Crohn's Disease : Causes, symptoms, diagnosis , treatment
Gastroenterology / / April 28, 2016
Crohn's disease and ulcerative colitis - is inflammatory bowel disease.All inflammatory bowel diseases cause chronic inflammation of the digestive system.Crohn's disease usually occurs in the lower part of the small intestine, specifically in the ileum and the beginning of the colon but can affect any part of the gastrointestinal tract.
difference between Crohn's disease and ulcerative colitis
These two diseases are linked, but they are considered separate disorders with several different treatment options.The main differences between ulcerative colitis and Crohn's disease are at the location and severity of the disease.However, some patients in the early stage of infectious Bursal disease or Gumboro disease - an infectious, contagious, viral inflammatory disease of the internal organs, affects the bursa of Fabricius, have the features and characteristics of both disorders.This is called "indeterminate colitis."
Ulcerative colitis - a chronic inflammatory disease of the colon.Ulcers form the inner l
These and other inflammatory bowel diseases are associated with an increased risk of developing colorectal cancer.
Crohn's disease, also known as "regional enteritis" - similar to ulcerative colitis chronic relapsing inflammatory bowel disease characterized by granulomatous inflammation with segmental lesions of different parts of the digestive tract, which usually occurs in the lower part of the small intestine - the ileum.This inflammation, which extends into the deeper layers of the intestinal wall, most commonly encountered in overcoming the small and large intestines - in particular, in the ileum and caecum (ileocaecal region).
In Crohn's disease the pathological process develops mainly in the intestine, but may be affected all regions of the gastrointestinal tract (GIT).The non-immune inflammation spreads to the entire intestinal wall and shows leukocyte infiltration.The infiltration of the mucosa in the area of formation of deep ulcers, fistulas and abscess developed, followed by scarring and narrowing of the intestinal lumen.Crohn's disease evolves more rarely elsewhere gastrointestinal tract, including the anus, stomach, esophagus, and even in the mouth.It may also affect the entire colon, including ulcers form in one part of the colon.It can also develop as multiple scattered clusters of sores around the stomach, passing between clusters of healthy tissue.
gastrointestinal tract or the digestive system, is the system of organs, extending from the mouth to the anus.It is a complex or system of organs that carry food from the mouth down the esophagus into the stomach, and then through the small and large intestine, display it out through the rectum and anus.
- esophagus. Esophagus - narrow and long muscular tube that begins under the tongue and ends at the stomach.
- stomach. in stomach acid moving food particles so small that the nutrients can be absorbed in the small intestine.
- small intestine (jejunum). The small intestine is the longest part of the digestive tract.Meals, moving from the stomach into the small intestine gradually passes through three parts:
- small intestine;
Most of the digestive process occurs in the small intestine.
- colon. undigested material - such as vegetable fibers - passes next to the large intestine, mainly in liquid form.Colon wider than thin.Colon absorbs excess water and salts in the blood.The rest of the waste is converted into feces by the bacteria.The large intestine is a continuous structure, but it has several components.
- cecum and its processes. cecum is the first part of the colon and leads to other parts located in the lower right quadrant of the abdomen.Colon continued in several departments:
- in the first section - the ascending colon - extends upward from the cecum to the right side of the abdomen;
- in the second section - transverse colon - crosses the upper part of the abdomen on the left side;
- in the third section - goes down on the left side of the abdomen to the pelvis (descending colon);
- the last, fourth section - the sigmoid colon.
- rectum and anus. Feces are stored in the descending and sigmoid colon, as long as they do not pass through the intestine and anus.
Doctors do not know exactly what causes inflammatory bowel disease.They seem to be associated with the complex interaction of many factors, including genetics, immune system disorders and environmental factors.As a result of an abnormal immune system response, in turn, causes inflammation in the small intestine.Crohn's disease and ulcerative colitis, as well as other IBB considered autoimmune disorders.
- inflammatory response. inflammatory reaction occurs when the body tries to protect itself from what it perceives as an invasion of foreign substances (antigens).Antigens may be such as viruses, bacteria and other harmful substances.
