Gastrointestinal Diseases at a Glance (cont.)

About Crohn's Disease

Crohn's disease is a condition of chronic inflammation potentially involving any location of the gastrointestinal tract, but it frequently affects the end of the small bowel and the beginning of the large bowel. In Crohn's disease, all layers of the intestine may be involved and there can be normal healthy bowel in between patches of diseased bowel.

Symptoms include persistent diarrhea (loose, watery, or frequent bowel movements), cramping abdominal pain, fever, and, at times, rectal bleeding. Loss of appetite and weight loss also may occur. However, the disease is not always limited to the gastrointestinal tract; it can also affect the joints, eyes, skin, and liver. Fatigue is another common complaint.

The most common complication of Crohn's disease is blockage of the intestine due to swelling and scar tissue. Symptoms of blockage include cramping pain, vomiting and bloating. Another complication is sores or ulcers within the intestinal tract. Sometimes these deep ulcers turn into tracts—called fistulas. In 30% of people with Crohn's disease, these fistulas become infected. Patients may also develop a shortage of proteins, calories, or vitamins. They generally do not develop unless the disease is severe and of long duration. Until recently an increased risk of cancer was thought to exist mainly for ulcerative colitis patients, but it is now known that Crohn's patients have an increased risk of colon cancer as well.

The five groups of drugs used to treat Crohn's disease today are aminosaliclylates (5-ASA), steroids, immune modifiers (azathioprine, 6-MP, and methotrexate), antibiotics(metronidazole, ampicillin, ciprofloxin, others) and biologic therapy (inflixamab). Two-thirds to three-quarters of patients with Crohn's disease will require surgery at some point during their lives. Surgery becomes necessary in Crohn's disease when medications can no longer control the symptoms.

SOURCES:

CDC

Loftus EV. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastro May 2004;126(6):1504–1517.

PL Lakatos. Recent trends in the epidemiology of inflammatory bowel diseases: Up or down? World J Gastroenterol 2006 October 14;12(38): 6102–6108.

S Hanauer. Inflammatory Bowel Disease: Epidemiology, pathogenesis and therapeutic opportunities. Inflamm Bowel Dis Jan 2006;12, Suppl 1.

Sleisenger & Fordtran's gastrointestinal and liver disease : pathophysiology, diagnosis, management / [edited by] Mark Feldman, Lawrence S. Friedman, Lawrence J. Brandt.—8th ed. Publisher Saunders an imprint of Elsevier, Philadelphia, PA . Printed in Canada 2006.