May 28, 2012 | In 1932 Dr. Burrill Crohn published a landmark paper describing the features of the inflammatory bowel disease that came to bear his name. Crohn’s disease affects men and women equally and seems to run in some families. About 20 percent of people with Crohn’s disease have a blood relative with some form of inflammatory bowel disease, most often a brother or sister and sometimes a parent or child. Although early research showed that people of Jewish heritage have an increased risk of developing Crohn’s disease while African Americans were at lesser risk, physicians are now recognizing much higher rates of Crohn’s disease in African Americans than previously believed. Crohn’s disease can affect any area of the gastrointestinal tract but it most commonly affects the lower part of the small intestine or ileum. The swelling extends deep into the lining of the affected organ and can cause pain and can make the intestines empty frequently, resulting in diarrhea.

May 28, 2012 | Crohn’s disease begins with inflammation, most often in the lower part of the small intestine or in the colon, but sometimes in the rectum, stomach, esophagus or mouth. Unlike ulcerative colitis, in which inflammation occurs uniformly throughout an affected area, Crohn’s disease can develop in several places simultaneously, with healthy tissue in between. In time, large ulcers that extend deep into the intestinal wall may develop in the inflamed areas. No one has been able to determine what triggers the inflammation in Crohn’s disease although research shows that the inflammation seen in the gastrointestinal tract involves several factors: the genes the patient has inherited, the immune system itself, and the environment. Foreign substances, also known as antigens, are found in the environment. One possible cause for the inflammation may be the body’s reaction to these antigens, or that the antigens themselves are the cause for the inflammation.

May 28, 2012 | The most common symptoms of Crohn’s disease are abdominal pain, usually in the lower right area, and diarrhea. Weight loss, arthritis, skin problems, and fever may also occur. Rectal bleeding is another symptom which, when persistent, can lead to anemia. Diagnosing the disease requires a thorough physical exam and a series of tests. A blood test may reveal a high white blood cell count, which is a sign of inflammation somewhere in the body. A stool sample can determine if there is bleeding or infection in the intestines. The physician may also do an upper gastrointestinal series or specialized magnetic resonance scans to look at the small intestine. For these tests, the person drinks a solution that coats the lining of the small intestine before the images are taken. Newer technology called computed tomography or magnetic resonance enterography gives clinicians much more detailed information about inflammation or other abnormalities in the small intestine.

May 28, 2012 | Patients with Crohn’s disease typically turn to medication as a therapeutic option. According to UAMS gastroenterologist Dr. Cyrus Tamboli, several categories of drugs that control inflammation in different ways may be prescribed, but what works well for some patients may not work for others, so it may take time to find a medication that helps. Surgery may be needed for serious complications or for patients that don’t respond to medication. Several different types of surgical procedures may be performed, depending on the type of complication, the severity of the illness, or the location of the disease in the intestines. Unfortunately, the benefits of surgery for Crohn’s are only temporary. The disease often recurs, frequently near the reconnected tissue or elsewhere in the digestive tract. Nearly three out of four people with Crohn’s eventually need some type of surgery. The best approach is to follow surgery with medication to minimize the risk of recurrence.

May 28, 2012 | Like many disorders, Crohn’s disease affects those dealing with it on an emotional level as well as a physical one. If the symptoms, including abdominal pain, gas and diarrhea, are severe, the patient’s life may revolve around the bathroom. In some cases, they may barely be able to leave the house, leading to anxiety that in turn makes their symptoms worse. The nature of the disease and the dietary restrictions it requires can cause isolation, embarrassment and often depression. The best thing you can do if you or a loved one has been diagnosed with Crohn’s disease is learn as much as possible about the illness. Although support groups aren’t for everyone, they can provide valuable information as well as emotional support. Group members frequently know about the latest medical treatments or integrative therapies. Some people find it helpful to consult a psychologist or psychiatrist who’s familiar with the disease and the difficulties it can cause.