In Crohn's disease and ulcerative colitis body mistakenly considers harmless substances (food, beneficial bacteria or their intestinal tissue) as harmful.To combat infection body produces various chemicals and white blood cells which in turn produce byproducts which cause chronic inflammation of the intestinal mucosa.Over time, the inflammation causes damage and permanent changes of the intestinal mucosa.
- Genetic factors. Although the exact causes of inflammatory bowel diseases is not known, genetic factors are, of course, play a role.Several of the identified genes and chromosomes play an important role in the development of ulcerative colitis, Crohn's disease, or both.However, genetic factors are more important in Crohn's disease, although there is evidence that both forms of inflammatory bowel disease are common genetic defects.
- Environmental factors. Inflammatory bowel disease is much more common in industrialized countries and cities.It is not clear how and why these factors increase the risk of their development.It is possible that lifestyle factors such as smoking, high physical activity, diet high in fat and sugar, as well as stress - play an important role in them.However, there is no conclusive evidence that it is improper diet and stress cause Crohn's disease or ulcerative colitis, although they may aggravate them.
Other possible environmental causes of Crohn's disease: exposure to sunlight and in the future - lower levels of vitamin D, reducing the impact of a child of certain types of bacteria and other microorganisms in the stomach.However, until now the theory has not been confirmed.
Risk factors for Crohn's disease
- Age. Crohn's disease can occur at any age, but is most frequently diagnosed in people aged 15-35 years.About 10% of patients - children under 18 years of age;
- Paul. Men and women are equally likely to develop Crohn's disease;
- Family history. 20-25% of patients with Crohn's disease in families have a close relative with the disease;
- race and ethnicity. Crohn's disease is more prevalent among whites, although incidence rates are rising also among the other races;
- Smoking. Smoking increases the risk of Crohn's disease and can worsen the disease (on the other hand, smoking is likely to reduce the risk of ulcerative colitis, however, because of the dangers of smoking - it should never be used to protect against ulcerative colitis.);
- Appendectomy. removal of the appendix (appendectomy) may be associated with an increased risk of developing Crohn's disease, but the reduction in the risk of ulcerative colitis.
Symptoms of Crohn's disease
two major inflammatory bowel disease - ulcerative colitis and Crohn's disease - have some common characteristics:
- symptoms of both diseases usually occur in young people;
- symptoms can develop gradually or have a sudden onset;
- both diseases are chronic.In any symptoms of the disease may flare up (relapse) after asymptomatic periods (remission) or without treatment, the symptoms may be continuous;
- symptoms may be mild or very severe, until his death.
Specific symptoms of Crohn's disease vary depending on where it is in the gastrointestinal tract disease (in the ileum, colon, stomach, duodenum, or small intestine).
Common symptoms of Crohn's disease - are:
- abdominal pain - usually in the lower right corner;
- weight loss;
- bleeding from the rectum;
- fever (high body temperature);
- nausea and vomiting;
- skin lesions;
- pain in the joints.
- Eyes. Inflammation in the eyes is sometimes an early sign of Crohn's disease.Retinal diseases may occur, but rarely.People with arthritis and its complications may be at increased risk of vision problems.
- Joints. Inflammatory bowel disease causes arthritis and stiffness in the joints.The back is often affected.Patients with Crohn's disease also are at risk of abnormal thickening and expansion at the ends of the fingers and toes.
- Mouth ulcers. wounds and ulcers are common, and when they occur, remain.Oral infections are also common in people with Crohn's disease.
- Skin diseases. Patients with Crohn's disease can develop dermal edema, tumors or other skin lesions - ulcers (including hands and feet), distant from the colon.
People with Crohn's disease have an increased risk of developing psoriasis.
difference between the symptoms of Crohn's disease, mild to moderate
- Mild Crohn's disease. fewer bowel movements, the softer the considered disease.In the mild form of the disease abdominal pain are minimal or absent.The patient - a sense of well-being, which is a normal or close to normal.There are a few complications, if any, is the gastrointestinal tract: the doctor did not detect the weight by pressing the abdomen.Erythrocytes in the blood is normal or close to normal.No fistulas, abscesses, or other chronic changes.
