Crohn’s disease is an immune-mediated serious illness of a chronic nature of unclear etiology, which has many pathological manifestations, the main of which is inflammation of the entire gastrointestinal tract.
It is quite rare, but every year 2-3 people out of 1000 become infected with it. What are the causes of the disease, symptoms, primary manifestations and how to treat it? This and many other issues concerning this topic will now be discussed.
Causes
As already mentioned, the etiology of this disease is not fully understood. But scientists have identified several factors that are provocative. Among them:
- Genetic predisposition. So far, a direct relationship with one or another HLA antigen has not yet been clarified. Only a mutation of the CARD15 gene was registered in most cases, which is responsible for encoding a protein with a caspase activation domain.
- Heredity. According to statistics, most often homozygous twins and siblings are prone to Crohn's disease, the symptoms of which will be discussed further. Also, in 17% of reported cases of the disease, people had blood relatives who also suffered from them.
- Infectious factors. It is believed that the disease has a bacterial or viral nature. Experiments have revealed that its development is affected by the pathogenic bacterium Mycobacterium avium paratuberculosis, which also causes Jone’s disease in animals (including primates). However, this is only a theory, not yet 100% proven.
- Immunological factors. The fact that with Crohn’s disease occurs systemic organ damage, made scientists think about the autoimmune nature of the disease. The theory is not formulated from scratch. In patients, an increase in T-lymphocytes, the appearance of antibodies to cow's milk protein, E. coli and lipopolysaccharides are indeed recorded. And during periods of exacerbation, immune complexes appear in their blood. Perhaps, some specific antigen leads to such consequences.
It should also be noted that most often this disease occurs among residents of North America and Northern Europe. He is most susceptible to people aged 15 to 35 years.
What happens with an illness?
This is the main question. Before proceeding to consider the symptoms of Crohn's disease, it is necessary to tell about the processes that occur in the body during its course.
Partial organ damage is characteristic of this ailment. It can affect areas from a couple of centimeters to several meters. And the focus in this case can be localized in absolutely any area of ​​the digestive tract.
But, according to statistics, in 75-80% of cases, the disease affects the small intestine. In the remaining 25-20% - the large intestine, esophagus and stomach. However, this is a conditional statistic, since usually the lesion has a combined character. For example, the disease spreads to most of the small intestine and to a small segment of the colon.
As a rule, the lesion is intermittent. After the affected area follows normal, then again affected, etc.
Symptoms of Crohn's disease include the following:
- Erosion of various forms.
- Stenoses. So-called narrowing, in which a segment of the intestine becomes hard and thickened.
- Ulcers of different depths. They are also intermittent. Ulcers alternate with normal mucous membranes. By the way, doctors call this sign “cobblestone pavement”.
- Fistula. This is the name of the pathological hole - a channel that forms a message between tissues and different organs.
- Lymphatic edema.
- Inflammation of the entire intestinal membrane.
- Epithelial granuloma. This inflammation is accompanied by the appearance of plaques consisting of a mass of cells of epithelial origin.
Many of the listed manifestations of the disease can only be seen with an armed gaze. Over time, they develop, lesions spread. Therefore, it is very important to consult a doctor on time, not ignoring the symptoms that you can feel. They will be discussed now.
Symptoms
They can be divided into general and local (local). The first category of symptoms of Crohn's disease include:
- Unreasonable weight loss. If the form of the disease is severe, then losing weight can be significant - from 10 kg.
- Fatigue and weakness.
- Stable, slightly elevated temperature, usually not exceeding 38 ° C.
- Minor skin lesions, manifested in inflammation and redness.
- Eye diseases - conjunctivitis, uveitis.
- Pain in the joints (arthralgia) and muscles (myalgia).
- Vascular inflammation, manifested in vasculitis.
- Blood clotting disorder, accompanied by the formation of blood clots.
Local symptoms of Crohn's disease in adults are much less, but they appear more often than general ones. These include:
- Pain in the abdomen. May have different intensity and nature of manifestation. Usually they are cutting or aching. As a rule, intensify after eating. Also often accompanied by bloating.
