Crohn's disease: symptoms, diagnosis and treatment

Crohn's disease is a chronic disease that is accompanied by non-specific inflammation of the mucous and submucous tissues of the digestive tube. Most often, the pathological process affects areas of the small or large intestine. The exact mechanisms for the development of this disease remain unknown today.

Since this is a relatively common pathology that children are susceptible to, many people are interested in information about it. Why does Crohn's disease develop? A photo with an image of symptoms, features of the clinical picture, effective methods of treatment, possible complications - this is important information that is worth exploring. So is it possible to completely get rid of the disease?

Brief information about the disease

Crohn's disease (ICD-10 assigned the disease code K50) is a non-specific granulomatous inflammation of various parts of the intestine. For the first time, the symptoms of the disease were described in 1932 by the American gastroenterologist B. Cron, in whose honor, in fact, the disease was named.

Due to some similarities in the clinical picture, the disease is often confused with colitis. Crohn's disease nevertheless has a number of differences. To begin with, it is worth noting that the mechanisms of its development are still not fully understood. Against the background of colitis, the inflammatory process affects only the mucous membranes of the colon. At the same time, inflammation in Crohn's disease can be located on any part of the digestive tract, from the oral cavity to the rectum. The pathological process first affects the mucous membrane, but then it can spread to the entire wall with the further formation of fistulas.

Ulcerative colitis and Crohn's disease are different diseases, despite the fact that sometimes they are accompanied by approximately the same symptoms. Colitis responds well to medication. It is impossible to get rid of Crohn's disease.

In most cases, the pathology develops at a young age. Often diagnosed with Crohn's disease in children. Chronic diarrhea, digestive disorders, loss of appetite in this case can lead to stunted growth and physical development.

Reasons for the development of pathology

Why does Crohn's disease develop? The reasons, unfortunately, are not exactly known today. Researchers nevertheless have several theories:

• It is believed that there is a hereditary predisposition. This statement has been laboratory confirmed. If we consider Crohn’s disease in children, then in 70% of young patients at least one parent suffers from the same disease.
• Some doctors are inclined to the hypothesis indicating that such ailment has an infectious origin. To date, it is believed that Crohn's disease develops against the background of the penetration of measles virus and mycobacterium paratuberculosis into the body. Of course, far from all people, invasion by such microorganisms causes inflammation in the intestines, this only happens when certain risk factors are exposed.
• Some researchers believe that Crohn's disease is of autoimmune origin. For one reason or another, the human immune system begins to secrete antibodies that attack the cells of its own body, in this case the intestinal mucous membranes. This is how the inflammatory process develops.

Information on risk factors. What can provoke the development of the inflammatory process?

Doctors identify several risk factors in the presence of which the likelihood of developing Crohn's disease (or relapse in an existing disease) increases significantly. Their list is quite impressive:

• smoking, which not only provokes the development of such an inflammatory process, but also significantly worsens its course;
• uncontrolled use of anti-inflammatory non-steroidal drugs or their abrupt cancellation (such drugs as “Nurofen”, “Ibuprofen”, “Diclofenac” are considered effective);
• long-term use of hormonal contraceptives (longer than five years without a break);
• negative environmental impact (for example, it is believed that among residents of industrial zones, as well as areas with extreme climatic conditions, this ailment develops more often);
• an improper diet can also trigger the development of an ailment (eating foods high in fat);
• food allergies, for example, gluten intolerance or lactase deficiency also increase the risk of developing Crohn's disease;
• mental or physical strain, constant stress, emotional exhaustion - all this affects the functioning of the immune system, which is potentially dangerous.

According to statistics, Europeans are more susceptible to such a disease than representatives of other nationalities. Despite the fact that sometimes the inflammatory process sometimes develops in old age, in most cases it is diagnosed in young people (up to 30 years old).

Symptoms of Crohn's disease. Photos and features of the clinical picture

According to statistics, in 80% of cases, the inflammatory process is localized in the tissues of the small intestine, in particular in the ileum. Nevertheless, pathology can affect the rectum, as well as any other parts of the digestive tube.

