Some people who suffer from Crohn’s disease have long periods of remission, sometimes for years, in that they have no symptoms.
It can not be predicted when there is a remission or when the symptoms return.

The d Crohn oença and ulcerative colitis are chronic inflammatory bowel diseases.

 

How does Crohn’s disease influence the gut?

In the early stages, Crohn’s disease causes small superficial ulcerations (erosions) on the inner surface of the intestine.
These erosions are called aphthous ulcers.
Over time, erosion becomes deeper and greater, over time becomes ulcer (which are deeper than erosion) and cause scars and stiffness of the intestine.
With the progression of the disease, the intestine becomes tighter until an obstruction occurs.

 

Causes of Crohn’s disease

The exact cause of Crohn’s disease is unknown. Previously, it was suspected that the causes were diet and stress, but now doctors know that these factors can aggravate the disease, but can not be the causes.

 

The factors that cause Crohn’s disease are:

Immune system. 
It is possible that a virus or a bacterium can trigger Crohn’s disease. When the immune system tries to fight off an invading microorganism, an abnormal immune response induces the immune system to attack the cells of the digestive tract.

Inheritance
Crohn’s disease is more common in people who have at least one member of the family with the disease.
This fact makes one suspect that one or more genes may make people more prone to Crohn’s disease.
However, most people with Crohn’s disease do not have a genetic predisposition to the disease.

 

What are the symptoms of Crohn’s disease?

When the disease worsens, inflammation can cause one or more of these discomforts:

Diarrhea. 
The diarrhea is the most common symptom and can range from mild to severe. Feces may also contain mucus, pus, or blood.

Feeling of urgency There
is often a sense of urgency to get to the bathroom. It is also often the feeling of having to go to the bathroom, even if there is no actual production of feces.

Pain in the intestine
Pain occurs in approximately 7 cases in 10.
The area of ​​pain depends on which part of the intestine is affected.
The last part of the small intestine (ileum) is the most frequent place.
The most common area of ​​pain is the lower right side of the abdomen.
When Crohn’s disease develops, it is usually confused with appendicitis .
The severity of the pain can vary from person to person.
In addition, a sudden change or worsening of pain may indicate a complication.
Unexplained weight loss is another frequent symptom.

Ulcers
An ulcer is an area of ​​the intestinal mucosa that can bleed.
You can see the blood in the stool .
Ulcers in the mouth and oral cavity are frequent.

Feeling of malaise that includes loss of appetite, fever and general tiredness .

The anemia can occur if you lose too much blood.

The formation of anal fissures is possible.
These are wounds on the skin of the anus. Small changes in the skin may appear, warts-like formations around the anus.

Symptoms may vary depending on which part or parts of the bowel are affected, such as:

  • It is not possible to have diarrhea if the disease is limited to the small intestine.
  • A persistent pain to the abdomen without other symptoms may be due to a small ulcer due to Crohn’s disease in the small intestine.
  • Generally a worsening can cause severe discomfort.
  • If a large part of the intestine is affected, it is not possible to absorb food well and there may be a deficiency of vitamins and other nutrients.

 

Other symptoms

In some people, other parts of the body, other than the bowel, may also be affected.
These are: inflammation and pain in certain joints ( arthritis ), rash ; ocular inflammation ( uveitis ), inflammation of the liver.
These disorders can cause various symptoms.
It is not clear why these problems occur. The immune system can trigger inflammation in other parts of the body when there is an inflammation in the intestine.
These disorders pass when bowel symptoms are resolved, but not always.
Crohn’s disease does not make you fat or lose weight.

 

What are the possible complications of Crohn’s disease?

Complications may occur, especially if exacerbations are frequent or severe.
Here are the complications that often require surgical treatment:

Stenosis
Intestinal stenosis is the narrowing of a part of the intestine.
It is due to scar tissue that forms in the inflamed part of the intestine.
A narrowing can cause difficulty in the passage of digested food.
This causes pain and vomiting .

