Diagnosis and Treatment of Crohn’s Disease

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Table of Contents

Summary
Introduction
Medications
Conclusion
Works Cited

Summary

Crohn’s disease also known as enteritis or ileitis causes inflammation, swelling and irritation of the digestive tract. The disease affects any part of the digestive tract that is starting from the mouth up to the anus. The ileum is the organ in the body, which is affected by the disease.

Cronh’s disease is a condition that is currently affecting people in the UK as well as the United States of America. It was reported that the percentage of women affected with crohn’s disease in the UK is higher than men while in the US both female and male are affected with the same percentage.

It was reported that some of the people infected by cronh’s disease were brothers or sisters with similar condition or a related infection like IBS (irritable bowel syndrome). Therefore, it affects people of all ages though the most affected are between the age of 15years and 40years according to the statistics.

Introduction

Crohn’s disease is a condition that is affecting many people and has therefore raised concern. The disease affects the digestive tract and gastrointestinal tract/gut causing inflammation and irritation on the affected part. When infected with cronh’s disease the swelling causes pain and frequent emptying of the bowels resulting to diarrhoea.

When the inflammation becomes chronic, scar tissues may build up in the intestines hence causing a stricture. A stricture makes the food to move slowly to the intestines causing pain as well as cramps.

The research was primarily conducted to report the causes of crohn’s disease and the people who can be infected by the disease. The research was also about the causes, symptoms, diagnosis, the complications and the treatment of the disease. Crohn’s disease is at times difficult to diagnose and its symptoms resembles intestinal disorders like colitis, ulcerative and irritable bowel syndrome. (Bosworth, Scherl and Weinstock 5).

Literature review. Crohn’s disease affects any part within the digestive tract causing inflammation, which can go deeper into the lining of the part affected and swelling of the affected part causing pain accompanied by irritation. The inflammation that is caused in patients with cronh’s disease has been always linked to the patient’s immune system, patient’s gene and the environment.

Research indicates that the causes of crohn’s disease are not clearly defined though the condition occur when there is an abnormal reaction of the immune system by treating useful bacteria to the body, food and other substances necessary in the human body as foreign and unwanted substances (Bosworth, Scherl and Weinstock 1).

Research shows that the patients who suffer from crohn’s disease develop problems such as blocking the intestines when they become thick as a result of scars as well as swellings. Research therefore shows that doctors treat patients infected with cronh’s disease by giving medications, through surgery, nutritional supplements or by recommending a combination of the options. (Hanauer, and Sandborn 1).

The research conducted that has been proven effective in preventing the cause of crohn’s disease or treating. In order to reduce the worsening of the symptoms it is advisable for the patients to take food that contain all the nutrients required in the body.

Cases have been reported on increased symptoms of cronh’s disease in patients who smoke as compared to those who do not smoke but smoking itself is not a cause of the disease. Through the research that was conducted women who are infected with cronh’s disease were able to conceive and give birth but they are always advised to consult their doctors before they get pregnant (Hanauer, and Sandborn 1).

Even though there are no specific symptoms for cronh’s disease, the common one in patients is the abdominal pain, which occurs at the right side and diarrhoea. The diagnosis of the disease is done by doctors either by performing physical examination such as stool test and blood test or by imaging tests like upper GI series, Computerized tomography (CT) scan, Lower GI series, flexible sigmoidoscopy and colonoscopy (Bosworth, Scherl and Weinstock 1).

Causes of Cronh’s Disease. Research shows that the cause of cronh’s disease has not been clearly defined since the scientists have not yet proved the several theories, which explain the cause. The experienced doctors believe that when the immune system reacts abnormally, the condition may occur in the body.

When the immune system is normal, it is able to destroy harmful substances, bacteria as well as viruses in order for the body to be protected against infections. However, in cases of cronh’s disease the immune system acts abnormally by attacking those bacteria, food and other substances, which are beneficial to the human body.

When the process is going on, inflammation is caused in the intestines after accumulation of white blood cells resulting to injuries or ulcers, which are difficult to treat. The research shows that people with crohn’s disease develop tumors because of production of protein. This confuses the researchers to tell whether this condition of high levels of TNF results from the crohn’s disease or causes it (Hanaper, Lichtenstein, and Sandborn 1).

