In the surgery, small incisions are made to the abdomen using the keyhole method (laparoscopy). Inflamed segment of the intestine is removed and healthy segments of the intestines are sewn together.
This method is applied in the presence of intestinal stricture. Stricture is removed without any bowel loss. However this surgery may not be suitable for all patients. Most of the time, surgeries are performed under general anesthesia.
Approximately one-week long hospitalization may be necessary and full recovery can take several months. Sometimes ileostomy (connecting the bowel to a pouch) can be required. As there is no definitive cure for Crohn’s disease, patients who undergo surgery have a high risk of relapse, even after many years.
Patients may undergo emergency surgery in case of obstruction or perforation of the intestine, uncontrolled intestinal bleeding or ceased intestinal motility.
Crohn’s disease in the large intestines may lead to an increased risk of colon cancer. If treatment is received for Crohn’s and the disease is controlled, than colon cancer risk can be reduced. In addition, having regular cancer screenings will increase the likelihood of early diagnosis and treatment success.
There are “good” bacteria in your digestive system that helps digestion and provides protection against “bad” bacteria. If you are using antibiotics, the number of these good bacteria will be reduced. Probiotics are live microorganisms that you intake and they are very similar to the good bacteria in your intestines.
You may have these through certain foods or use probiotic supplements. Probiotics can be less or more beneficial depending on the location and stage/severity of your disease. Although yoghurt is one of the most common probiotic sources, many Crohn’s disease patients are sensitive against dairy products. However, cabbage pickle and kefir are among probiotic-containing nutrients.
Prebiotics are food for probiotics and intestinal bacteria. Adding prebiotics to your diet can increase the functions of your normal intestinal bacteria. Using probiotics in combination with prebiotics can render probiotics more effective. Prebiotics are indigestible carbohydrates. Artichoke, honey, whole-wheat grains, banana, onion and garlic are prebiotic-containing foods.
Fish oil has been in use for many years to improve cholesterol health; however, recent studies claim that it is helpful for Crohn’s disease patients as well. Omega-3 fatty acids contained in fish oil has anti-inflammatory characteristics and can be helpful for reducing Crohn’s symptoms. Consult your doctor before starting on fish oil supplement. High doses of fish oil or using with blood thinner drugs can cause bleeding problems.
Slippery elm is a transparent herbal medicine. It protects irritated tissues and supports their healing process. Slippery elm contains a substance called mucilage that turns into a greasy gel when mixed with water. This substance provides relief to mouth, throat, stomach and intestines, and this improves Crohn’s symptoms.
Other herbal remedies helpful to alleviate the symptoms of Crohn’s disease are:
Consult your doctor before trying herbal remedies. Some of them may dangerously react with your medication. In addition, they may cause unwanted side effects.
References: 1- Crohn's disease 2- Causes of Crohn’s Disease 3- Crohn disease