Crohn's disease is an immune-mediated, severe chronic disease of unclear etiology that 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 things related to this topic will be discussed now.
Reasons
As already mentioned, the etiology of this disease is not fully understood. But scientists have identified several factors that are provoking. Among them:
- Genetic predisposition. So far, a direct connection with one or another HLA antigen has not yet been elucidated. 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 tostatistics, most often to Crohn's disease, the symptoms of which will be discussed further, are prone to homozygous twins and siblings. Also, in 17% of reported cases of the disease, people had blood relatives who also suffered from it.
- Infectious factors. It is believed that the disease is bacterial or viral in nature. Experiments made it possible to find out that its development is influenced by the pathogenic bacterium Mycobacterium avium paratuberculosis, which also causes Yone's disease in animals (including primates). However, this is only a theory, not yet 100% proven.
- Immunological factors. The fact that systemic organ damage occurs in Crohn's disease has led scientists to think about the autoimmune nature of the disease. The theory was not formulated in a vacuum. In patients, an increase in T-lymphocytes, the appearance of antibodies to cow's milk protein, Escherichia coli and lipopolysaccharides are indeed recorded. And during periods of exacerbations, 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. People aged 15 to 35 are most susceptible to it.
What happens when you get sick?
This is the main question. Before proceeding to consider the symptoms of Crohn's disease, you should tell about the processes that occur in the body during its course.
This disease is characterized by partial organ damage. It can affect areas from a couplecentimeters to several meters. And the focus at the same time 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 conditional statistics, since usually the lesion has a combined character. For example, the disease spreads to most of the small intestine and a small segment of the large intestine.
As a rule, the lesion is intermittent. After the affected area is normal, then affected again, and so on.
Symptoms of Crohn's disease include:
- Erosions of various shapes.
- Stenoses. This is the name of the narrowing, in which the segment of the intestine becomes hard and thickened.
- Ulcers of different depths. They also have a discontinuous nature. Ulcerations alternate with normal mucosa. By the way, doctors call this symptom "cobblestone pavement".
- Fistula. This is the name of the pathological hole - a channel that forms a message between tissues and different organs.
- Lymphedema.
- Inflammation affecting all linings of the intestine.
- Epithelial granuloma. This is an inflammation 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 eye. Over time, they develop, the lesions spread. Therefore, it is very important to consult a doctor in time, without ignoring the symptoms,that can be felt. We will talk about them now.
Symptoms
They can be divided into general and local (local). The first category of symptoms of Crohn's disease are:
- Unreasonable weight loss. If the form of the disease is severe, then weight loss can be significant - from 10 kg.
- Fatigue and weakness.
- Stable, slightly elevated temperature, usually below 38°C.
- Minor skin lesions, manifested in inflammation and redness.
- Eye diseases - conjunctivitis, uveitis.
- Pain in the joints (arthralgia) and muscles (myalgia).
- Inflammation of the vessels, manifested in vasculitis.
- Blood clotting disorder with blood clots.
Local symptoms of Crohn's disease in adults are much less, but they appear more often than the general ones. These include:
- Pain in the abdomen. They can have different intensity and nature of manifestation. They are usually cutting or aching. As a rule, they increase after eating. Also often accompanied by bloating.
- Diarrhea. How severe it is depends on the severity of the intestinal lesion.
- Blood stools.
- 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 appear and do not go away, then you should urgently contact a general practitioner or immediately a gastroenterologist.
Degrees of activity andcourse of the disease
This should also be briefly told, 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 process flow were distinguished. For the initial, mild, such manifestations are characteristic:
- Diarrhea, the attacks of which can disturb up to 4 times a day.
- Stools that sometimes contain blood.
- Temperature not exceeding 37.5 °C.
- Heart rate is normal.
For the average degree, similar manifestations are characteristic:
- Bouts of diarrhea occur at least 6 times a day.
- There is always blood in the stool.
- Pulse is kept at 90 beats per minute.
- Possible complications, which will be discussed later.
Finally, severe disease is manifested by the following symptoms:
- Bouts of diarrhea occur more than 10 times a day.