- Diarrhea. How strongly it is expressed depends on the strength of the intestinal lesion.
- Stool with blood.
- Purulent organic inflammation of the rectum (abscesses).
These are the most common symptoms of Crohn's disease in adults. If at least a few of them appeared and do not pass, then you must urgently consult a therapist or immediately a gastroenterologist.
Degrees of activity and course of the disease
This should also be briefly described, since we are talking about the symptoms of Crohn's disease (in the photo above you can see which parts of the body are affected most often). In total, three degrees of the course of the process are identified. For the initial, easy, such manifestations are characteristic:
- Diarrhea, attacks of which can disturb up to 4 times a day.
- A stool in which there is sometimes an impurity of blood.
- Temperature not exceeding 37.5 ° C.
- The pulse does not go beyond the norm.
For an average degree, similar manifestations are characteristic:
- Attacks of diarrhea occur at least 6 times a day.
- There is always blood in the stool.
- The pulse is held at 90 beats per minute.
- There may be complications, which will be discussed later.
And finally, a severe degree of the disease is manifested by the following symptoms:
- Attacks of diarrhea occur more than 10 times a day.
- The impurities of blood present in the stool are clearly visible.
- The temperature reaches 38 ° C.
- The pulse exceeds 90 beats per minute.
- New complications appear.
The nature of the course of bowel disease (Crohn), the symptoms and treatment of which is now in question, depends on the degree of damage. Usually, the pathology proceeds with regular exacerbations and partial remissions.
According to statistics, 30% of patients after recovery within 12 months experience exacerbation. At 50%, it occurs in the next 2 years. In the other 20%, everything is individual. If the treatment is poor, then remissions will be reduced, and the symptoms will intensify.
Intestinal perforation
This is one of the complications that occurs if you do not pay attention to the symptoms of Crohn's disease. The intestine is a very sensitive area, and perforation is a fatal pathology for it. It develops due to a violation of the mucous membrane.
In simple terms, a through hole appears in the intestinal wall, which is not normal. Through it, intestinal juice and feces enter the abdominal cavity, as a result of which peritonitis develops. This is an inflammation of the visceral and parietal peritoneal sheets, accompanied by a severe condition of the body.
Symptoms that indicate perforation of the intestinal wall include:
- Desires for vomiting and nausea.
- Intoxication of the body (sensations, as with severe poisoning).
- Tension of the abdominal wall.
- Intolerable pain in the abdomen, especially on the left side. May give to the shoulder.
- Blood in stool and urine.
- Lack of appetite.
- The intestine works without its inherent sounds.
- Diarrhea.
- Weak heartbeat.
Peritonitis has similar symptoms. Additional signs include dehydration, sudden weight loss (especially of the face), dry mucous membranes, and even confusion.
If problems are not resolved in time and emergency treatment is not started, a person may die.
Intestinal obstruction
Considering the topic related to the symptoms and treatment of Crohn's disease, it is necessary to talk about this complication. Intestinal obstruction is as much as 3.8% of all emergency conditions in abdominal surgery.
This is a serious pathology, manifested in a violation of the movement of semi-digested food masses along the digestive tract.
Obstruction may be enteric or colonic, partial or complete, chronic or acute, acquired or congenital.
Like many other diseases, it has several stages. In an early person, only local abdominal symptoms and pain are disturbing. Then the stool delay begins to make itself felt, the asymmetry of the abdomen, bloating, the gases cease to flow. At the last stage, hemodynamics are disturbed and peritonitis develops. All stages pass very quickly - from 2 to 36 hours.
Disease in children
It is found quite often. Symptoms of Crohn's disease in children are more often manifested in adolescence. Unfortunately, the quality and life expectancy of those who have had this illness in childhood is significantly reduced. Based on this, scientists concluded that this ailment makes a certain contribution to the structure of childhood disability and mortality.
In children, symptoms of Crohn's disease and treatment are almost similar to adult cases. Only the dosage of the drug is selected in accordance with the age of the child.
