Crohn's Disease
Crohn’s disease is one of the inflammatory bowel diseases.
It can affect almost any part of the gastrointestinal system,
but most commonly affects the end of the small bowel (terminal
ileum) and the colon (or both). It tends to occur mostly
in young people (between teenage years and 40) but can
occasionally occur in older patients. The initial symptoms
may be quite vague, with excess gas, bloating, abdominal
discomfort and intermittent diarrhea, fevers and sweats.
In others it may present with severe abdominal pain, bloody
diarrhea, fevers, chills, nausea, vomiting and bowel
obstruction. Complications can include intra-abdominal
abscesses, fistulas (connections) between the large and small
bowel, or rectal abscesses or fistulas. The disease may be
mild, intermittent, persistent or severe. In a small
percent, the disease remits and may never recur.
Gallstones often form in these patients, cause gallbladder pain
or infection.
While the cause of Crohn’s disease is unknown, there is much
that can be done to treat this disease. Depending upon
which part of the bowel is effected, the medical treatment may
vary. Medications such as Flagyl, Dipentum, Prednisone,
Imuran, 6-MP and Azasan may be used. For refractory cases,
Remicade and Cyclosporin IV may be utilized, the former, often
being used in cases complicated with fistulas.
Surgery may be necessary in severe, acute cases that do not
respond to medical treatment when there are intra-abdominal
abscesses or bowel obstruction. Unfortunately, even after
the Crohn’s segment is removed, the disease may recur, weeks or
decades later.
Despite the fact that Crohn’s disease may be a terribly frustrating disease, it is totally unpredictable, and may go into remissions or flares for months or years at a time. Stress tends to exacerbate the activity of the disease, especially the kind of “life-stresses” that people tend to hold inside of themselves.
Contrary to what has been suggested in the medical and lay literature, we have not found any increased risk of cancer associated with long term disease.
Today there are many potential treatments for Crohn’s disease. Newer drugs are being worked on right now, that may benefit even the toughest cases in the future.