- The presence of blood in the stool is clearly visible.
- Temperature reaches 38°C.
- Heart rate 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 precisely on the degree of damage. Usually, the pathology proceeds with regular exacerbations and partial remissions.
According to statistics, 30% of patients experience an exacerbation within 12 months after recovery. In 50% it occurs in the next 2 years. In the other 20%, everything is individual. If the treatment is of poor quality, then remissionswill decrease and symptoms will increase.
Intestinal wall perforation
This is one of the complications that occurs when the symptoms of Crohn's disease are not addressed. The intestine is a very sensitive area, and perforation is a fatal pathology for it. It develops as a result of 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 inflammation of the visceral and parietal layers of the peritoneum, accompanied by a serious condition of the body.
Symptoms that signal perforation of the intestinal wall include:
- Gagging and nausea.
- Intoxication of the body (feelings like severe poisoning).
- Abdominal tension.
- Unbearable pain in the abdomen, especially on the left side. Can radiate to the shoulder.
- Blood in stool and urine.
- Lack of appetite.
- The bowel works without its usual sounds.
- Diarrhea.
- Weak heartbeat.
Peritonitis has similar symptoms. Additional signs include dehydration, dramatic weight loss (especially of the face), dry mucous membranes, and even confusion.
If problems are not solved in time and emergency treatment is not started, a person may die.
Intestinal obstruction
Considering the topic of symptoms and treatment of diseaseCrohn, we need to talk about this complication. Intestinal obstruction accounts for 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 through the digestive tract.
Obstruction can be small or large bowel, partial or complete, chronic or acute, acquired or congenital.
Like many other diseases, it has several stages. At an early stage, a person is only concerned about local abdominal symptoms and pain. Then, stool retention, asymmetry of the abdomen, bloating begin to make themselves felt, gases stop leaving. At the last stage, hemodynamics is disturbed and peritonitis develops. All stages pass very quickly - from 2 to 36 hours.
Disease in children
Meets quite often. Symptoms of Crohn's disease in children are more common during adolescence. Unfortunately, the quality and life expectancy of those who had this disease in childhood is significantly reduced. Based on this, scientists concluded that this disease makes a certain contribution to the structure of childhood disability and mortality.
In children, Crohn's disease symptoms and treatment are almost the same as in adults. Only the dosage of the drug is selected in accordance with the age of the child.
Unfortunately, this disease 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 regularexamination and register with a specialist.
Diagnosis
This topic also needs to be touched upon. If symptoms of Crohn's disease are present, diagnosis should be mandatory.
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, including 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 is a long list of such, including dozens of items.
Then, after an initial diagnosis of symptoms of Crohn's disease in adults, the patient is referred for the following procedures:
- Endoscopic examination. It will help visually confirm the diagnosis and take materials (biopsy) for examination under a microscope. Moreover, they take samples in different parts of the digestive tract.
- Colonoscopy. This procedure makes it possible to compile a complete picture of the condition of the large intestine. With an endoscope immersed inward to assess the surface, it is possible to detect the presence of ulcers, bleeding or inflammation.
- Ultrasound. With it, you can find out if there is free fluid in the abdominal cavity and what is the diameter of the intestinal loops. This allows diagnosing complications, in particular the notorious perforation and peritonitis.
- Radioscopy. This procedure helps to detectnarrowed areas or areas affected by granulomas. Other neoplasms can also be detected using fluoroscopy.
- Laboratory research. Carrying out 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 makes recommendations and prescribes treatment.
Crohn's disease symptoms covered so we can move on to learning more about how to get rid of it.
List of effective medicines
After identifying the 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 an anti-inflammatory effect. Analogues are also popular - Salazodimethoxin, Salazopyridazine and Salazopyrin. Take before meals four times a day with plenty of water. The daily norm is 1-2 grams during an exacerbation. After the patient's condition improves, 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, antitoxic, 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. it5-aminosalicylic acid, available in various forms. During exacerbations, take 0.4-0.8 grams per day, dividing this amount into 3 doses. If it is decided to take the drug in the form of a suspension, then it will be enough to take 60 mg once a day at bedtime.
