Crohn's disease is a chronic disease that is accompanied by non-specific inflammation of the mucous and submucosal 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 affects children, many people are interested in information about it. Why does Crohn's disease develop? A photo with an image of the symptoms, features of the clinical picture, effective methods of treatment, possible complications are important information that is worth studying. 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. Kron, after whom, in fact, it was nameddisease.
Due to some similarities in the clinical picture, the disease is often confused with colitis. Crohn's disease, however, 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 anywhere in the digestive tract, from the oral cavity to the rectum. The pathological process first affects the mucous membrane, but then can spread to the entire wall with 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 medical treatment. There is no cure for Crohn's disease.
In most cases, the pathology develops at a young age. Crohn's disease is often diagnosed in children. Chronic diarrhea, digestive disorders, loss of appetite in this case can lead to growth retardation and physical development.
Causes for the development of pathology
Why does Crohn's disease develop? The reasons, unfortunately, are not known exactly today. Researchers, however, have several theories:
- It is believed that there is a hereditary predisposition. This statement has been laboratory confirmed. When considering Crohn's disease in children, 70% of young patients have at least one parent suffering from the same disease.
- Some doctors lean towards the hypothesisindicating that such an ailment is of an infectious origin. To date, it is believed that Crohn's disease develops against the background of penetration into the body of the measles virus and mycobacterium paratuberculosis. Of course, invasion by such microorganisms does not cause inflammation in the intestines of all people, this happens only when exposed to certain risk factors.
- Some researchers believe that Crohn's disease has an autoimmune origin. For one reason or another, the human immune system begins to secrete antibodies that attack the cells of their own body, in this case, the intestinal mucosa. This is how the inflammatory process develops.
Information about risk factors. What can provoke the development of the inflammatory process?
Doctors identify several risk factors that increase the likelihood of developing Crohn's disease (or recurrence if the disease is already present) significantly increases. The list of them is quite impressive:
- smoking, which not only provokes the development of such an inflammatory process, but also significantly worsens its course;
- uncontrolled intake of non-steroidal anti-inflammatory drugs or their abrupt withdrawal (drugs such as Nurofen, Ibuprofen, Diclofenac are considered effective);
- long-term use of hormonal contraceptives (more than five years without a break);
- negative environmental impact (for example, it is believed that residents of industrial zones, as well as areas withextreme climatic conditions, this disease develops more often);
- the wrong diet can also provoke the development of the disease (eating high fat foods);
- Food allergies such as gluten intolerance or lactose intolerance also increase the risk of Crohn's disease;
- mental or physical strain, constant stress, emotional exhaustion - all this affects 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 (under 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. However, pathology can affect the rectum, as well as any other parts of the digestive tube.
The disease is accompanied by a number of symptoms, the intensity of which depends on the degree of spread of the inflammatory process and the depth of its penetration.:
- Almost all patients with this diagnosis suffer from diarrhea. The fact is that the defeat of the mucous membranes affects the processes of digestion, and also causes spasms of the muscles of the intestine. This is what leads toloose 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.
- The list of symptoms includes cramps and pain in the abdomen. The fact is that inflammation and ulceration of the mucous membranes of the intestine affects peristalsis. Food masses cannot move normally through the intestines, which leads to discomfort. Sometimes discomfort turns into intense pain. The above symptoms also include severe nausea and vomiting.
- Ulcerative lesions of the mucous membranes are often accompanied by the appearance of blood streaks in the feces. But it is worth noting that sometimes traces of blood cannot be seen - their presence can only be confirmed during a laboratory analysis.
- The mucous membranes of the mouth are also often covered with small sores.
- Due to nausea, pain and diarrhea, the patient's appetite deteriorates, resulting in rapid weight loss.
- In adult patients, the disease is sometimes complicated by inflammatory lesions of the joints, skin and eyes.
- Possibly inflammation of liver and bile duct tissues.
- If there is a fistula in the rectum, then there may be pain in the anus, which intensifies during physical exertion or defecation.
What is dangerous pathology? List of possible complications
How dangerous is Crohn's disease? Reviews of experts indicate that the pathology lends itself welldrug treatment in the event that it was detected in the early stages of development. Nevertheless, sometimes the disease leads to the development of dangerous complications. Their list is worth checking out:
- The inflammatory process sometimes spreads to large areas, penetrates into the submucosal 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 closes completely. This is how intestinal obstruction develops - food stops moving through the digestive tract. Sometimes patients in this condition require emergency surgery.
- As already mentioned, the inflammatory and ulcerative process often extends 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, tissue ulceration leads to perforation of the intestinal wall, which is accompanied by massive bleeding. In addition, perforation allows stool to enter the abdominal cavity, resulting in inflammation.
- The disease is sometimes accompanied by the formation of an anal fissure, which must 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 adults (over 50 years of age) increases the risk of bowel cancer, inparticularly the rectum. 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, sometimes the processes of assimilation of nutrients in the intestine are disrupted. All this can lead to a sharp weight loss, the development of anemia and beriberi.
- It is worth saying that the treatment of Crohn's disease in adults and children includes taking drugs that in one way or another inhibit the activity of the immune system. That is why patients are more susceptible to various infectious diseases. It also increases the risk of developing certain cancers, such as skin cancer or lymphoma.
Diagnostic measures
Immediately it should be said that pathology cannot be diagnosed on the basis of a general examination and even laboratory tests. Crohn's disease is accompanied by too non-specific symptoms. Violations that occur against the background of pathology may indicate a wide variety of diseases.
Instrumental diagnosis of Crohn's disease includes several procedures:
- A colonoscopy is mandatory. Using special optical equipment, the doctor examines the mucous membranes of the large intestine. If areas of inflammation were found, then a biopsy is performed at the same time.
