Gastrointestinal Symptoms Of Crohn's Disease

Crohn’s disease is a disease that can affect the entire gastrointestinal tract and can have vast negative effects on the body if not caught and treated properly. This gastrointestinal disease affects men and women equally but is found commonly in Caucasians and people of the Jewish-European decent. Crohn’s is also found more commonly in developed countries compared to undeveloped countries. The symptoms for this disease can occur at any age but are usually prevalent among 15 to 35 year olds. Research has only shown speculated ideas of how this disease manifests itself in the body, but researchers have found out that Crohn’s disease is affected by hereditary factors, genetics, and environmental factors. Although there is no cure to Crohn’s
disease there are numerous treatments and surgery’s that are used to make the patient’s quality of life better than before. There are a handful of symptoms that coincides with Crohn’s disease; those are abdominal pain in the lower right quadrant where the intestines and colon are located, excessive diarrhea causing dehydration, rectal bleeding or blood in stool, lack of vitamin and protein absorption capabilities, arthritis, skin problems, weight loss and fever. With symptoms come complications if the symptoms are not treated in time, some complications include blockage; this is caused by the thickening of intestinal walls due to inflammation. Crohn’s can also cause fissures or small tears in the intestines and kidney stones because of fat mal absorption. The Crohn’s and Colitis Foundation of America has been researching Crohn’s disease for more than a handful of years, and yet there are limited answers as to what causes Crohn’s.
One of those limited answers that have opened up research on Crohn’s is part of the reason why there are a lot of gastrointestinal symptoms, that is because the bacteria in the digestive system is mistaken for harmful invaders so cells travel toward the intestines and cause inflammation. This inflammation doesn’t usually subside like it would in someone who doesn’t have the disease instead it lead to chronic inflammation, ulcerations, and the thickening of intestinal walls. This is caused by an abnormal immune system reaction that occurs in people that are genetically predisposed to this disease, researchers have found a link to this immune system reaction in chromosomes five and ten. There is a prominent datum brought up by Dr. Sartor who is the medical adviser of the Crohn’s and Colitis Foundation of America, that datum is that patients that have Crohn’s have a specific combination of genetics, immunological function and bacterial profiles that leads to the onset of this disease. Overall just having the common symptoms does not mean that someone has Crohn’s disease; there are specific tests that are done to diagnose this
disease. There are plenty of different ways to diagnose Crohn’s, but usually the first test is just a physical examination, a general health screening and family history visit with a family doctor. If there is a family history and the symptoms are demonstrable from there the patient would see a gastroenterologist. The first two tests that the gastroenterologist would perform is a endoscopy and colonoscopy with biopsy, the endoscopy is when the doctor takes an endoscope that is flexible instrument with a light and camera on the end into the upper digestive tract, this would show ulcers, bleeding and other signs of Crohn’s. The colonoscopy is pretty much the same as the endoscopy but just the opposite, this exam goes up into the rectum and through the lower part of the digestive tract. The doctor would be looking for inflammation, bleeding, ulcers and fissures. During both of these examinations usually biopsies are taken of gastrointestinal tissues for further testing on bacterial make up of that patient and the doctor would compare it to someone who has Crohn’s. There is more than one test that can be done, but those first two are the most common routes taken by suspecting Crohn’s disease patients. Three more ways of diagnosing are chromo endoscopy, lower bowel MRI and CT scan, and the capsule endoscopy. Chromo endoscopy is a lead off procedure that can be done during a colonoscopy, this is when blue liquid dye is sprayed into the lower gastrointestinal tract to detect changes in the tissue lining and can identify early polyps. The MRI and CT scans would show cross sections of the digestive tract and show if there are any thickening in mucosa and intestinal wall that is correlated with Crohn’s disease. Last but not least, for those who are not a fan of the endoscopy or colonoscopy there is the capsule endoscopy, it is a pill sized camcorder that the patient just swallows and it records the images of the entire digestive track from top to bottom. After all the testing, examinations and careful review the gastroenterologist can determine if Crohn’s disease is present in that patient, if it is not it doesn’t mean they will never have it, the disease is just not