Crohn’s disease

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What is it about ?

Crohn’s disease is a chronic inflammation of the digestive system. The digestive system processes food and is made up of the mouth, throat, esophagus, stomach, small intestine, and large intestine (colon), among others.

Damage to the digestive system

Crohn’s disease can affect the entire digestive system, from the mouth to the last portion of the large intestine (rectum) included. Healthy and inflamed portions alternate. The end of small intestine and portions of the large intestine are most often affected.

Flare-ups and periods without complaints

Some people with Crohn’s disease have more symptoms than others. Likewise, the affection may not always have the same intensity in the same person:

  • The inflammations sometimes remain under control for a long time. In this case, we are talking about remission.
  • Sometimes symptoms can appear suddenly and intensely. In this case, we are talking about push.
Causes

The exact cause of Crohn’s disease is not known. Our own immune system probably plays an important role. That is, the immune system overreacts to the body. This is called a autoimmune disease.

Risk factors

Other factors that can be involved in Crohn’s disease are:

  • heredity;
  • smoking;
  • the stress.
Other inflammations

Inflammations are most often localized in the intestines. But other places in the body can also become inflamed:

Crohn’s disease sometimes looks like ulcerative colitis. Both are chronic inflammatory bowel disease (IBD).

What is its frequency?

Crohn’s disease affects about 12-20 in 10,000 people.

Where do we meet her?

Crohn’s disease is usually discovered between the ages of 20 and 30. But the condition can occur at any age, including childhood.

How to recognize it?

The most common symptoms are :

The less frequent symptoms are :

How is the diagnosis made?

The GP may suspect Crohn’s disease based on your story.

A specialist in the gastrointestinal system (gastroenterologist) can perform a bowel endoscopy (colonoscopy) to diagnose the condition.

What can you do ?

Crohn’s disease is not cured, but it can usually be treated well. Take your medication well and see your doctor regularly for check-ups.

Here are some others advice useful:

  • Eat regularly.
  • Eat healthy and varied, eat enough fruits, vegetables and fiber. It is (usually) not necessary to follow a special diet.
  • Drink enough water (1.5 to 2 liters per day).
  • Do not smoke.
  • Get enough exercise.
  • Try to avoid stress.
  • Get enough rest.

What can your doctor do?

The treatment depends on different elements:

  • the portion of the intestines that is inflamed;
  • the duration of the inflammation;
  • the severity of the inflammation;
  • the frequency of symptoms;
  • etc.
Medications
Tablets, suppositories and enemas

There are drugs in tablets, but also in suppositories or enemas for anal use. Suppositories and enemas go directly into the intestine, where they can work locally. Since the drug only reaches the last portion of the large intestine, and does not penetrate the rest of the body much, the risk of side effects is reduced.

Anti-inflammatory

These drugs inhibit (slow down) inflammation:

  • cortisone, especially at the onset of the disease and during severe flare-ups;
  • sulfasalazine and mesalazine (sometimes);
  • immunosuppressants (for example, azathioprine, mercaptopurine, and methotrexate), which suppress the immune system;
  • biological drugs (for example, infliximab and adalimumab), especially when other drugs are not working enough.
Food supplements

Crohn’s disease increases the risk of developing a deficiency of certain nutrients, such as:

If necessary, the doctor will refer you to a dietitian and / or prescribe supplements.

Surgery

When the drugs do not work (or no longer) or when there are serious complications, an operation may be necessary. The possible interventions are as follows:

  • removal of the inflamed portion of the intestine;
  • dissection of the fused intestine portions;
  • resection of fistulas and abscess ;
  • removal of the large intestine;
  • placement of a (temporary) stoma.
Regular

The doctor will check regularly:

  • your blood to quickly detect drug deficiencies and / or side effects;
  • your large intestine (colonoscopy), as there is a slightly increased risk of bowel cancer.

Sources