This is a disease of chronic inflammation involving any part of the intestinal tract. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). It is relatively uncommon in the Asian population.
Crohn's disease is a chronic condition and may recur at various times over a lifetime. Some people have long periods with no disease, sometimes years, when they are free of symptoms. There is no way to predict when the disease can flare.
There are several types of Crohn's disease, classified based on the area of the digestive tract affected:
Symptoms of Crohn's disease can vary depending on the part of the digestive tract affected and the severity of inflammation. Common symptoms include:
There is no way to prevent Crohn's disease, but lifestyle changes can help manage symptoms and reduce flare-ups:
The cause of Crohn's disease is unknown. However, it is believed to result from a combination of various factors. These include an abnormal immune response, where the immune system mistakenly attacks healthy cells in the digestive tract, and environmental factors that may trigger inflammation. Genetic predisposition also plays a role.
The risk factors for Crohn's disease include:
These factors may contribute to the likelihood of developing Crohn's disease, but they do not directly cause it.
Crohn's disease is diagnosed medical history, physical examination and various tests to confirm inflammation in the digestive tract. The diagnostic process typically includes:
Initial treatment is with medication. The most common drugs used are steroids such as prednisolone, and various anti-inflammatory agents. The drugs do not "cure" Crohn's disease (there is no "cure" available yet), but the drugs are used to relieve its symptoms and may help to avoid recurrence.
In more serious cases, stronger drugs such as azathioprine, biologics or small molecules may be used. However, these drugs have more side effects and suppress the immune system, making the patient more prone to infection.
In more advanced or complicated cases of Crohn's disease, surgery may be recommended.
Emergency surgery is performed when complications, such as a perforation of the intestine, obstruction (blockage) of the bowel, or massive bleeding occur with Crohn's disease. Operations may also be needed in patients who do not respond to medication, patients with abscess formation, fistulas (abnormal communication from the intestine), and patients with severe anal disease.
Although drug treatment is used initially, up to three-fourths of patients may eventually require surgery. Surgery is not "curative," although many patients never require additional operations. A conservative approach is frequently taken at surgery, with only the diseased portion of the intestines being removed.
Surgery may provide long-term relief of symptoms, decreasing the need for medications. Surgical therapy is best conducted by a surgeon skilled and experienced in the management of Crohn's disease.
While Crohn's disease itself is not usually life-threatening, it can cause serious complications if not managed properly. These may include bowel obstructions, severe infections or malnutrition, which can require emergency medical treatment. Early diagnosis and proper management can help prevent these risks.
Stress does not cause Crohn's disease, but it can trigger or worsen flare-ups. Emotional or physical stress may aggravate symptoms, so managing stress through techniques like exercise, mindfulness or therapy can be an important part of symptom control.
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