What is Crohn’s disease?

Crohn’s disease is a chronic inflammatory bowel inflammation that can affect all parts of the digestive tract, from the mouth to the esophagus and rectum. Inflammation is mostly seen in the last part of the small intestine and/or the beginning of the large intestine. Symptoms of the disease often come and go, meaning that symptom-free periods alternate with inflammatory periods at regular or irregular intervals. Along with ulcerative colitis , Crohn’s disease is a type of inflammatory bowel disease .

Unlike ulcerative colitis, in Crohn’s disease not only is the intestinal surface inflamed, but the deeper layers of the intestinal wall may also be affected. Scientists have so far not been able to explain exactly what causes it. However, a genetic predisposition likely plays a role, as the disease runs in families.

What is the incidence?

Experts think that 50-80 thousand people in Turkey suffer from crohn’s and other inflammatory diseases. The disease rarely occurs in children and the elderly, affected people usually fall ill between the ages of 20 and 35.

What causes Crohn’s disease?

The exact causes of Crohn’s disease are unknown. Experts assume that hereditary disposition and environmental influences play a role. In this case, the intestinal barrier function is probably impaired.

Smoking is an important risk factor for developing Crohn’s disease. An increased frequency was found among smokers. Studies have shown that smoking also increases relapse rates. Therefore, it makes sense to quit smoking.

The view that Crohn’s disease is caused by mental stress or malnutrition has not been confirmed. However, these factors can affect the course and management of the disease. The illness itself and associated complaints naturally also have an impact on mood and can become a mental burden for those affected.

What are the symptoms of Crohn’s disease?

The most common sign of Crohn’s disease is diarrhea , which usually lasts for more than six weeks. Other common complaints are weight loss and abdominal pain that may radiate throughout the abdomen . It is not uncommon for pain to appear in the lower right abdomen and can be easily mistaken for appendicitis. Fever, fatigue, and anemia are common signs of inflammation.

Due to frequent diarrhea and difficult absorption of food components in the intestine, malnutrition with weight loss can occur. Growth disorders can also occur in children.

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Intestinal fistulas develop in about 40 percent of cases. These are the channels between two parts of the intestine, between the intestine and another organ, or between the intestine and the skin. A quarter of those affected develop abscesses and fissures . The anal region is often affected by this condition.

Sometimes, a narrowing of the intestine ( stenosis ) occurs due to adhesions and dimples in the intestine, which can cause intestinal obstruction.

Some other possible symptoms are:

  • Joint inflammation (osteoarthritis)
  • eye infections
  • skin lesions
  • Bile and kidney stone formation
  • Bone loss (osteoporosis)
  • Bile duct inflammation

The longer the duration of the disease, the greater the risk of developing a malignant tumor in the intestine. Therefore, regular bowel examinations are necessary to detect such a process at an early stage.

How is Crohn’s disease diagnosed?

Usually, the symptoms experienced for a long time take the person concerned to the doctor. The medical examination includes a variety of blood and stool tests , in addition to a health history and physical examination . Inflammatory causes of symptoms are indicated by increased inflammatory value (CRP) in blood and increased calprotectin value in stool.

The doctor can diagnose Crohn’s disease with a colonoscopy . With this procedure, he closely examines the intestinal mucosa and can take tissue samples for microscopic examination to make a clear diagnosis. That’s because tissue samples can be used to see typical changes in Crohn’s disease.

Other examination methods include ultrasound , special x- ray examinations, procedures such as computed tomography and magnetic resonance imaging .

Capsule endoscopy is suitable for detecting infection in the small intestine. The patient swallows a capsule containing a mini camera. During intestinal transit, the camera takes pictures of the inside of the intestine and sends them radio waves to an external device.

How is Crohn’s disease treated?

There is currently no single treatment that works for everyone for Crohn’s disease. The goal of medical treatment is to reduce the inflammation that triggers your symptoms. It is also to improve the long-term outlook by limiting complications.

Medication

Drug treatments are quite extensive and the physician may prescribe many drugs according to your condition. Detailed information on the subject is given below:

  • Anti-inflammatory drugs : Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease.
  • Immune system suppressants : These drugs also reduce inflammation. The way it works is that it targets your immune system, which produces substances that cause inflammation.
  • Antibiotics : Antibiotics can reduce the amount of inflammation, sometimes healing fistulas and abscesses, in people with Crohn’s disease.
  • Other medications : In addition to controlling inflammation, some medications can help relieve your signs and symptoms, but always talk to your doctor before taking any over-the-counter medication.
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Treatment of symptoms

For frequent diarrhea and cramp-like abdominal pain, the doctor may prescribe medication that inhibits intestinal activity and relaxes intestinal muscles. However, these drugs are not recommended in all cases and therefore only the treating physician should be consulted.