- "Prednisolone". This is the name of a glucocorticoid steroid medication that suppresses the functions of tissue macrophages and leukocytes. In the acute stage, use 4-6 tablets per day. To prevent complications, drink 1-2 pieces per day.
- "Budenofalk". The daily dose is 3 mg. This amount is divided into 3 doses, drinking the drug 30 minutes before a meal. The course usually lasts 2 months. After 2-4 weeks after its start, a persistent positive effect is noted.
The drugs listed above usually help with the symptoms of Crohn's disease. Treatment of adults, in addition, also involves taking antibacterial agents and vitamins of group D. In case of such a complication as ulcerative colitis, one should also take Azathioprine.
It is important to reiterate 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 visiting the doctor as soon as possible if at least some signs of illness were noticed.
Many patients who self-medicate, according to them, only harmed their he alth. This caused them not only a number of complications, accompanied by severe pain and hormonal imbalance, but also necessitated a longer, more complex and expensivetreatment.
Folk remedies
Crohn's disease, the symptoms and causes of which have been described above, is a serious, severe pathology. Can it be cured 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 discomfort in the intestines, promote tissue regeneration of damaged areas. However, before using them, you should consult a doctor.
Well, here are some popular recipes:
- Anise seeds (30 g) pour into a thermos and pour hot water, but not boiling water (400 ml). Give one hour to brew. The resulting volume should be drunk during the day, taking 50-100 ml 15 minutes before meals.
- Pour ground cumin seeds (40 g) into 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 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 noted the recipe for the preparation of sourdough on celandine. To make 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 (15d).
- Three-liter container with whey or boiled water.
Cooking won't take long. 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 (but not a product made of an oxidizable material) so that it does not float. The container should then be covered with a towel and sent for 10 days in a warm place. After the time has elapsed, filter the infusion.
The resulting sourdough is drunk half an hour before meals daily, 2 times a day, in the amount of 100-150 ml.
People note that in the process of treating Crohn's disease with folk remedies, the symptoms of the disease become weaker. It is necessary to regularly change the applied infusions so that addiction does not occur. They can also be made from onion skins, yarrow, hyssop (fresh), sunflower, comfrey root, and sunflower. But it is not recommended to completely replace traditional therapy with alternative therapy.
Diet: prohibited and permitted foods
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 affects the intestines, then the person exposed to it must follow a certain diet and diet.
This 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's whatstrictly forbidden to eat:
- All fatty, too s alty, spicy, spicy, smoked.
- Duck and goose meat.
- Raw vegetables, garlic in any form, radishes and radishes, cucumbers.
- Sausage.
- Canned vegetables.
- Hard boiled eggs.
- Beans, however cooked.
- Milk soups.
- stew.
- Barley, corn porridge.
- Smoked and canned fish.
- Marinated and fried mushrooms.
- Alcohol.
- Ice cream.
- Chocolate.
- Grape juice.
Permitted foods include:
- Low-fat mashed potatoes.
- Fresh dairy products in small quantities.
- Mashed cereals.
- Kissel.
- Soups with low-fat fish or second meat broth.
- Boiled chicken.
- Seafood without seasonings and lemon juice (not fried).
- Crackers from white bread.
- Boiled lamb.
More precise recommendations regarding nutrition will be given by the doctor. It all depends on the individual characteristics of the organism and how the disease proceeds.
General recommendations
If a person has overcome Crohn's disease, then he needs to:
- Switch to portioned meals. Eat small meals at least 5 times a day.
- Create a diet in such a way that the ratio of proteins, fats and carbohydrates does not exceed 150, 70 and 250 grams, respectively. The energy value should not be more than 2100calories per day.
- Minimize the amount of s alt consumed in foods. Or better yet, abandon 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.
- Steam, bake or boil food.
It is also necessary to minimize stress in everyday life and ensure a he althy, full sleep. With an exacerbation, bed rest is shown, which is important to observe until the condition improves.