- Gastroduodenoscopy -a diagnostic procedure during which a specialist can examine the inner surfaces of the esophagus, stomach, and duodenum.
- Informative is radiography with the use of contrast agents. In the pictures, the doctor can see the narrowing of the intestinal lumen, determine the presence of cracks and erosion.
- Computed tomography is performed if abscesses and some other complications are suspected.
- Using ultrasound equipment, a specialist can detect the accumulation of free fluid in the abdominal cavity (a common complication that develops in the background of Crohn's disease).
- An electrogastroenterographic study is also being carried out. This procedure helps to assess the motor activity of certain sections of the intestine.
- Magnetic resonance imaging with contrast helps to determine the presence of fistulas and enlarged lymph nodes, as well as assess the degree of damage to the intestinal mucosa.
Medicated treatment
Treatment of Crohn's disease must be comprehensive. Immediately it should be noted that drug therapy only helps to reduce the activity of the inflammatory process, to stop its spread to neighboring he althy areas. Drugs help to eliminate symptoms and achieve remission. But today it is impossible to get rid of the disease forever.
First of all, anti-inflammatory drugs are included in the treatment regimen:
- If there is inflammation in the tissues of the rectumintestines, 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 lot of complications.
- More effective are steroidal anti-inflammatory drugs, such as those containing prednisone. Such remedies help to quickly relieve inflammation and associated symptoms. New generation corticosteroids, in particular Budenofalk, are considered more effective. It is only worth noting 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.
An obligatory part of the treatment is taking immunosuppressants. Such drugs affect the immune system, which is effective if the disease is of an autoimmune origin. By the way, these drugs are sometimes used to prevent relapses.
- In inflammatory bowel disease, the most commonly used drugs are Mercaptopurine and Azathioprine. It should be noted 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.
- Medications such as Cimzia, Adalimumab, and Infliximab can also relieve the symptoms of Crohn's disease.
- As an alternative, drugs such as Rheumatrex and Methotrexate are sometimes used. These medicinesintended for the treatment of rheumatoid arthritis, psoriasis and cancer. For patients with Crohn's disease, the drug is prescribed if other drugs do not have the desired effect.
- Medicines containing cyclosporine and tacrolimus are used when inflammation is associated with fistula formation.
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 given drugs to help manage symptoms and prevent some complications:
- Antidiarrheal drugs, in particular "Imodium", "Loperamide", "Citrusel" help to cope with persistent 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, establish social contacts.
- Painkillers are used to relieve pain and spasms. 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, the doctor introduces iron preparations into the treatment regimen. Such drugs help prevent the development of anemia, which often develops against the background of Crohn's disease.
- This pathology often leads to the development of B12-deficiency anemia. That is why patients are periodically prescribed injections of vitamin B12.
- Inflammation therapy involves taking hormonal drugs. Such drugs adversely affect the state of the musculoskeletal system and often lead to the development of osteoporosis. That is why, for the purpose of prevention, patients periodically take calcium supplements and solutions containing vitamin D.
- It will not hurt to take pre- and probiotics, which help restore beneficial microflora (Crohn's disease, as well as antibiotic therapy, often lead to the development of dysbacteriosis).
Diet for sickness
Diet for Crohn's disease is extremely important, because against the background of inflammation, digestion processes are disturbed. It is very important to saturate the body with useful substances and energy substrates, while not creating stress on the intestines.
First of all, the doctor recommends that the patient keep a food diary. If, after consuming a certain product, a person’s condition deteriorates sharply, then this is worth writing down. Thus, the patient can form the most safe diet.
In addition, doctors give some general recommendations:
- should give up baking and flour or reduce their consumption to a minimum;
- alcohol, spices and spicy dishes are also contraindicated;
- include low-fat foods in your diet;
- dishes are best boiled or steamed;
- you need to give up too hot or cold food, as it is annoyingmucous membranes of the digestive tract;
- banned mushrooms, raw vegetables and fruits, canned food, pickles, semi-finished products, mushrooms, legumes, sour juices, carbonated drinks, coffee, chocolate;
- it is better to introduce slimy cereals, weak broths, vegetable soups, fermented milk products into the menu.
When is surgery needed?
If medical treatment of Crohn's disease is ineffective, the patient may be recommended surgery. Its essence is as follows: the doctor removes the damaged section of the intestine, after which it imposes an anastomosis, connecting he althy sections of the digestive tract. Of course, such a procedure gives a positive result, but it is temporary. The operation, alas, does not allow to get rid of Crohn's disease. Ulcerative/inflammatory process begins in he althy areas.
In addition, surgery is indicated in the presence of complications, in particular in the formation of fistulas or abscesses. According to statistics, almost every patient with this pathology undergoes an operation on the intestines at least once in their life.
Crohn's disease: recommendations and preventive measures
Unfortunately, there are no specific prophylactic agents, as well as drugs that can completely cure the disease. However, following some rules, you can reduce the risk of developing a pathology such as Crohn's disease, as well as reduce the number of relapses with an existing problem:
- Proper, balanced nutrition is extremely important.
- Periodical people recommendtake vitamin complexes - this helps to normalize metabolism, strengthen the immune system.
- A person needs good sleep, timely rest, the right mode of work.
- It is important to avoid stress, as exacerbations develop against their background. Experts also recommend developing stress resistance, such as regular breathing exercises, yoga and other similar practices.
- It is extremely important to give up alcohol (or at least keep it to a minimum) and smoking.
- Don't forget about physical activity. Regular light exercise helps to strengthen the immune system, normalizes the intestinal tract, increases resistance to stress.
Compliance with these simple rules helps to reduce the number of relapses. With timely diagnosis, proper therapy and nutritional correction, the prognosis for patients is favorable. It is currently impossible to get rid of the disease, but a long-term remission can be achieved.