Perforation
The intestinal perforation is a small hole that forms in the wall of the intestine. The contents of the bowel may come out and cause an infection or an abscess inside the abdomen.
The drilling can be serious and dangerous.

Fistula
A fistula is a phenomenon where inflammation causes the formation of a channel that joins two separate parts of the body.
For example, a fistula may form between a part of the small intestine and part of the colon.
The fistula can form between a part of the intestine and other organs such as the bladder or uterus.
The contents of the intestine may come out in these organs.
Sometimes a perianal fistula develops from the anus or rectum to the skin in the anus.
At the same level may develop anal fissures or perianal abscess .

Cancer
People with Crohn’s disease have a small increased risk of developing colon cancerthan the general population.

 

Non-intestinal complications

Approximately 4% of patients have a disease that does not affect the gut, for example:

  • Eritema nodoso .
  • Ulcers or canker sores in the mouth.
  • Acute arthropathy that affects large joints (eg, wrists, hips, knees).
  • Sacroileíte.
  • Ankylosing spondylitis.
  • Episclerite.
  • Pioderma gangrenoso.
  • Previous Uveíte.
  • Conjunctivitis ,
  • Irite,
  • Esteatose hepatic ,
  • Primary sclerosing cholangitis ,
  • Renal stones ,
  • Osteoporosis –  The increased risk of reduced bone density is due to food malabsorption occurring in some people with severe Crohn’s disease.
  • Growth retardation – In children with Crohn’s disease a growth retardation has been detected due to malabsorption of nutrients.

 

How is the diagnosis of Crohn’s disease made?

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The doctor asks for the symptoms and performing a physical examination.
It is possible to do radriografía and laboratory tests to find out if you suffer from Crohn’s disease.
Tests for Crohn’s disease include:

Radiography with bariumfrom the small intestine or colon.

Colonoscopy . In this test, the doctor uses a thin, lighted tube to look into the colon.

Biopsy. The doctor removes a tissue sample and sends it to the laboratory for analysis.
The biopsy is used to find out if you suffer from Crohn’s disease or another disease such as cancer.

 

Stool analysis

This is a test that is performed to look for signs of infection in a stool sample.

With blood tests you can not reach a diagnosis of Crohn’s disease.

 

What is the treatment for Crohn’s disease?

Crohn’s disease is a disease that can become severe and can affect the quality of life, so it is important to learn how to deal with it correctly.
Treatment options include medications, surgery and / or nutritional supplements. The physician’s goal is to control inflammation, correct nutritional problems, and alleviate symptoms.

 

Drugs for Crohn’s disease

Anti – inflammatory medicines – Your doctor will probably start with mesalamine and sulfasalazine, which help reduce inflammation. Some doctors may prescribe 5-ASA (5-aminosalicylic acid), such as Pentasa, if the patient does not tolerate sulfasalazine or have no benefit from it.

Cortisone or steroids, cortisone is a medicine that contains cortisone .
During the early stages of Crohn’s disease doctors often prescribe prednisone.
Among the side effects of cortisone there is a greater risk of infection.

Immunosuppressive
drugs These drugs reduce the patient’s immune response. Your doctor may prescribe mercaptopurine (purinethol) or azathioprine.
Immunosuppressive drugs block the immune reaction that should cause inflammation. The side effects are nausea , vomiting and low resistance to infection.

 

Biological drugs (Infliximab and adalimumab, anti-TNF alpha monoclonal antibodies)

Remicade® (Infliximab)
Remicade blocks the inflammatory reaction of the body. This medication is indicated for patients with moderate or severe symptoms not responding to the treatment listed above. It is also indicated for the treatment of fistulas.

Antibiotics
A fistula, stenosis or preventive surgery can cause bacterial proliferation. Doctors usually treat Crohn’s disease with the prescription of the following antibioticsampicillin, sulfonamide , cephalosporin, tetracycline or metronidazole.

