Do you feel pain in stomach? It is probably the Crohn’s disease. What is it and how to treat it you will learn in the article below.
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract characterized by the occurrence of granulomatous inflammation (inflammation in which there is the formation of granulomas (nodules)).
The mucous membrane on any part of the gastrointestinal tract from the mouth to the rectum can be damaged, but most commonly the inflammation is in the ileum and the initial division of the colon. Crohn's disease may develop in any person regardless of age and gender.
The disease is named after the American gastroenterologist Burrill B. Crohn, who in 1932 along with Leon Ginzburg and Gordon D. Oppenheimer published the first description of this disease.
The reasons for the development of Crohn's disease are not completely understood, but the factors contributing to the development of the disease:
• Immunological factors. In patients a pathological immune response to the intestinal flora by food entering the intestines, other substances is detected. The immune system marks them as alien and nourishes the intestinal wall by leukocytes, resulting from an inflammatory reaction, erosion and ulcerative lesions of the mucosa.
• Genetic factors. Very often the disease is detected in twins and siblings. Approximately 17 % of patients have blood relatives also suffering from this disease.
• Infectious factors. The role of these factors is not confirmed completely, but there is a suggestion of viral or bacterial nature of the disease.
• A way of life. Smoking, alcohol abuse, drugs, environmental factors can also contribute to the development of Crohn's disease.
Since Crohn's disease is caused by the increased aggressiveness of the immune system against body's own tissues, other signs of immune inflammation often appear, such as joint damage (arthritis), oral mucosa (stomatitis), skin (erythema nodosum – appearance of the painful skin tight formations), the whites of the eyes (episcleritis), etc.
The symptoms of Crohn's disease
The presence of Crohn's disease can be suspected when persistent or nocturnal diarrhea, abdominal pain, intestinal obstruction, weight loss, night sweats. Diarrhea is often accompanied by pain when urinating. The urge to defecate can be up to 6 or more times a day. Often, patients complain of bloating and vomiting.
During Crohn's disease, the mucosa of the colon became inflamed and covered with superficial ulcerations, causing pain in the abdomen, blood, and mucus in the stool.
The increase of body temperature during periods of acute illness can be up to 38-39°C.
General malaise, loss of appetite and weight, dry mouth, constant thirst can also be observed.
The extraintestinal manifestations of Crohn's disease include cutaneous manifestations, lesions of the joints, inflammatory diseases of the eye, diseases of the liver and biliary tract, vasculitis (inflammation of blood vessels), disorders of hemostasis and thromboembolic complications, blood disease, osteoporosis (bone thinning).
Crohn's disease runs a long time. In the development of the disease also there are periods of exacerbation and remission. In the period of exacerbation, the symptoms of the disease can be severe, however, in the period of remission they may be completely absent.
Clinical manifestations of Crohn's disease are very similar to the symptoms of ulcerative colitis; it is, therefore, necessary to distinguish one disease from another.
Diagnosis of Crohn's disease
Diagnosis of Crohn's disease consists of typical complaints of patients and symptoms of the disease and includes:
• The analysis of the anamnesis of disease and complaints – when did abdominal pain appear, is there a seasonality of the exacerbations, the patient connects the appearance of these symptoms.
• Analysis of life history - whether the patient has an intestinal infection, poisoning, surgery on the intestine, and other diseases of the gastrointestinal tract.
• Analysis of family history - the presence of relatives with the gastrointestinal tract diseases (gastritis, gastric ulcer and duodenal ulcer, cholelithiasis).
• Examination of the patient on palpation of the abdomen is determined by its tenderness, most often in the lower abdomen, below the belly button (just right).
Treatment of Crohn's disease is determined by the degree of disease activity. In the period of exacerbation, the patient should provide complete physical and mental rest.
With a little of disease activity, your doctor may prescribe intestinal anti-inflammatory drugs salicylic acid derivatives.
With higher level of disease the following groups of drugs are prescribed:
• Hormonal drugs. Reduce inflammation in the body.
• Immunosuppressants. Suppress the immune system, involved in the development of the disease.
• Antibacterial drugs.
With the extremely high level of disease, surgical treatment should be used to remove the affected intestine, followed by the appointment of antibacterial and anti-inflammatory drugs.
Diet in Crohn's disease Patients with Crohn's disease a special prescribed diet which allowed wheat bread yesterday's baking, biscuits, dry biscuits, NES dob Noe buns, lean beef, veal, rabbit, poultry without skin, sausage diet, doctoral, dairy, lean fish boiled, aspic, steam, boiled eggs, all grains, pasta, cereal, water, meat broth, puddings, rice, noodles.
Strictly prohibited products such as fatty meat, fish, poultry, meats, eggs, raw, fried, boiled, milk in its natural form, acute, smoked, salty cheese, cabbage, cucumbers, radish, turnip, radish, spicy and fatty sauces, pepper, mustard, horseradish, grape juice, kvass, carbonated drinks.
Patients in the period of exacerbation of the disease designate partial intravenous feeding with solutions of amino acids, and in addition to the normal diet, are prohibited pasta, fish, doctorate, dairy sausage, biscuits, and a biscuit.
All patients are administered with vitamin complexes rich in vitamins A, E, K, D and B12 and folic acid, as due to injury of the intestine, these substances do not enter the body with food.
Complications and consequences of Crohn's disease
• Fistulas (absent in normal channels) and strictures (narrowings) of the intestines.
• The occurrence of abscesses (ulcers) in the intestines.
• Intestinal bleeding.
• The development of intestinal obstruction (problems with the promotion of intestinal contents through the intestines).
• Perforation (a violation of the integrity of the intestinal wall).
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