What is Crohn's Disease?
What is Crohn’s Disease?
What is Crohn's disease? According to the National Center for Biotechnology Information, U.S. National Library of Medicine at the National Institutes of Health, Crohn’s disease is an inflammatory autoimmune disease. An autoimmune disease occurs when the body recognizes its own cells as foreign and begins to attack them. The inflammation of Crohn’s disease can potentially occur anywhere throughout the gastrointestinal tract from the mouth to the rectum. The intestinal walls thicken as a result of Crohn’s disease. (1)
You have a higher risk of developing colon cancer or bowel cancer if you have Crohn’s disease. (1)
Crohn’s disease statistics / Prevalence of Crohn’s disease:
What are some disease statistics for Crohn's disease? According to the Centers for Disease Control and Prevention (CDC), it is estimated that there may be as many as 1.4 million people in the United States living with Crohn’s disease or related Inflammatory Bowel Diseases (IBD) such as ulcerative colitis. The peak age of onset is 15-30 years old with less than 10% occurring in individuals below 18 years old. This disease requires lifelong care for patients and is estimated to cost a health care burden of $1.7 billion in the United States. (2)
The cause of Crohn’s Disease:
What causes Crohn's disease? Currently a definitive cause of Crohn’s disease is unknown. Individuals are said to be at greater risk if they smoke, if they are Jewish or if they have a family history of the disease. Other genetic and environmental factors come into play as well. (1)
According to the University of Maryland Medical Center, individuals of Jewish descent are 3-6 times more likely to suffer from this illness than the general population. Two to seven out of 100,000 people overall may be affected and that number is believed to be growing. (3)
Crohn’s Disease symptoms
Symptoms can run the gamut from mouth sores to stomach pain to bowel accidents. Symptoms may also include weight loss, joint pain, fatigue, eye inflammation and lumps on the skin. (1) Gallstones, anemia, nutritional problems (for which your doctor might recommend a multivitamin including vitamins B, D and K), narrowing or abscessing of the colon, depression and anxiety, fistulas and osteoporosis (bone loss) are all examples of symptoms as well. (3)
Crohn’s Disease diagnosis
Tests used to diagnose Crohn’s disease include but are not limited to Endoscopy and Colonoscopy. Physical tests may reveal a mass in the stomach for example. (1) Barium enemas and CT scans that allow a full view of the intestine are other examples of tools used for diagnosis. (3)
Illustration of Endoscope used to diagnose Crohn's disease patients
Medscape illustration of 'bottom up" approach in treatment
Crohn’s disease treatment
Crohn’s disease is treated with various medicines including over the counter medicine such as Imodium to control diarrhea and stronger prescription medicines such as corticosteroids if necessary. (1) Other possible medicines include immune system suppressor (suppressing the autoimmune response and decreasing inflammation), antibiotics to treat conditions such as ulcers and fistulas, and Mesalamine which reduces inflammation with less side effects than Sulfasalazine, an older drug that reduces inflammation but includes possible side effects such as nausea, stomach discomfort and in men, reduced sperm count. (3)
It is important for individuals to take medicine regularly to avoid flare up because this condition can go through periods of dormancy or flare up. To avoid disease symptoms from returning, the medicine is very important. Additionally, individuals suffering from this condition should drink plenty of water, eat only small (not large) meals throughout the day, avoid fatty and greasy foods as well as avoid foods with high fiber content. (1)
If symptoms of very severe, a patient might possibly be advised to have an elemental diet (liquid diet consisting of main nutrients) under the supervision of a physician. (3)
Homeopathy and Acupuncture have long been identified as effective alternative remedies that patients might be informed of and consider. (3)
During pregnancy, a patient’s Crohn’s disease might be in remission but it can possibly be active as well. If it is active, the patient must continue a medication regimen during pregnancy. Pregnant women with Crohn’s disease have a higher risk of miscarriage or still birth. (3)
If the condition does not respond adequately to medicines and alternative remedies, surgical intervention might be deemed necessary. Possible surgeries to mitigate the symptoms of Crohn’s disease include removal of the colon (with or without the rectum) or bowel resection to remove the damaged parts of the intestine.(1) Over seventy percent of patients with Crohn’s disease will have to undergo surgery for the condition at some point in their lives with an thirty percent who have surgery having to undergo repeat surgery within five years of the first procedure. (3)