Anti-diarrhea (Drugs against diarrhea)
When inflammation decreases, diarrhea usually becomes a minor problem.
However, sometimes the patient may need a medicine for belly pain and diarrhea.
The most commonly prescribed medications are loperamide and codeine.

 

Surgery

If changes in diet and lifestyle and pharmacological treatments do not relieve symptoms, your doctor may prescribe surgery.
During surgery, the surgeon removes the damaged part of the digestive tract and attaches the ends of the healthy sections. In addition, surgery can be performed to close the fistulas and drain the abscess.
A common procedure for  Crohn’s disease is surgery on the intestinal wall to dilate a segment of the intestine that has become very tight.
Generally, the advantages of surgery for Crohn’s disease are temporary.
The disease is likely to relapse, often near the reconnected tissue or elsewhere in the digestive tract.

Smoking aggravates Crohn’s disease?

Studies have shown that people with Crohn’s disease who smoke  can have more severe symptoms and complications.
Surgery is done more often in patients who smoke.

Is Pregnancy Safe For Women With Crohn’s Disease? 
Women with Crohn’s disease can get pregnant and have a baby. Most children born to women with Crohn’s disease do not get sick.

 

Natural Remedies

Eating, Dieting and Nutrition
No particular diet has shown to be effective in preventing or treating Crohn’s disease, but it is important to avoid foods that appear to worsen symptoms, often with milk.
Those who suffer from Crohn’s disease often have a loss of appetite that can influence nutrition.
In addition, Crohn’s disease is associated with diarrhea and malabsorption of nutrients. Foods do not cause Crohn’s disease, but foods like candy, spices, alcohol and dairy products can increase diarrhea and abdominal cramps .

Lemon can help because it does all the digestive tract and joints well, we recommend a glass of juice every morning.

The absorption of vitamin B12 occurs in the ileum, so if this part of the bowel is inflamed serves an integrator.
Some patients report that taking vitamin B12 decreases abdominal pain.

Probiotics
There are several types of probiotics (living microorganisms) with different characteristics.
Not all probiotics are effective, in fact, some can be harmful under certain circumstances.
Depending on the patient’s illness, the gastroenterologist has to choose the microorganisms best suited to his specific case.

 

Can Stress Aggravate Crohn’s Disease?

There is no scientific evidence that  stress has an influence on Crohn’s disease.
However, sometimes people with Crohn’s disease have an increase in stress because they live with a chronic illness.
Some people with Crohn’s disease report an aggravation of the disease  when they live in a stressful situation or event.
For people who see a connection between stress level and worsening symptoms, there are relaxation techniques such as meditation, yoga, Reiki or shiatsu that can help you feel better.

 

Crohn’s disease and colon cancer

If Crohn’s disease affects at least half the surface of the large intestine (colon), there is a slight increase in the risk of developing cancer.

 

How long does it take to cure Crohn’s disease (expectancy)?

The prognosis is variable, but it is very difficult to cure. It depends on which part of the intestine was affected by the frequency and severity of the exacerbations.

Prospects if Crohn’s disease is not cured:
About 3 people out of 20 with Crohn’s disease have severe and / or frequent worsening.
Some people have only one or two exacerbations during their lifetime and for the rest of their lives they have no symptoms.
Many have relapses, but may have long periods without symptoms.
Sometimes a severe relapse is dangerous and a small number of people die due to complications such as a bowel perforation.
Up to 8 people out of 10 with Crohn’s disease need surgery at some point in their lives for a complication.

About half of patients with Crohn’s disease will undergo surgery within the first ten years after disease onset.
The most common reason is removal of a stenosis that has been formed.
Some people need more operations over the course of their lives.
Anyone with Crohn’s disease can expect to have two or four surgeries in their lifetime.
However, lately the number of surgeries has decreased, probably due to more modern treatments and new medicines available.

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