Signs and Symptoms of Crohn’s Disease. Symptoms in crohn’s disease usually vary in relation to the particular part of the gut, which is affected. When there is inflammation or swelling in the affected part of the digestive tract, the patient is likely to suffer from the following symptoms:

Pain is one of the common symptoms that patients experience. The level of pain varies according to patient and it depends on the part, which is affected in the gut. The pain is mostly experienced in the abdomen at the lower-right side since most inflammations occur in the ileum.
The ulcers of the gut occur when the patients have sores which are not healing. The patient may therefore bleed and this is noticed in the patient’s stool.
Mouth ulcer is also another symptom that can be experienced by patients infected with crohn’s disease.
Diarrhoea is experienced by patients infected with crohn’s disease. This condition can be mild in some patients or severe in others. This may be accompanied with mucus, pus or blood.
Some patients may be anaemic due to blood loss.
Patients are likely to lose weight due to lack of appetite (Kugathasan and Sauer 1).

Diagnoses of Crohn’s Disease. During diagnosis, the doctor examines carefully the list of signs and symptoms. There are also other physical signs that are noticed when the inflamed bowels are stuck together to form a lump that can be felt in the patient’s abdomen. After the physical examination, the doctor schedules a number of tests to diagnose the disease (Bosworth, Scherl and Weinstock 1).

Blood Tests. The doctors get blood specimen to be tested from the patients, which are later taken to the laboratory and analyzed. It is analysed to determine the level of white blood cell, which indicates the sign of an inflammation or infection within the body. The blood test also helps to determine if the patient is suffering from anaemia which is a sign of blood lose in patients (Hanauer, Lichtenstein and Sandborn 2).

Stool Tests. The doctor uses the stool of the patient for analysis in the lab. Stool tests are done to examine whether there are causes of gastrointestinal diseases like crohn’s disease. After the stool test, it is possible to determine bleeding in the intestines since the blood particles can be seen during analysis (Bosworth, Scherl and Weinstock 1).

Flexible Sigmoidology and Colonoscopy. Experienced doctors in the hospital or health centers such as the gastroenterologist do the tests. Once the tests are done, it is possible to diagnose the disease in order for proper treatment to be prescribed to the patients.

Colonoscopy is a test whereby the doctor uses a long flexible telescope to investigate the ileum, rectum and the colon of the patient. The doctor uses sigmoidoscopy when viewing the lower colon and the rectum of the infected patient. Before the tests are carried out doctors issue written bowl preparation instructions that patients follow while at home before the tests. The patients are told to take liquids for 1 to 3 days prior to the tests (Kugathasan and Sauer 1).

During the test, the doctor is able to see the inflammation, ulcers or the bleeding on the wall of the colon after inserting the flexible tube into the anus of the patients. After the tests, patients are advised not to drive until 24 hours are over and patients may experience bloating and cramping during the first two hour after the test.

Computerized Tomography (CT) Scan. The x-rays as well as computerized technology are useful in order to obtain the desired results. The patients take a solution or injected before the test is done. This test helps in the diagnosis of crohn’s disease (Bosworth, Scherl and Weinstock 2).

Upper GI Series. This test is done to examine the small intestines. When patients are to undergo the test they are not allowed to eat or drink for 8 hours before the test is done. After the test, patients are authorized to remain standing or seated near the x-ray machine as well as drink barium. The barium helps to show if there are infections in the small intestine by forming coats, which are observed in the x-ray machine (Bosworth, Scherl and Weinstock 2).

Lower GI Series. This help to examine the normal function of large intestines. The experienced doctor provides instructions to the patient to be followed at home before the test is done. A laxative medicine makes the stool loose as well as increasing its movement so that they can be ready a few days before the test. During the process the doctor inserts the a flexible tube into the anus of the patient and the large intestine is filled with barium, which form coats in the intestines hence a clear view on the x-rays (Hanauer, Lichtenstein, and Sandborn 2).

Complication of Crohn’s Disease. Crohn’s disease leads to blockages after the walls of intestines become thick due to the swellings that have occurred for a long period. Patients infected with crohn’s disease may develop ulcers complications, which result due to the sores in the intestines. Fistulas are another complication in patients infected with crohn’s disease. The tunnels occur in the area around the anus or the rectum of the patient and these tunnels are infectious and are treated through medication or surgery. The fissures in the muscular membrane of the anus affect the patients making them to develop complications that require medical attention.

Some of the complications in crohn’s disease occur due to the failure of food absorption because the infected intestines are not able to absorb nutrients into the body. This therefore results to iron deficiency in the body causing anaemia in patients. Patients infected with crohn’s disease and are treated with steroid medications develop osteoporosis, which occurs due to the weakening of the bones. Patients may therefore have weak restless legs and feels uncomfortable when asleep or seated (Kugathasan and Sauer 1).