Pregnant with Crohn's Disease
Crohn’s disease prevention
Because this is a disease of unknown cause, literature concerning prevention is scarce. Crohn’s disease also has no known cure but mainly medicine management of the illness. Mind/ body exercises such as tai chi and yoga and exercise in general can help to relieve the stress and subsequent depression associated with this illness. (3) Individuals who smoke should stop because studies have shown that smoking worsens symptoms. (3)
While there is no known cause, prevention or cure for Crohn’s disease, research continues on all fronts. As recently as last week, a breakthrough was made by scientists at the University of Calgary in Canada. Over 200,000 patients are suffering from Inflammatory Bowel Diseases in Canada. It had been known that something causes neuron death or damage in the gut of the Crohn’s diseases or colitis patient but it has now been discovered that the things that cause this are specifically proteins called “pannexins”. (4)
Cell death is prevented when drugs are used to block these pannexins. Research was done on mice to discover this. Nevertheless, the principal investigators and research study team including Roger Thompson, Keith Sharkey and others at Calgary’s Hotchkiss Brain Institute and the Snyder Institute for Chronic Diseases highlight the fact that the same pannexins are found in human beings. This research can bring medical experts closer to finding more successful drug therapies for Crohn’s disease and ulcerative colitis patients. (4)
Support for Crohn’s disease patients
Many physical diseases have psychological repercussions because of the stress associated with dealing with the disease which can be taxing and devastating for many. In the case of Crohn’s disease, bowel accidents for example can cause people to experience embarrassment, sadness and even depression. For the many possible symptoms that occur from Crohn’s disease, support is available for patients. The Crohn’s and colitis foundation of America offers many such support groups. (1)
Some famous people with Crohn’s Disease or other IBD
1. Cynthia McFadden, Prime Time news correspondent, diagnosed with Crohn’s disease in the 1970s, while in college. Mainly in remission since and a spokesperson and advocate for those with the condition. (5)
2. Shannen Doherty, actress, diagnosed with Crohn’s disease in 1999, does not discuss the details in the media because having to discuss the often embarrassing disease symptoms is “not sexy” (5)
3. Dwight Eisenhower (1890-1969), 34th President of the United States (6)
4. John F. Kennedy (colitis) (6)
U.S. Presidents were often advised to keep health conditions secret but if they had to be hospitalized for surgeries for example, the public would often be made aware.
5. David Garrard, football player- Jacksonville Jaguars quarterback, diagnosed with Crohn’s disease in 2004.
Doctors have stated that with the disease management, he can continue to play football. (6) He has been an involved advocate for the cause and has helped raise over $180,000 for an awareness campaign called “In the zone with Crohn’s”. (7)
6. Mike McCready, rock musician- Pearl Jam guitarist, has stated that he wants people to know that you can still have a life and a career with this disease. (5)
7. Anastacia, singer, first diagnosed with Crohn’s disease at age 13, has had to undergo abdominal surgery, once tried a high fiber diet that caused significant Crohn’s disease flare ups. (7)
References:
1. A.D.A.M. Medical Encyclopedia, Crohn's Disease. PubMed Health. U.S. National Library of Medicine http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001295/ online retrieved 3/24/2012
2. Centers for Disease Control and Prevention, Inflammatory Bowel Disease
http://www.cdc.gov/ibd/ online retrieved 3/24/2012
3. Crohn’s Disease
http://www.umm.edu/altmed/articles/crohns-disease-000043.htm
online retrieved 3/26/2012
4. Stephenson, Amanda, Postmedia news
Researchers make Crohn’s disease breakthrough: They discover proteins responsible for death of damage to neurons in victims’ guts
http://www.vancouversun.com/health/Researchers+make+Crohn+disease+breakthrough/6323110/story.html, online retrieved 3/26/2012
5. 11 Celebrities with Crohn’s disease
http://www.health.com/health/gallery/0,,20510108_3,00.html online retrieved 3//24/2012
6. Famous People Living with IBD
http://crohn-colitis.hu/eng/famous-people-with-ibd.php, online retrieved 3/26/2012
7. Rodriguez, Diana
Crohn’s disease doesn’t care if you’re famous (medically reviewed by Lindsey Marcellin, MD, MPH)
http://www.everydayhealth.com/crohns-disease-pictures/7-celebs-with-crohns-disease...
Online retrieved 3/26/2012