Crohn’s disease is a long-term inflammatory bowel disease that severely hampers the quality of one’s life and can have debilitating effects if gone unresolved. It causes severe inflammation in multiple digestive tract regions, leading to abdominal cramps, weight loss, diarrhea, etc.
At present, it is unknown what causes the disease. Still, it is speculated that an abnormal immune response in a genetically susceptible individual to a virus or bacterium may well be the cause. Most people with Crohn’s disease are diagnosed between the ages of 15 and 30, although the symptoms can start at any age.
Crohn’s disease is classified into five types, which are differentiated based on where they affect the gastrointestinal tract, namely:
Ileocolitis: The most prevalent form of the disease( 40% of people with Crohn’s disease have Ileocolitis). It affects the large intestine and the end of the small intestine.
Ileitis: It causes inflammation of the final section of the small intestine called the ileum.
Crohn’s Colitis: It affects the large intestine(colon) and may cause severe ulcers and lesions in the anal region.
Gastroduodenal Crohn’s Disease: It causes severe inflammation in the stomach and the upper part of the small intestine.
Jejunoileitis: The least common form of the disease affects only the upper half of the small intestine.
Crohn’s disease symptoms range from mild to severe, and there could be periods where no symptoms are experienced. Abdominal pain, Diarrhea, Vomiting, Fever, Bloody diarrhea, Anal fistulae, Perirectal abscesses, Weight loss are all common symptoms of Crohn’s disease. Severe symptoms such as inflammation of eyes, skin, liver, delayed sexual development in children, and colon cancer may result from misdiagnosis or a reluctance to seek medical help.
Diagnosis of the disease in suspected patients can be made through one or a combination of the following tests and procedures:
Blood Tests: A test for anemia or infection may be conducted while simultaneously examining stool samples for hidden blood.
Colonoscopy: A visualization technique where the practitioner views the entire colon using a colonoscope and may take samples of tissues for analysis to confirm the diagnosis.
CT scan and MRI: CT scan utilizes x-rays to map a detailed image of the bowel and the surrounding areas, whereas MRI uses Magnetic Radiation for the same purpose.
Capsule Endoscopy: In this technique, the patient ingests a capsule containing a camera that takes pictures of the small intestine. The images captured are downloaded on a computer for analysis. Usually, Capsule endoscopy is coupled with biopsy.
There is no universal treatment for Crohn’s disease; a treatment plan must be specifically curated on a patient-to-patient basis. A treatment plan aims to mitigate inflammation that causes the symptoms and improves the quality of life. The foremost step in the treatment is the usage of anti-inflammatory medications such as Corticosteroids and Oral 5-aminosalicylates.
Another class of drugs called immunosuppressants may target the immune system and suppress its action to reduce inflammation. Examples of such drugs are Azathioprine, Infliximab, Methotrexate, etc. In addition to controlling the inflammation using drug therapy, certain auxiliary medications such as Anti-diarrheals, Pain Relievers, Calcium, and Vitamin B supplements may alleviate the symptoms.
Lastly, if all the mentioned procedures fail to manage the disease, surgery may well be a lucrative option. During surgery, the damaged portion of the intestine is removed while the remaining sections are reconnected. The operation benefits are temporary, and the disease usually recurs, hence to minimize the risk of reoccurrence, an approach of drug therapy following the surgery could prove optimal.
Crohn’s disease severely impacts a patient’s mental and physical health. To experience even marginal reduction in signs and symptoms, one has to alter their lifestyle, eating habits, food choices and abstain from numerous pedantic pleasures. Dietary measures include eating small meals throughout the day instead of eating a large meal twice or thrice, drinking plenty of liquids( primarily water), taking multivitamins, abstaining from dairy products, spicy food, cigarettes, and alcohol. Sleep too is perversely affected, and if not managed, may well lead to chronic insomnia.
Stress is a significant symptom of Crohn’s disease. Interestingly, stress is a cause and effect of the disease. It is well known in the medical community that increased stress causes higher cortisol levels, thereby increasing inflammation. Hence it makes sense to effectively manage stress through Yoga, meditation, biofeedback, cognitive behavioral therapy, or herbal medication. Many articles and research papers on Herbal supplements such as ashwagandha, rosemary, tulsi, Brahmi, lion’s mane, etc., vouch for their cortisol controlling quality.
A recent dieting fad called the ketogenic diet has garnered the medical community’s attention for its impact on gut microbiology and inflammation. Simply put, a ketogenic diet aims to reduce the number of carbohydrates to about 5% of the total dietary macronutrients. Long-term pursuance of such a diet ushers the body into a ketosis state wherein the body starts to use ketones as the primary energy source instead of carbohydrates. The benefits of ketosis are manifold since it mitigates inflammation, reduces cortisol, and improves mental health.
The war against Crohn’s disease is a perennial one and requires immense support from family, friends, doctors, and colleagues. Mundane tasks such as going to school or work start taking a toll on you, especially in the absence of a support framework. Due to a lack of awareness, there is a social stigma attached to the disease, leading to strained relationships. Thank you for Reading