Adams disease-Crohn's disease-treatment

History of Crohn's disease

Crohn's disease belongs to the category of chronic inflammations of the bowel. Medical literature defines this group as IBD-from the English Anti-inflammatory Bowel Disease. The disease first described the Polish doctor Antoni Leśniowski. In its publications carefully characterized by cases of chronic inflammatory bowel disease. In 1932, a group of doctors-Burrill b. Crohn, Leon Ginzburg and Gordon d. Oppenheimer – examined the same problem by specifying it Crohn's disease. Due to the double look at these cases, Polish literature says about Crohn's disease.

A healthy intestine without Crohn's disease

A healthy gut

Gut with Crohn's disease

Diseased small intestine

Incidence of disease

Impact on the intensity of the incidence of Crohn's disease has a variety of factors, ranging from geography to the degree of socio-economic development. The highest incidence of the disease is observed in highly developed countries. Impact on the possibility of developing the disease are also genetic factors. Similar changes observed in 15% of the relatives of the first degree. The offspring and parents this indicator is close to 9%, and parents-3.5%. Crohn's disease mainly affects two age groups. One of them are children, while the second are 60. year of life. However, over the years the statistical age of patients is reduced, so more and more often are diagnosed with this disease in 30-and 40-year-olds.

In Europe the incidence varies from 1 to over 11 to 100 thousand. people in the course of the year. British scientists suggest doubling the number of cases of inflammatory bowel conditions over each decade.

Symptoms of

The most general symptoms include weakness, fever, weight loss associated with malabsorption or wrong nutrition. While the local symptoms are determined by location, breadth and degree of advancement of the inflammation and its changes. Sometimes may also disclose to the complications of parenteral, for example. skin, joints or ocular.

When the disease affects children, is a clear growth inhibition. Changes cause anemia and weight deficiencies-although not always. In maturing adolescents can be seen stopping sexual development. secondary amenorrhoea in girls. In many cases, children go to the hospital with suspected appendicitis, accompanied by similar symptoms. Only the observation allows you to exclude inflammation and to diagnose Crohn's disease. In the youngest patients placing the appropriate diagnosis usually lasts about a year.

In half the cases the changes has agreed to be the last episode of the ileum. The first signs can be anemia, and fever. Symptoms are accompanied by abdominal pain, awitaminoza, hypoproteinaemia, electrolyte disturbances, and sometimes diarrhoea – especially fatty, caused by malabsorption. This, in turn, in the later stages can result in malnutrition or wasting of the body. At nearly 1/3 of patients can sense a tumor located in the lower right part of the abdomen.

1/3 of cases the changes affect both the large intestine, and thin, and 1/5 – only the large intestine. The last variant of the disease can be confused with ulcerative colitis because of similar symptoms: diarrhea, abdominal pain. If inflammation attacks around the anus, patients can receive the galls, fissures, abscesses, fistulae or abscesses. In some cases, these are also the first alarm signals to alert you to the possibility of developing Crohn's disease and need treatment. The least occupied are the top sections of the digestive tract or Appendix.

If you notice in symptoms such as:

  • recurrent diarrhea,
  • abdominal pain,
  • fever,
  • sudden weight loss,
  • bleeding from the gastrointestinal tract,
  • changes (e.g. rectal. abscess, fistula, fissure).

be sure to contact your doctor. Each internal medicine should be carried out to identify and refer you to a specialist. If the symptoms point to the beginning of Crohn's disease, it is possible that the treatment will take place without the need for hospitalization. While those whose symptoms are already clearly sharp, most likely will be placed in a hospital, in order to further observation. Keep in mind that the gastrointestinal bleeding can result in serious complications, so it's important to consult a specialist.

Crohn's disease-treatment

Before your doctor determines the presence of Crohn's disease and decides to proper treatment, is establish the diagnosis. To this end, it is mandatory to carry out intelligence, which can confirm the instance condition. The doctor takes out a series of research symptoms, symptoms, and additional, as well as evaluation of the endoscopic view of the intestine, which gets a slice for Histopathological examination. Small children are subjected to the general anesthesia. To examine the small intestine, it is necessary to carry out magnetic resonance imaging or radiologic studies.