present at that time. If it is present there is even more careful review to determine what kind of Crohn’s it is and design a treatment plan that would be specific to that person. There is five types of Crohn’s which are; Ileocolitis, Ileitis, Gastro-Duodenal, Jejunoileitis, and Granulomatous. Ileocolitis affects the end of the small and large intestines with main symptoms being cramping and lower right or middle pain in the abdomen. Ileitis affects the end of the small intestines otherwise known as terminal ileum; with this type effecting a small yet crucial part of the intestines the complication can include fistulas and inflammatory abscess in the lower right quadrant. Gastro-Duodenal affects the stomach and beginning of the small intestines with this type of Crohn’s directly affecting the stomach a prominent symptom is loss of appetite and weight loss because of nausea and vomiting. Jejunoileitis is patchy but it affects the upper half of the small intestines this causes intense abdominal pain and cramps following meals. Granulomatous is a colon only Crohn’s, the most important symptoms include rectal bleeding, and potential skin lesions around the anus. Knowing what kind of Crohn’s disease is extremely important to finding treatment, since there is no exact cure to Crohn’s each case has its own treatment plan to sustain the patients’ quality of life. To treat Crohn’s disease it could include medication, diet, nutrition, and surgical procedures.
There are four categories of medication that would be used for treatment; those are anti-inflammatory drugs, immune system suppressors, antibiotics, and a miscellaneous category. Two commonly used anti-inflammatory drugs are Oral 5-Aminosalicylates and Corticosteroids. Oral 5-Aminosalicylates are only used if Crohn’s affects the colon because this kind of medication is not helpful with the Crohn’s that affects the intestines and comes with side effects that no one would that wants to keep their quality of life would want including nausea, diarrhea, vomiting, and headaches. Another category is the immune system suppressors. Azathioprine is a common immunosuppressant; this drug keeps patients in remission and to keep the body from attacking itself by suppressing the immune system. Although it is an expensive medication it is extremely effective but the side effects are not something to disregard. Patients on this medication have to be kept under close surveillance to make sure that blood cell counts are normal and that there is no inflammation of the liver or
pancreas.
The last big category of medications is antibiotics; Metronidazole is a good example of a common Crohn’s disease medication. Antibiotics can help reduce drainage and help heal fistulas, abscesses and is also believed to harmful intestinal bacteria which jumpstart the negative immune system response. Although Metronidazole is widely used to treat Crohn’s it does come with side effects which include numbness and tingling in limbs, muscle spasms, and tendon ruptures. Last but not least is the miscellaneous medication treatments, these include; anti-diarrheal, over the counter pain medications, iron supplements if intestinal bleeding is a regular occurrence, and vitamin C and D because of the effects on the bones because of the other medications. The last two treatment choices a patient with Crohn’s has is to regulate diet and nutrition or if it comes down to it surgery. Diet regulation includes low fiber diet to reduce intestinal blockage, avoiding trigger foods, keeps a high calorie and high protein diet and in simple terms just eat nutritional food. If lifestyle and diet changes, drug therapy and other treatments don’t work, surgery is the last resort. Two thirds to three quarters of Crohn’s patients will require surgery; even though surgery doesn’t cure Crohn’s disease it will conserve the gastrointestinal tract. It is required when the diseased tissue develops fistulas, fissures or other intestinal obstructions. In order to fix these obstructions a resection surgery is required, this involves cutting out the unhealthy intestines and anastomosis the two healthy parts of the intestines together. Even though this doesn’t cure the disease and it could be a reoccurrence it keeps symptoms and more surgery at bay for a little bit of time. With a combination of all these treatments someone with Crohn’s disease can maintain a perfectly healthy life with little to no problems. In a whole Crohn’s disease comes with a bundle of symptoms and complications, if not treated properly this disease can end up being life threatening. If treated in time one can go into remission and have a good quality of life. This disease has been manageable since new technology and research has been found to diagnose and treat. The Crohn’s and Colitis Foundation of America are putting a lot of time and effort into this research and are being funded well in order to find new information. It is expected that in the next five years there will be new astounding information discovered, but only time will tell.