- Severe Crohn's disease. In severe forms of Crohn's disease in the patient's bowel movements are often enough, so need strong medicine against diarrhea.Abdominal pain is severe and is usually located in the right lower quadrant (location of the pain may not indicate a real problem area - a phenomenon known as "referred pain").The level of red blood cells - low.The patient has a poor sense of well being and experience complications, which may include: weight loss, joint pain, inflammation in the eyes, redness or skin ulceration, fistulas (abnormal channels between tissues), abscesses, fever.Surgical and medical treatments for Crohn's disease with ulcerative colitis give their complications that may be severe.
no specific diagnostic test for Crohn's disease.The doctor makes the diagnosis "Crohn's disease" based on medical history, diagnostic examination and the results of laboratory, endoscopy (biopsy) and test images.
- Analyses. Blood tests are used for a variety of purposes, including to determine the presence of anemia (low red blood cells).Increasing the number of white blood cells and elevated levels of inflammatory markers - such as C-reactive protein - can indicate the presence of inflammation.Feces can be examined on the blood, infectious organisms or a combination of both.
- Flexible sigmoidoscopy and colonoscopy. This procedure relating to the winding fiber-optic tube - endoscope, which looks through the rectum mucosa of the colon.The physician can also insert instruments therethrough to remove tissue samples.
sigmoidoscopy is used to examine the rectum and just left (sigmoid) colon, lasts about 10 minutes and is performed without sedation (sedative) funds.This can be somewhat inconvenient, but not painful.
Colonoscopy offers a view of the entire colon and requires sedation, but this is also a painless procedure is performed on an outpatient basis.Colonoscopy can also help see colon cancer.
These treatments can help the doctor distinguish between ulcerative colitis and Crohn's disease, and other diseases.
- Wireless capsule endoscopy. Wireless capsule endoscopy - a new approach Imaging, which is sometimes used to diagnose Crohn's disease.The patient swallows a capsule containing a tiny camera that records and transmits an image as it passes through the digestive tract.
- Barium enema with barium. colon examination carried out by simultaneous application of X-rays with a barium enema.The procedure is called a barium enema.Barium is applied to them were covered with the intestinal wall.This allows the doctor to conduct a more informative research than without the use of barium.Barium, while in the small intestine, is found on the X-ray image that can reveal inflammation, ulcers, and other disorders.intestinal study also conducted using barium.However, it is delivered to the destination is not using the enema - the patient must drink the barium, diluted with water.Then, wait for 5.2 hours while barium through the gastrointestinal tract to reach the small intestine.Further X-ray images are also made.
- Imaging. transabdominal ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) may also be used to assess the patient's condition.
exception diseases similar to Crohn's disease
- Ulcerative colitis. diarrhea associated with ulcerative colitis are usually more severe than diarrhea caused by Crohn's disease.Abdominal pain more constant in Crohn's disease than in ulcerative colitis.Fistulas and strictures are Crohn's disease, but very rare in ulcerative colitis.Endoscopy and imaging tests often show greater involvement of Crohn's disease than ulcerative colitis throughout the gastrointestinal tract.
- Irritable Bowel Syndrome (IBS). Irritable Bowel Syndrome, also known as "irritable bowel syndrome" - a functional bowel disease, irritable bowel syndrome - may cause some of the same symptoms, and inflammatory bowel disease - IBD (however, this is not the same).Bloating, diarrhea, constipation, abdominal pain - symptoms of IBS.Irritable bowel syndrome is not caused by inflammation, but no fever or bleeding occur with him.Behavioral therapy may be useful in the treatment of IBS (not improve psychological therapy of inflammatory bowel diseases).
- Celiac disease. Celiac disease - is intolerance to gluten (found in wheat), which causes inflammation in the small intestine, diarrhea, vitamin deficiencies and violations of the chair.It is common in people with inflammatory bowel disease, and usually often in children.
- Acute appendicitis. Crohn's disease can cause pain in the right lower abdomen, where the appendix.