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Crohn's Disease - Treatment
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, the cause of which is unknown. First described in 1932, it was thought to affect only a portion of the small intestine. Since that time, it has been discovered that the effects (inflammation and irritation) can be found throughout the entire gastrointestinal tract, from the mouth to the anus. The peak incidence of onset of this disease is between 15-25 years of age. Crohn's disease also often occurs in patients between 55-60 years of age. Common symptoms include: RECURRENT abdominal pain, fever, nausea, occasional vomiting, diarrhea (sometimes bloody), and weight loss. About 50% of the cases will have complications of perianal abscess and anal fissures. Patients often arrive at the hospital malnourished and dehydrated.
Evaluation in these patients usually involves an extensive GI investigation for the cause of the symptoms. Upper GI series, UGI endoscopy and LGI endoscopy are frequently performed Stool cultures may be taken in some cases to rule out an infectious (bacterial, viral or parasitic) gastroenteritis. Patients with Crohn's disease will have characteristic changes seen upon direct (endoscopic) visual inspection of the intestinal wall. Microscopic analysis by a Pathologist will confirm the presence of this disease. Red blood cell counts (CBC) are commonly low (anemia) and usually secondary to chronic blood loss in the stools.
Treatment is with medications to reduce the active inflammation in the intestines. Steroid medications and anti-inflammatories have been used with some success. These patients have a typical remitting and exacerbating course, finding themselves admitted to the hospital at least once a year. Surgery has been used in cases of severe disease to remove sections of the intestine that have been irreversibly damaged by the disease. Recurrence of Crohn's in other regions of the intestine is common. A Gastroenterologist is the expert in the care of these patients.
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