The ailment is accompanied by a number of symptoms, the intensity of the manifestation of which depends on the degree of spread of the inflammatory process and the depth of its penetration .:

• Almost all patients with a similar diagnosis suffer from diarrhea. The fact is that the defeat of the mucous membranes affects the digestion processes, and also causes spasms of the intestinal muscles. This leads to the formation of loose stools.
• The inflammatory process is accompanied by symptoms of intoxication. Body temperature rises to about 37-38 degrees. Patients suffer from constant weakness, increased fatigue.
• Symptoms include cramping and abdominal pain. The fact is that inflammation and ulceration of the intestinal mucous membranes affects peristalsis. Food masses cannot normally move through the intestines, which leads to discomfort. Sometimes unpleasant sensations turn into intense pain. The above symptoms also include severe nausea and vomiting.
• Peptic ulcer of the mucous membranes is often accompanied by the appearance of blood streaks in the stool. But it is worth noting that sometimes blood traces cannot be noticed - their presence can be confirmed only during laboratory analysis.
• The mucous membranes of the oral cavity are also often covered with small ulcers.
• Due to nausea, pain and diarrhea, the patient's appetite worsens, as a result of which he begins to lose weight dramatically.
• In adult patients, the disease is sometimes complicated by inflammatory lesions of the joints, skin and eyes.
• Inflammation of the tissues of the liver and bile ducts is possible.
• If there is a fistula in the rectum, then pain in the anus can occur, which intensifies during physical exertion or defecation.

What is the pathology dangerous? List of possible complications

Why is Crohn's disease dangerous? The reviews of experts indicate that the pathology lends itself well to medical treatment if it was detected in the early stages of development. Nevertheless, sometimes an ailment leads to the development of dangerous complications. You should familiarize yourself with their list:

• The inflammatory process sometimes spreads to large areas, penetrates into the submucous membranes and muscle layers, which leads to the formation of ulcers and scars on the inner surface of the intestine.
• The disease leads to swelling of the mucous membranes, as a result of which the intestinal lumen narrows and sometimes completely closes. This is how intestinal obstruction develops - food stops moving along the digestive tract. Sometimes patients in a similar condition require emergency surgery.
• As already mentioned, the inflammatory and ulcerative process often spreads to the deeper layers of the intestine. Damage to the muscle layer often leads to the formation of fistulas - channels that connect the cavity of the digestive tract with other nearby organs.
• In the most severe cases, ulceration of the tissues leads to perforation of the intestinal wall, which is accompanied by massive bleeding. In addition, during perforation, feces enter the abdominal cavity, which leads to inflammation.
• The ailment is sometimes accompanied by the formation of an anal fissure that needs to be treated. The fact is that the appearance of such injuries is accompanied by severe pain. A crack can also be a gateway for a bacterial infection.
• Crohn's disease in adult patients (over 50 years old) increases the risk of developing colon cancer, in particular the colon. That is why people with a similar diagnosis are recommended to periodically take tests and undergo a colonoscopy procedure. The sooner cancer is diagnosed, the greater the chance of successful treatment.
• Abdominal pain, diarrhea and other unpleasant symptoms often lead to a decrease in appetite. In addition, the processes of assimilation of nutrients in the intestine are sometimes disturbed. All this can lead to a sharp weight loss, the development of anemia and vitamin deficiency.
• It is worth saying that the treatment of Crohn's disease in adults and children includes the use of drugs that, to one degree or another, inhibit the activity of the immune system. That is why patients are more susceptible to various infectious diseases. In addition, the risk of developing certain oncological pathologies, such as skin cancer or lymphoma, is increased.

Diagnostic measures

Immediately it is worth saying that pathology cannot be diagnosed on the basis of a general examination and even laboratory tests. Crohn's disease is accompanied by too nonspecific symptoms. Violations that occur against the background of pathology can indicate a wide variety of diseases.

Instrumental diagnosis of Crohn's disease includes several procedures:

• A colonoscopy is required. Using special optical equipment, the doctor examines the mucous membranes of the colon. If areas of inflammation were detected, then a biopsy is performed at the same time.
• Gastroduodenoscopy is a diagnostic procedure during which a specialist can examine the internal surfaces of the esophagus, stomach and duodenum.
• Informative is radiography using contrast agents. In the pictures, the doctor can see a narrowing of the intestinal lumen, determine the presence of cracks and erosion.
• Computed tomography is performed if there is a suspicion of the formation of abscesses and some other complications.
• Using ultrasound equipment, a specialist can detect the accumulation of free fluid in the abdominal cavity (this is a common complication that develops with Crohn’s disease).
• An electrogastroenterographic study is also being conducted. This procedure helps to assess the motor activity of certain sections of the intestine.
• Magnetic resonance imaging using contrast helps to determine the presence of fistulas and enlarged lymph nodes, as well as to assess the degree of damage to the intestinal mucous membranes.