Some of these complications may clear up when crohn’s disease is treated but in some cases, they need to be treated separately. Other complications are arthritis, internal bleeding and perforations of the gut, skin problems, kidney stones and liver diseases, inflammation of the mouth and eyes and high risks to diseases like asthma.

Treatment for Crohn’s Disease. When treating patients infected with crohn’s disease doctors may use medications, surgery, nutrition supplements or a combination of the three options.

During the treatment of crohn’s disease, the main aim of doctors is ensure that inflammations do not occur and dealing with deficiencies which result from poor nutrition to eradicate pain in the abdomen as well as bleeding. The kind of treatment therefore to be administered depends on the infection and how severe the condition is (Hanauer, Lichtenstein and Sandborn 3).

Since research has shown that there is no cure of crohn’s disease, patients are therefore given treatments, which help in controlling the disease toreduce the frequency of the recurrence. Patients who are infected require medication for a long period and visiting the doctor many times for the condition to be monitored.

Medications

Anti-inflammation medications

Medicines that contain mesalamine help to treat inflammation before patients are given other medicines. Mesalamine-containing medications are like sulfasalazine or 5-aminosalicylic acid (5-ASA) agents such as Dipentum, Asacol or Pentasa, which are introduced to patients who do not respond to sulfasalazine (Bosworth, Scherl and Weinstock 2).

Cortisone or Steroids

The drugs are also called corticosteroids and patients use them to reduce inflammation. During the earlier stages of crohn’s disease doctors prescribe corticosteroids especially when the symptoms are worse and then the dose is reduced once symptoms have been controlled (Kugathasan and Sauer 2).

Immune system suppressors

Immunosuppressive medications are medications used to suppress the immune system when treating crohn’s disease. This kind of medication works by blocking the immune system from reactions, which cause inflammation. The doctor can prescribe drugs like 6-mercaptopurine or any other related drug

Biological Therapies

These are medications given to patients by injecting the vein, which is inflixmab (Remicade), or by injecting the skin- adalimumab (HUMIRA). Therapies, which are biological, help the patients when the standard therapies do not help them. It is prescribed to patients with either severe or mild symptoms of crohn’s disease (Hanauer, Lichtenstein and Sandborn 4).

Antibiotics

Infections such as stricture or fistulas may cause bacterial growth in the intestine and the use of antibiotics like metrinidazole, ampicilline, cephalosporine, sulfonamide or tetracycline can be used to treat the conditions (Bosworth, Scherl and Weinstock 3).

Anti-diarrhoea medications and fluid replacements

In case the diarrhoea and abdominal pain are not relieved after the treatment of crohn’s disease anti-diarrhoea medications are given to the patients. They include codeine, loperamide or other related medications.

Surgery

The research conducted indicates that surgery is required for patients who suffer from crohn’s disease and many doctors recommend it immediately. Surgery therefore relieves symptoms, which do not respond to medical therapy. The common surgery occurs through removing the rectum, small portion of the colon or the whole colon.

The stool is collected through Ileostomy when ostomy pouch is placed outside the body. Another kind of surgery is the intestinal resection surgery where the infected part of the intestine is removed hence joining the healthy sections together (Kugathasan and Sauer 2).

Nutritional Supplementation

The patients are advised to supplement the nutrients by the experienced doctors especially when there is slow growth of the body organs. This helps people who require more nutrients in situations where intestines cannot absorb the required nutrients after the food is eaten.

Conclusion

Patients with crohn’s disease are therefore advised to visit the doctors regularly for diagnoses to ensure that they are able to control the condition. People should also be aware of the symptoms of crohn’s disease for them to detect the symptoms earlier in case they are infected for earlier treatment.

Works Cited

Bosworth, Benard, Scherl Erick and Weinstock Linus. “Crohn’s disease is associated with restless legs syndrome.” Inflammatory Bowel Disease 16 (2010): 2. Print

Hanauer Samwel, Sandborn Wayne and Lichtenstein George. “Management of Crohn’s disease in adults.” American Journal of Gastroenterology, 104(2009): 2. Print

Kugathasan, Shallon and Sauer, Cosmas. “Pediatric inflammatory bowel disease: highlighting paediatric differences in IBD.” Gastroenterology Clinics of North America 38 (2009): 4. Print

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