Inflammatory diseases are diagnosed by laboratory tests, for example. by CRP concentration or blood. In addition, the doctor may order a CT scan, during which checks the thickness of the intestinal wall or the occurrence of abscesses in the abdomen. It is interesting to know that to distinguish Crohn's disease Crohn of ulcerative colitis is extremely difficult, hence the need to carry out a series of research-there is no one method that allows you to explicitly specify the instance.

What medication is used to treat Crohn's disease?

  • anti-inflammatory/immunosuppressive – acute symptoms
  • aminosalicylany/glucocorticoids – with the mild,
  • mesalazyny – inflammation of the small intestine,
  • sulfasalazine is the inflammation of the colon,
  • glucocorticoids (intravenous) – in the most severe cases,
  • monoclonal antibodies.

However, most patients undergo surgery to reduce or eliminate local complications in the form of abscesses or fistulas.

The same treatment is chronic. The key is to Crohn's disease does not lead to flare-ups of acute symptoms. Today, a complete cure is not possible, however, professionals can lead to a condition in which the effect of Crohn's disease will not be as noticeable and painful, by relieving symptoms and eliminate inflammation. Treatment can lead to remission-that is freedom from the effects of Crohn's disease, which lasted up to 10 years. Some patients, however, exhibit resistance to the listed treatments-in such cases, the use of biologic agents.

Biological therapy

Biological treatment methods use the natural mechanisms of human organisms, such as for example. production of antibodies. The lymphocytes, which you download from the man and the training of researchers, produce antibodies that block trigger factors. Served the sick, however, they can cause allergic reactions and even infection, therefore, belong to the Group of medicines of last resort.

What is the Biological therapy? These drugs are very expensive, which is why patients eligible for treatment only when other therapies do not work, and the patient is in a really serious condition. Must complete 6. year of life, because in Poland these drugs not be given younger children. Period of therapy covers up to one year and is quite rigidly. Unfortunately, this practice before the Decade, when doctors were not aware that Crohn's disease requires chronic treatment.

Treatment-and what's next?

The same treatment is only half the battle. It is important to follow the doctor's advice about what to do when it finishes. Categorical it is forbidden to let me stop taking drugs. In the period of remission, even when the patient does not already is struggling with the symptoms, continue to need is chronic treatment, accompanied by follow-up studies (i.e.. morphology, liver, etc.). Only then can effectively prevent recurrence and catch possible complications of Crohn's disease or medications. If the Crohn's disease persists for over 10 years, treatment should be based on an endoscopy and colonoscopy, which, if any, will allow for the detection of cancer of the colon is frequent in such cases.

Patients should also be tested in the direction of osteoporosis, calcium-phosphate economy disorder often affects people with Crohn's disease.

When it comes to a special diet in the treatment of Crohn's disease, has not been conclusive recommendations. Patients should use diet rich in nutrients, especially due to malnutrition and deficiencies, which is often accompanied by przypadłościom. In such cases, it is important to replenish iron, zinc and folic acid.

On the other hand, if we are talking about exclusions, most important of all, to eliminate components that may exacerbate symptoms. Depending on individual predisposition of the sick, attention is drawn to:

  • dairy products,
  • the wheat,
  • yeast infection,
  • corn,
  • bananas,
  • tomatoes,
  • the eggs,
  • wine.

In patients with acute symptoms extra problem may be wholemeal bread, legumes, vegetables or fruits wzdymające. These products are characterized by a high content of fibre, which leads to the severity of the diarrhea.

When you use the ubogoresztkową diet and bowel, tapering access, excluding:

  • Apples,
  • citrus fruits,
  • lettuce and spinach,
  • beets,
  • cucumbers,
  • the peel of the fruit and vegetables,
  • mushrooms,
  • nuts,
  • the seeds.

Prevention, which is how to prevent Crohn's disease?

Because it is impossible to determine the causes of the disease, it is impossible to determine how it should be prevented. Some factors, such as cigarette smoking or the presence of a family history of non-specific inflammatory diseases of the intestine, may increase the risk of morbidity. In such cases, it is necessary to systematically subjecting tested by professionals. Quick to diagnose Crohn's disease and to be subject to the treatment can eliminate a number of severe consequences.

Zobacz także