Iron deficiency or vitamin deficiency can be treated by applying appropriate substances. To prevent osteoporosis, those affected can take calcium and vitamin D, but this should be decided by the doctor.

Surgical treatment

Surgery may often be required for abscesses, scarred narrowing of the bowel, intestinal fistulas, or symptoms that persist despite medication.

However, the benefits and possible consequences of operational intervention must be carefully weighed. In case of intestinal obstruction and similar emergencies, the operation should not be postponed under any circumstances.

Surgical intervention may involve removing an affected part of the intestine. The important thing here is to remove as little intestine as possible but only as much as necessary. The surgeon will remove as little bowel as possible to prevent functional disorders due to shortened bowel.

balloon therapy

In some cases, an alternative to surgery may be to dilate sections of the small intestine with a balloon catheter. Based on current experience, balloon dilation may delay surgery in many patients, but often does not prevent it.

supportive psychotherapy

According to available information, psychological factors do not cause Crohn’s disease, but their influence on the course of the disease has been proven. Life changes with chronic disease. Quality of life and performance may be impaired.

Psychotherapeutic procedures are a useful addition to purely physical therapy. Psychotherapy often leads to better treatment of illness, improving mental well-being and quality of life.

diet therapy

There is no specific diet for Crohn’s disease. However, those affected should take care of adequate intake of calcium and vitamins, as the absorption of nutrients in the intestine can be impaired.

Food choice can affect symptoms. In particular, those affected should avoid high-fiber foods.

The affected person should know which foods they can tolerate well and which foods they should avoid. Because they can cause discomfort and even an inflammatory flare-up. People with Crohn’s disease have an above-average lactose intolerance. Therefore, he should pay extra attention to the foods he eats.

In the case of a mild acute attack, a low-fiber or liquid-based diet is appropriate to relieve the bowels. In the event of a severe relapse, parenteral nutrition via infusions may be necessary.

What should people with Crohn’s disease eat?

Below are some foods that people with Crohn’s report benefits. By eating one or more of these foods during a flare-up, you can reduce symptoms and lead a more pain-free life.

  • Yogurt: Yogurt can be a great food if you have Crohn’s disease. The probiotics in it can help the gut heal. You may want to avoid yogurt if you have trouble digesting milk proteins, as it can worsen the diarrhea and gas symptoms associated with Crohn’s.
  • Oily fish: Oily fish such as salmon, tuna, and herring may help with some of your Crohn’s symptoms. Some types of fatty fish contain omega-3 fatty acids, which have anti-inflammatory properties and may help reduce the aggravation of your symptoms.
  • Fruits and vegetables: A diet rich in fruits and vegetables can help reduce symptoms. If raw fruit is making your flare-ups worse, you can try applesauce and banana. Both are good for you and can satisfy your cravings for sugar.
  • Cooked carrots: For many people with Crohn’s, carrots can be a great filling vegetable without exacerbating symptoms. During a Crohn’s flare, be sure to cook the carrots until they are tender, as cooked carrots are not only easy to digest but also contain antioxidants that can help with Crohn’s symptoms.
  • Potatoes: The insides of potatoes can be great to eat during a Crohn’s flare. Like bananas, potatoes are a great source of potassium and can help your body maintain fluid balance while managing a flare-up.
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Can Crohn’s disease be prevented?

As it has not yet been clarified what causes Crohn’s disease, general prevention is not possible. However, there are measures that can delay the next attack, these are:

  • Not smoking: Smoking not only increases the risk of developing the disease, but smokers are more likely to have inflammation than nonsmokers. Studies have shown that quitting smoking is just as helpful as taking certain medications.
  • Regular checkups: Experts recommend that people with the disease have their blood values ​​checked and that checkups be done regularly, even during symptom-free stages. This allows the doctor to recognize an exacerbation or any complications as soon as possible.
  • Diet: There are no dietary recommendations from experts for Crohn’s disease. Patients do not need to take supplements unless they have proven specific nutrient deficiencies. Anyone with a food intolerance or allergy should avoid the related stuff.
  • Therapy: If you suffer greatly from chronic illness, you may withdraw from your social contacts and develop depression. In this case, therapy can help you cope with the illness.
  • Relaxation: Relaxation techniques such as autogenic training, meditation and yoga are available to reduce stress. Adequate exercise, adequate sleep, and a healthy lifestyle can help relieve the stress of everyday life.

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