Drug treatment

Crohn's disease treatment must be comprehensive. It is immediately worth noting that drug therapy only helps to reduce the activity of the inflammatory process, to stop its spread to neighboring healthy areas. Drugs help eliminate symptoms and achieve remission. But today it is impossible to get rid of an illness forever.

First of all, anti-inflammatory drugs are included in the treatment regimen:

• If there is inflammation in the tissues of the rectum, then patients are prescribed aminosalicylates, in particular Sulfasalazine. In modern medical practice, such drugs are used only in case of emergency, since such therapy is associated with a host of complications.
• More effective are steroidal anti-inflammatory drugs, for example, drugs that contain prednisolone. Such drugs help to quickly relieve inflammation and its associated symptoms. New generation corticosteroids, in particular Budenofalk, are considered more effective. It should only be noted that such drugs sometimes lead to the appearance of a mass of side effects, so therapy cannot last longer than 3-4 months. As a rule, this time is enough to achieve the desired effect.

A mandatory part of treatment is the use of immunosuppressants. Such drugs have an effect on the immune system, which is effective if the disease is of autoimmune origin. By the way, these drugs are sometimes used to prevent relapse.

• In inflammatory bowel diseases, drugs such as Mercapturin and Azathioprine are most often used. It is worth noting that long-term therapy is fraught with a decrease in the body's resistance to various infections - patients often suffer from colds, flu, tonsillitis, etc.
• To stop the symptoms of Crohn’s disease, such medicines as Symzia, Adalimumab and Infliximab also allow.
• As an alternative, such drugs as Rheumatrex and Methotrexate are sometimes used. These drugs are intended to treat rheumatoid arthritis, psoriasis, and cancer. Patients with Crohn's disease are prescribed if other drugs do not have the desired effect.
• Medicines that contain cyclosporin and tacrolimus are used if the inflammatory process is associated with the formation of fistulas.

If there are infectious complications, such as abscesses or fistulas (according to statistics, this happens quite often), then antibacterial agents are introduced into the treatment regimen. Such drugs as Klion, Ciprofloxacin and Flagil are considered effective.

Additionally, patients are prescribed drugs that help cope with the symptoms and prevent the development of some complications:

• Antidiarrheal drugs, in particular Imodium, Loperamide, Citrusel, help to cope with constant diarrhea, as well as normalize intestinal motility. This has a positive effect on the patient’s well-being, gives him the opportunity to lead a normal life, to establish social contacts.
• Pain relievers are used to relieve pain and cramping. Analgesics in this case should be selected by the attending physician, since not all drugs in this group are safe for Crohn's disease.
• If the patient's hemoglobin level decreases, then the doctor introduces iron preparations into the treatment regimen. Such drugs help prevent the development of anemia, which often develops against the backdrop of Crohn's disease.
• This pathology often leads to the development of B12-deficient anemia. That is why patients are periodically prescribed injections of vitamin B12.
• Therapy of inflammation involves the use of hormonal drugs. Such drugs adversely affect the condition of the musculoskeletal system and often lead to the development of osteoporosis. That is why, for the purpose of prevention, patients periodically take calcium preparations and solutions containing vitamin D.
• The use of pre- and probiotics, which help restore useful microflora (Crohn’s disease, as well as antibiotic therapy, often lead to the development of dysbiosis, will not hurt).

Diet for the disease

Diet for Crohn's disease is extremely important, because against the background of inflammation, digestion processes are disrupted. It is very important to saturate the body with useful substances and energy substrates, while not creating burdens on the intestines.

First of all, the doctor recommends that the patient keep a nutrition diary. If, after consuming a certain product, a person’s condition deteriorates sharply, then this is worth recording. Thus, the patient can form the most safe diet.

In addition, doctors give some general recommendations:

• it is worth abandoning baking and flour or reduce their consumption to a minimum;
• alcohol, spices and spicy dishes are also contraindicated;
• include foods low in fat in the diet;
• dishes are best cooked or steamed;
• it is necessary to refuse too hot or cold food, as it irritates the mucous membranes of the digestive tract;
• banned mushrooms, raw vegetables and fruits, canned goods, pickles, convenience foods, mushrooms, legumes, sour juices, carbonated drinks, coffee, chocolate;
• on the menu, it is better to introduce mucous porridges, weak broths, vegetable soups, dairy products.

When is surgery necessary?

If drug treatment of Crohn's disease is ineffective, then surgery may be recommended to the patient. : , , . , , . , , . / .

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Following these simple rules helps reduce relapses. With timely diagnosis, proper therapy and nutritional correction, the prognosis for patients is favorable. It is impossible to get rid of the disease today, but it is possible to achieve long-term remission.