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Crohn’s disease

Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract. It belongs to a group of conditions known as Inflammatory Bowel Diseases (IBD) which include ulcerative colitis and Crohn’s disease and that are defined by conventional clinical, radiological, histological and endoscopic criteria. Both illnesses are chronic with bouts of inflammatory activity.

Although Crohn’s disease often affects the large intestine, it most commonly affects the end of the small bowel (the ileum) and the beginning of the colon. However, it may affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. The inflammation begins with sores that over time can become ulcerous and can lead to tears or fistula in the lining of the anus, which go through the layers and reach other nearby structures.

The number of persons in Europe with Crohn’s disease are estimated to be about one million and almost one and a half million with inflammatory bowel disease. Persons between the ages of 25-40 are most apt to have these diseases and, in general, men and women alike are affected.

Symptoms

Persons with Crohn’s disease usually have active periods (flare-up) alternating with asymptomatic or remission periods. In some persons, symptoms are continuous (chronic) despite correct treatment. The symptoms experienced may depend on which part of the GI tract is affected and can be varied. In certain cases, there are no symptoms (for example, only a slight anemia). Finally, at times it can cause anal discomfort (called perianal illnesses) or in severe forms (perforations and abdominal abscesses).

The flare-up symptoms are varied, bjut almost always include diarrhea, abdominal pain and weright loss. Diarrhea is the main symptom, stools are mixed with blood or mucus and much less frequently, there may be anal hemorrhages. Abdominal pain is characteristic with cramping, localized around the belly button and in the lower right side of the abdomen. Fever is frequent. Chronic symptoms are those lasting more than 2 – 4 weeks.

The anus is affected by the development of pockets of pus (abscesses) or the elimination of pus through tunnels or fistulas around the anus. There can also be symptoms in other organs (extra-intestinal manifestations).

When there is a flare-up of the illness, there may be alterations in the analyses: elevations in the inflammation tests (speed of sedimentation, C protein), anemia and others. Using these alterations and based on what the patient describes, the doctor can calculate the severity of each flare-up and thus, determine the type of treatment.

In some persons, flare-ups can be caused by some drugs, stress and intestinal infections.

Prevention

If you have been diagnosed with an IBD, it is very important that you follow the measures and recommended below and treatments prescribed by your doctor, as these may not only lessen pain but also prevent future flare-ups as well as avoiding possible complications, improving the prognosis of the illness.

Recommendations:

  • See your doctor is you have frequent intestinal discomfort, especially if you have anal bleeding
  • Do not take medicines or other products not recommended by your doctor
  • Some patients being treated with corticoids for some time may also need calcium and vitamin D supplements. Anemic patients may also need iron and vitamin B12 supplements.

Gene or region studied

  • 7q36.1
  • 2q37.1
  • RSPH6A
  • SLC22A4
  • 5q31.1
  • 1p31.3
  • 5p13.1
  • BSN
  • 10p15.1
  • 5q33.1
  • SLC22A5
  • MST1
  • DEFB1
  • CDKAL1
  • 6q23.3
  • 1q24.3
  • 10q21.2
  • IL23R
  • 6p21.32
  • NOD2
  • NELL1
  • 18p11.21
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