Crohn's Disease

Overview

Crohn's disease is a inflammatory process of full thickness of the intestinal layers that can affect any part of the gastrointestinal tract from the oral cavity to the anal margin. The effect of this disease can be both painful and debilitating, and may even lead to life-threatening complications. There is no complete cure for this but with appropriate treatment the clinical symptoms can be managed greatly and even can result in long term remission.

Signs and Symptoms

Diarrhoea extending over many months occuring bouts, Intestinal colic, Pain at right iliac fossa, Tender abdominal mass, Blood in stool, Loss of appetite, Mouth ulcers, Intermittent fevers, Secondary anemia, Weight loss

Common Causes

Complex interplay of genetic and environmental factors, Heredity, Abnormal immune response (autoimmune)

Risk Factors

Age below 30 years, Ethnicity: Ashkenazi Jewish more prone than Asians, Cigarette smoking, NSAIDs: ibuprofen and diclofenac sodium can aggravate Crohn's, Diet: high in fat and refined food

Investigation Techniques

Full blood count, C- reactive protein, Stool occult blood test, Colonoscopy, Endoscopy, Capsule endoscopy, Computed tomography (CT), Magnetic Resonance Image (MRI), Fistulography in patient with enterocutaneous fistula

Treatment and Prevention

Corticosteroids: can be used topically or systemically, 5-aminosalicylate: considered limited benefits but reduces recurrent, Azathioprine, Monoclonal antibodies, Methotrexate: to those who does not respond well to other medicines, Antibiotics to prevent and control infection, Iron supplements and vitamin B12, Calcium and Vitamin D, Nutrition: as the patient is prone to malnourishment, Surgery: Ileocaecal resection, segmental resection, colectomy and ileorectal anastomosis, subtotal colectomy and ileostomy, temporary loop ileostomy, proctocolectomy, strictureplasty