What is Crohn's disease?
Crohn's disease is an inflammatory bowel disease that can affect any part of the digestive tract - from the mouth to the anus - although it is more frequent in the final part of the small intestine (ileum) and the beginning of the thick (blind) . It belongs to a group of disorders known as inflammatory bowel diseases (IBD), which also includes ulcerative colitis.
What types are there?
The symptoms and possible complications of Crohn's disease differ depending on the part of the gastrointestinal tract that is affected. According to this criterion, there are five types of this IBD:
- Gastroduodenal Crohn's disease : affects the stomach and duodenum (the first part of the small intestine).
- Jejununoleitis : produces irregular areas of inflammation in the jejunum (the upper half of the small intestine).
- Ileitis : affects the ileum (the last section of the small intestine).
- Ileocolitis : it is the most common form of Crohn's disease and affects the colon and ileum.
Who is affected?
According to the Spanish Society of Digestive Pathology (EDPS), one in every 450 people suffers from an inflammatory bowel disease in our country, and specifically, Crohn's disease is the most prevalent of them, with more than 100,000 cases diagnosed in Spain, more or less the mitas of all those affected by those IBD. It is a condition whose prevalence rates have increased in recent years.
Crohn's disease affects men and women equally, although it occurs more in young people (up to 40 years); In fact, about one third of cases are diagnosed before age 20. It also exists in children and in other phases of life.
What causes Crohn's disease?
There does not seem to be a single cause that causes this pathology, but there can be several factors that trigger it or even the conjunction of them:
- Genetic factors . There are genes that, if present, increase the risk of Crohn's disease. In fact, 20% of people suffering from this disease have a relative - brother or sister, father, mother or son - with some type of inflammatory bowel disease.
- Immunological factors . Immune system disorders trigger an exaggerated and permanent response to food or bacterial agents.
Therefore, we can say that a person's genes and environmental factors seem to play a role in the development of Crohn's disease, since the body may be overreacting.
What are your symptoms?
The symptomatology of this pathology is very variable and normally alternates periods of appearance (outbreaks) and other periods of remission, as well as different intensities according to each patient.
In addition, also the area where the disease is located influences the type of discomfort it causes. A) Yes:
- If it is located in the small intestine, it usually causes diarrhea, abdominal pain, weakness, weight loss and lack of appetite.
- If it is located in the colon, diarrhea predominates, sometimes with blood.
- If it affects the anus more, the typical lesion is the fistula, abscess or ulcer , with its corresponding discomfort.
In addition, in each patient other digestive symptoms can be added, such as vomiting or intestinal obstruction or some dependent on anemia (weakness, joint pain ...).
What complications can it have?
Occasionally, Crohn's disease can lead to complications such as perforation or obstruction (blockage) of the intestine, considerable bleeding, stenosis, fistulas (abnormal bowel communications) or abscesses, among others. Rarely, colorectal cancer may develop.
How is it diagnosed?
The diagnosis of initial suspicion can be made by the attending physician through the patient's medical history and a general examination in which he determines abdominal tenderness, skin rash, inflamed joints or mouth ulcers. The blood test usually shows nonspecific alterations, such as increased sedimentation rate, as well as white blood cells and platelets. There may also be a shortage of protein, iron (anemia) and of B12 vitamins and folic acid. A stool culture can also help rule out other causes of diarrhea.
The diagnosis is confirmed by radiological studies (CT, ultrasound, intestinal transit), which offer information about the location and possible complications, such as abscesses, fistulas or stenosis. In addition, there are tests, such as colonoscopy that allows you to explore the intestinal mucosa and take samples to perform a biopsy.
Finally, in some cases a scan or nuclear test may be necessary, which allows you to assess the extent of inflammation.
How is Crohn's disease treated?
Gastroenteritis diagnosis is made from the patient's symptoms and, if necessary, a diagnosis is made
Crohn's disease is a chronic and uncured pathology, but treatment can help maintain the remission of symptoms over time, as well as prevent new outbreaks, reduce the duration of those that arise and relieve discomfort. Based on these objectives, three pillars can be established for the treatment of this disease, which also refer to aspects such as where it is located, level of severity and if there are problems associated with it or previous treatments:
- General measures : the patient must follow a complete and balanced diet, low in fat and fiber, to ensure proper nutrition. If there are deficiencies of vitamins and minerals (vitamin B-12, folic acid, vitamin C, iron, calcium, zinc, and magnesium) or if there is difficulty in taking a sufficient amount of food and obtaining the necessary calories, it may be necessary to identify and Correct these deficiencies with vitamin and nutritional supplements taken by mouth.
- Pharmacological treatment : in this part we have to differentiate two phases: the taking of medications during acute outbreaks, in which corticosteroids predominate; and the maintenance phase, in which other medications are taken.
- Surgery : it is estimated that about 70% of Crohn's patients should undergo an intervention throughout their lives. It is usually in cases where the medications do not work and a removal of the damaged or diseased part of the intestine is necessary or also for the drainage of an abscess. However, this intervention does not cure the disease, since the inflammation usually reappears near the surgery site.
10 tips to prevent Crohn's disease
Although Crohn's disease has no cure, taking care of food and avoiding some harmful habits can help the patient control outbreaks:1. Follow the treatment established by your doctor faithfully.
Don't leave it even if you feel good. And if you suspect that you have a relapse, go to the consultation as soon as you notice the first symptoms to see your specialist and restart the treatment if necessary.
2. Consult the use of certain drugs.
For example, always check with your doctor before taking a medicine for diarrhea, as well as for hemorrhoid treatment.
3. Be careful with taking painkillers.
Medications such as indomethacin, ibuprofen and naproxen can trigger a reactivation of the disease in some patients. Therefore, if you need pain relievers, choose to take paracetamol.
4. Eat a varied diet.
The nutritional aspect is key in this medical condition. The goal of your diet should be to prevent and correct malnutrition, as well as not worsen digestive symptoms (abdominal pain, diarrhea, ...). For this, it is important to follow a diet rich, but balanced in protein, calcium and iron.
5. Don't blame a food.
There is currently insufficient scientific evidence to point to a particular food triggering, perpetuating or worsening the inflammatory process of Crohn's Disease. Therefore, you should avoid only those that increase or worsen your symptoms repeatedly and systematically.
6. Yes to dairy and fiber ... in some cases.
Milk and dairy products are a great ally to prevent bone decalcification. Although the lactose of these products can cause diarrhea in some cases, it is better that the milk is lactose free. In addition, you can take fiber, through fruit, for example, except when buds appear, and keep in mind that the quince and banana squeeze and that the cherries and plums are laxative.
7. Stop smoking.
The risk of relapses and needing surgery is doubled in smokers compared to non-smokers. In addition, tobacco worsens the response to treatment and makes it difficult to maintain remission of symptoms.
8. Manage stress.
Your bowel problems may get worse if you fail to manage stress in problematic circumstances and times. Learning relaxation techniques, meditation or practicing disciplines such as yoga or tai chi can be very useful.
9. Travel prepared.
Do not give up travel either, but inform your doctor before leaving. He will advise you what medications you should take and what precautions to take.
10. Talk about your problem.
Many people with Crohn's disease sometimes feel very discouraged. When it happens, seek support in your family or friends. Patient associations can give good information and support.