Unfortunately, this ailment in children is most often chronic. Long-term remissions are not uncommon, but the prognosis is not always favorable. Therefore, the child must be taken to regular examinations and registered with a specialist.
Diagnostics
This topic also needs to be addressed. If symptoms of Crohn's disease are present, diagnosis should be performed.
First of all, the doctor collects an anamnesis. He clarifies the symptoms, finds out the patient's age, family diseases, the presence of other pathologies and other nuances.
After this, a visual examination is performed, which includes the study of the mucous membranes and skin, palpation of the abdominal cavity and palpation of the lymph nodes. All this is necessary to exclude ailments that are similar in symptoms to Crohn's disease. There are a long list of such, including dozens of items.
Then, after the initial diagnosis of the symptoms of Crohn's disease in adults, the patient is prescribed a referral to the following procedures:
- Endoscopic examination. It will help to visually confirm the diagnosis and take materials (biopsy) for examination under a microscope. Moreover, sampling is performed in different departments of the digestive tract.
- Colonoscopy This procedure makes it possible to compile a complete picture of the state of the large intestine. Using an endoscope immersed inward to assess the surface, it is possible to detect the presence of ulcerative formations, bleeding or inflammation.
- Ultrasonography. With its help, you can find out if there is free fluid in the abdominal cavity and what is the diameter of the intestinal loops. This allows you to diagnose complications, in particular - the notorious perforation and peritonitis.
- Fluoroscopy. This procedure helps to detect narrowed areas or areas affected by granulomas. Other neoplasms can also be detected using fluoroscopy.
- Laboratory research. Conducting biochemical and general analyzes is the most popular, simple and common way to detect a particular disease. This case is no exception.
After a thorough study of the results obtained during the above procedures, the doctor explains the situation to the patient, and then he voices the recommendations and prescribes treatment.
Symptoms of Crohn's disease are considered, so that we can proceed to the study of information regarding how to get rid of it.
The list of effective medicines
After identifying signs and symptoms of Crohn's disease in adults, only a doctor can prescribe treatment. As a rule, the following drugs are prescribed:
- Sulfasalazine. More common under the name "Azulfidine." It has anti-inflammatory effect. Also popular are analogues - Salazodimethoxin, Salazopyridazine and Salazopyrine. Take before meals four times a day, drinking plenty of water. The daily norm is 1-2 grams during the period of exacerbation. After improving the patient's condition, the dosage is reduced to 0.5 g.
- "Methylprednisolone." A powerful drug with a wide spectrum of action. It has a desensitizing, immunosuppressive, anti-inflammatory, anti-toxic, anti-shock and anti-allergic effect. The daily dose varies from 0.004 to 0.048 grams, depending on the severity of the disease.
- Mesalazine. This is 5-aminosalicylic acid, available in various forms. During exacerbations, take 0.4-0.8 grams per day, dividing this amount into 3 doses. If you decide to take the drug in the form of a suspension, then it will be enough once a day before bedtime at 60 mg.
- "Prednisolone." This is the name of a glucocorticoid steroid medication that suppresses the function of tissue macrophages and leukocytes. In the acute stage, 4-6 tablets are used per day. To prevent complications, drink 1-2 pieces a day.
- "Budenofalk." The daily dose is 3 mg. This number is divided into 3 doses, drinking the drug 30 minutes before a meal. The course usually lasts 2 months. 2-4 weeks after its onset, a persistent positive effect is noted.
These drugs usually help in eliminating the symptoms of Crohn's disease. Treatment of adults, in addition, also involves the use of antibacterial agents and vitamins of group D. If there is a complication such as ulcerative colitis, you must also take "Azathioprine."
It is important to make a reservation again that only a doctor can prescribe treatment for a person with symptoms of Crohn's disease. Reviews of people who neglected this recommendation make you think about an early visit to the doctor if at least some signs of illness have been noticed.
Many patients who self-medicated, they said, only harmed their health. This caused them not only a number of complications, accompanied by severe pain and hormonal imbalance, but also necessitated a longer, more complex and expensive treatment.
Folk remedies
Crohn's disease, the symptoms and causes of which have been described above, is a serious, difficult flowing pathology. Is it possible to cure it with folk remedies?
