Crohn’s disease is a chronic disease that develops as a result of inflammation of some parts of the digestive system; the exact cause is not yet fully known. However, experts think that genes, autoimmune (immune) response, or smoking may be the main causes of the disease. Common symptoms are persistent diarrhea, abdominal pain and cramps, extreme fatigue or weakness, weight loss, and a feeling of bloating. There is no cure. The treatments applied only help to reduce and control symptoms. This disease can affect people of all ages, and its symptoms usually begin in childhood and early adulthood (20-35).
Crohn’s disease is a type of inflammatory bowel disease. The other type is ulcerative colitis. It causes inflammation and irritation in the digestive system and lasts a lifetime, but it can progress in calm periods for weeks or years. It can affect any part of the digestive system, from mouth to anus. But it often affects the tip of the small intestine and the beginning of the large intestine (colon). The disease usually progresses slowly and can get worse over time.
Crohn’s disease does not affect lifetime. Although it can be seen at almost any age, it mostly starts between the ages of 15-30. In Crohn’s disease, there are inflammatory changes in the intestine, which causes the bowel wall to become thicker. As a result, the bowel diameter narrows and the passage of the contents becomes difficult. Crohn’s disease can occur anywhere from mouth to anus. However, it is most common in the terminal ileum (end of the small intestine) and in the initial part of the colon, including the cecum. Here are some Crohn’s disease symptoms.
Crohn’s disease Symptoms
There are many varieties of Crohn’s disease symptoms that are said to be more prevalent in women than men, and do not show much in the first days. Although the symptoms in Crohn’s disease may differ from person to person, the most common symptoms in general can be listed as follows:
- Diarrhea, abdominal pain,
- Constipation and bloating in some cases,
- Nausea and vomiting, fever,
- Crack formation around the anus,
- Blood and inflammation in the stool.
Diagnosis of Crohn’s Disease
Diagnosing Crohn’s disease is sometimes difficult because the symptoms may be similar to the symptoms of other diseases. If Crohn’s disease is suspected using a physical examination and laboratory (blood, urine, and fecal) tests, refer the patient to a gastroenterologist to confirm the diagnosis. Here are the Crohn’s disease diagnosis. It needs some tests for diagnose:
- Emar (MR) or Computed Tomography (CT) scan
Treatment of Crohn’s disease
There is no cure for Crohn’s disease, but there are treatment options that can control or reduce symptoms. These treatments are arranged according to the severity of the disease and symptoms. Here are the Crohn’s disease treatments:
It helps to reduce the activity and inflammation of the immune system. It is prescribed to patients with moderate and severe symptoms. It should be used very carefully due to its side effects.
It has side effects such as weight gain, indigestion, sleep problems, slow growth in children, bone mass loss, acne, high blood sugar, high blood pressure, the possibility of developing infections, complex mood. The dose of drugs can be increased during periods of exacerbation of the disease.
These drugs reduce immune system activity and cause less inflammation in your digestive system. It is prescribed to help improve disease symptoms or when the patient does not respond to other treatments. They can cause serious side effects because they strongly suppress the immune system.
There may be side effects such as a higher probability of infection, feeling tired, complex mood and sickness or feeling sick, nausea and vomiting, pancreatic inflammation, liver problems. Therefore, it is necessary to make careful decisions when starting treatment with these drugs.
If other medicines do not help, stronger medicines called biological medicines may be required. Biological drugs are proteins that inhibit inflammation in the body. It is usually given by injection into the vein every two to eight weeks.
It may have side effects such as itching, joint pain, high fever, high infection, risk of developing tuberculosis. In some cases, antibiotics may be prescribed, for example in the treatment of abscesses and fistulas around the rectum.
If symptoms of Crohn’s disease are severe, it may be necessary to rest the intestines for a few days to a few weeks. Three different ways can be followed in this treatment method:
- A liquid containing food is drunk.
- A liquid containing nutrients is given from a feeding tube placed in the stomach or small intestine.
- Serum and nutrients are given through the vein.
Enteral nutrition (fluid diet) is food intake with a special beverage containing all the nutrients needed for a normal diet. The patient is fed in this way for several weeks. It can help reduce the symptoms of children and young adults in particular, and prevents the risk of growth with steroids.
Crohn’s Disease Surgery
In some cases, surgical intervention may be required for Crohn’s patients. These situations are:
- Insufficient treatment and side effects of drugs
- Stenosis in the intestine
- Development of abscess and fistula (channel formation between outer skin tissue and intestine)
- Slow growth in children
The main operation used in Crohn’s disease is called resection. Resection is the process of cutting out the diseased part of an organ. During the surgery, small cuts are made in the abdomen by the keyhole method. The inflamed part of the intestine is cleaned and healthy parts of the intestines are sewn together.
It is applied in case of intestinal narrowing. In this surgery, stenosis is removed without loss of bowel. However, this surgery may not be suitable for every patient. Most of the operations are performed under general anesthesia. It may be necessary to stay in the hospital for about a week, and it may take several months to fully recover. Sometimes an ileostomy (connecting the intestine to the bag) may be needed. Since there is no cure for Crohn’s disease, a patient who has been operated has a high probability of recurrence, even years later.
Patients may need to be taken to emergency surgery as a result of obstruction or puncture of the intestine, uncontrolled intestinal bleeding, or stopping bowel movements.
Herbal Remedies for Crohn’s Disease
Your digestive system contains “good” bacteria that help digestion and protect against “bad” bacteria. If you are using antibiotics, these good bacteria begin to decrease in your body. Probiotics are living microorganisms that you consume and are very similar to good bacteria in your gut. You can take it with some foods or use probiotic supplements. Probiotics may be more or less useful depending on the location and stage of your disease.
Although yogurt is one of the most common sources of probiotics, many people with Crohn’s disease are sensitive to dairy products. However, sauerkraut or kefir are probiotic-containing foods.
Prebiotics are food for probiotics and gut bacteria. Adding prebiotics to your diet can increase the function of your normal gut bacteria. Using prebiotics with probiotics can make probiotics more effective.
Prebiotics are undigested carbohydrates. Artichoke, honey, whole grains, banana, onion and garlic are foods that contain prebiotics.
Fish oil has long been used to improve cholesterol health, but it is also suggested to have benefits for Crohn’s patients. Omega-3 fatty acids found in fish oil have anti-inflammatory properties and can help reduce Crohn’s symptoms.
Talk to your doctor before starting fish oil supplements. Taking high doses of fish oil or using it with blood thinning medications can cause bleeding problems.