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Crohn's disease

Crohn’s disease, a digestive and debilitating disease

Highlighted in 1932 by Dr. Burrill Bernard Crohn, affecting the digestive system and its lining, Crohn’s disease is an inflammatory disease that is chronic (for a lifetime), regardless of age and gender (even if there is an age range that favors the development of this disease, namely young patients of 13 to 30 years old). Particularly affecting the large intestine also called the colon (specifically the end part of the small intestine, known as ileum) the disease can still affect any part of the digestive tract, including esophagus and anus.

The causes of this disease, a question for medicine

There are many factors and the medical community still has much trouble in identifying the real and exact cause of Crohn’s disease. Therefore, we cannot focus on a single cause of the disease’s onset. We can still note that certain factors stand out, the factors on which we have to focus:
  • The genetic factor that has been recently highlighted by researchers (after a study of the gene NOD2 / CARD15, a gene that increases the risk of disease in the carrier subject), the genetic provisions should not be considered as the sole cause triggering the disease.
  • The environmental factor is also an interesting factor to consider, which shows us that both the patient’s lifestyle (among others smoking, physical inactivity, poor or lack of physical activity, excessive use of antibiotics, poor diet) but also the action of certain bacteria or viruses have an impact on the disease onset.
  • The autoimmune nature of the disease. The body then defends against itself, more precisely against such viruses and bacteria naturally present in the intestine, considering them as foreign bodies so falsely harmful once the disease gets established.

Symptoms and consequences of Crohn’s disease

Crohn’s disease causes inflammation, swelling, chronic irritation of the walls and lining of the digestive tract. Therefore, the main symptoms (more or less serious), we can distinguish among most patients and which remain debilitating in everyday life, are:
  • Ulceration of the digestive tract
  • Anal fistula but also development of abscesses
  • Anal fissures
  • Constipation with possible obstructions of the bowel (requiring hospitalization)
  • Chronic diarrhea sometimes coupled with rectal bleeding (blood loss through the anus)
  • Presence of mucus in the stool
  • Fatigue
  • Fever
  • Anemia
  • Loss of weight and appetite (with vitamin deficiencies, more exactly the diseased area of ​​the intestine does not play its role of nutrients absorption)
  • Bloating
  • Sometimes severe abdominal pain and anal pain
  • Vomiting and nausea
  • Aphthous stomatitis, erythema nodosum (painful nodules under the skin in the legs), pyoderma gangrenosum (ulcers in the lower limbs)
  • Eye injury (blurred vision, tearing …)
  • Rheumatism
As the disease is chronic, the patient will go through disease remissions and crisis phases more or less severe, the latter being difficult to predict. However, it could have been noticed, in a large number of patients, that maintaining
Prevention of the disease
The patient can contact / go to a nutritionist to set up a healthy diet (and without fiber during flare-ups) to prevent too frequent recurrences (certain foods like red meat and dairy products tend to aggravate the disease). Similarly, quitting smoking and moderate alcohol consumption should be considered. The patient should make every effort to relieve and treat his/her digestive system, therefore anti-inflammatory drugs not approved by the doctor are not recommended. Patients affected by Crohn’s disease and pregnant women or those who desire to become pregnant should talk to their doctor, the risk of abortion or problems of fetal development but also an intrauterine growth restriction (of the fetus affected by the disease) are common.

Screening and treatments of Crohn’s disease

A multidisciplinary screening
After an initial consultation in order to check the patient’s general health status (the doctor identifying all the clinical signs that may indicate the disease), during a crisis and in order to confirm the diagnosis and to eliminate other diseases that may be closer to Crohn’s disease such as ulcerative colitis, the doctor will prescribe:
  • Laboratory blood tests in order to identify a patient’s anemia caused by blood loss but also an infection if the white blood cell count is high.
  • Laboratory stool analysis which shows the presence of blood in the stool, therefore an impaired intestine
  • More extensive and invasive tests such as colonoscopy, enteroclysis, entero-MRI or capsule endoscopy to explore the intestine using miniature cameras and perform biopsies if necessary.
Treatment of Crohn’s disease
It is preventive as we have previously seen with the monitoring of a healthy lifestyle but it is also curative based on drug treatment (anti-inflammatory drugs (5-ASA), immunomodulators, antibiotics (metronidazole …), cortisone, steroids, injections in the context of a biotherapy …); surgery is the last resort to significantly reduce symptoms by approaching the affected part of the digestive tract by resection of the latter, but it must be said, without suppressing the disease which can be controlled to improve the patient’s life but which cannot be cured of the disease.