There are no drugs that would be more effective than the above, as well as their analogues. But folk remedies can be a good concomitant therapy. They optimize digestion processes, relieve uncomfortable conditions in the intestine, and promote tissue regeneration of damaged areas. However, before using them, you should consult your doctor.
Well, here are some popular recipes:
- Pour anise seeds (30 g) into a thermos and pour hot water, but not boiling water (400 ml). Give one hour to brew. The resulting volume must be drunk during the day, taking 50-100 ml 15 minutes before meals.
- To grind the caraway seeds (40 g) in a thermos, pour hot water (400 ml), insist. Drink 60-80 ml before meals.
- Take 60 grams of oat grains and grind. Pour in water (900 ml) and bring to a boil, stirring the mass. Remove from the stove immediately. After 8-10 hours, this jelly can be drunk. Divide the resulting volume into three equal portions and take before meals.
Special attention should be paid to the recipe for preparing sourdough on celandine. To do it, you will need:
- Finely chopped celandine (200 g). You can take fresh or dry - there is no difference.
- Sugar (200 g).
- Quality fresh homemade sour cream (15 g).
- Three-liter capacity with whey or boiled water.
Cooking does not take much time. You need to pour sugar into the liquid and add sour cream. Wrap the celandine in a bag of thin fabric and lower it there. It can be weighted with something (just not a product of an oxidizable material) so that it does not float. The container must then be covered with a towel and sent for 10 days to a warm place. After the time has passed, filter the infusion.
The resulting yeast is drunk half an hour before meals daily, 2 times a day, in an amount of 100-150 ml.
People note that during the treatment of Crohn's disease with folk remedies, the symptoms of the disease become weaker. It is necessary to regularly change the infusions used so that there is no addiction. They can also be made from onion peel, yarrow, hyssop (fresh), sunflower, comfrey root and sunflower. But completely replacing traditional folk therapy is not recommended.
Diet: Prohibited and Allowed Products
Much has already been said about the symptoms and treatment of Crohn's disease. Photos of patients suffering from this ailment, once again make sure that the patient experiences quite severe discomfort in the abdomen. Of course, since the disease concerns the intestines, then the person exposed to it must follow a certain diet and diet.
It is very important. It is necessary to use such products in the digestion of which the damaged intestine could take part and not get even more damage. So, here is what is strictly forbidden to eat:
- Everything is fatty, too salty, spicy, spicy, smoked.
- Duck and goose meat.
- Raw vegetables, any kind of garlic, radish and radish, cucumbers.
- Sausage.
- Canned vegetables.
- Hard boiled eggs.
- Legumes, in whatever form they are cooked.
- Milk soups.
- Stew.
- Barley, corn porridge.
- Smoked and canned fish.
- Pickled and fried mushrooms.
- Alcohol.
- Ice cream.
- Chocolate.
- Grape juice.
Approved products include:
- Mashed potato.
- Fresh dairy products in small quantities.
- Mashed cereals.
- Kissel.
- Soups on low-fat fish or second meat broth.
- Boiled chicken.
- Seafood without seasoning and lemon juice (not fried).
- Crackers made of white bread.
- Boiled lamb.
More precise recommendations regarding nutrition will be given by the doctor. It all depends on the individual characteristics of the body and on how the disease proceeds.
General recommendations
If a person has overcome Crohn's disease, then he needs:
- Switch to portioned meals. Eat in small portions at least 5 times a day.
- Make a diet so that the ratio of proteins, fats and carbohydrates does not exceed 150, 70 and 250 grams, respectively. Energy value should not be more than 2100 calories per day.
- Minimize the amount of salt consumed in foods. And it’s better to refuse it altogether. The maximum allowable amount is 8 grams per day.
- Eat more foods with calcium and potassium.
- Drink 1.7-2 liters of fluid per day.
- Steaming products by baking or boiling.
It is also necessary to minimize the strain in everyday life and ensure a healthy, full sleep. With exacerbation, bed rest is indicated, which is important to observe until the condition improves.