Crohn's disease

What is Crohn’s disease?

    Crohn's disease, categorized as an inflammatory bowel disease (IBD), prompts inflammation in the digestive tract tissues, resulting in symptoms such as abdominal pain, severe diarrhoea, fatigue, weight loss, and malnutrition. The inflammation associated with Crohn's disease can affect various digestive tract segments, commonly targeting the small intestine. This inflammation often penetrates the deeper layers of the bowel, exacerbating symptoms. Crohn's disease can significantly impair quality of life and may pose life-threatening complications. While there is currently no cure for Crohn's disease, treatments exist to alleviate symptoms, induce long-term remission, and promote healing of inflammation. With appropriate therapy, many individuals with Crohn's disease can manage their condition effectively and lead fulfilling lives.

What are the causes of Crohn’s disease?

    The exact cause of Crohn's disease remains unclear to doctors. At the same time, some consider it to be an autoimmune disorder, but recent research challenges this notion. Instead, evidence suggests that prolonged inflammation may not stem from the immune system attacking the body itself but rather from its response to harmless viruses, bacteria, or food in the gut. This perspective underscores the complex interplay between immune system function and external factors within the gastrointestinal tract, shedding new light on the underlying mechanisms of Crohn's disease.

What are the risk factors of Crohn’s disease?

    Several factors can increase your likelihood of developing Crohn's disease:

  • Genetics: Crohn's disease often runs in families, with approximately 20% of affected individuals having a close relative with either Crohn's or ulcerative colitis.
  • Age: While Crohn's disease can affect individuals of all ages, it predominantly manifests in younger individuals. Most diagnoses occur before the age of 30, although the disease can also affect older individuals, including those in their 50s, 60s, 70s, or later in life.
  • Smoking: Smoking is a modifiable risk factor that can exacerbate Crohn's disease and elevate the likelihood of requiring surgery.
  • Medications: Although nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen do not directly cause Crohn's disease, they can aggravate bowel inflammation and worsen symptoms.
  • Geographical Location: Individuals residing in urban areas or industrialized nations are more susceptible to developing Crohn's disease.
  • Diet: Consuming a diet high in fat or processed foods may increase the risk of developing Crohn's disease.
  • Infections: Certain bacteria, such as Mycobacterium avium paratuberculosis, which induces a similar condition in cattle, and certain strains of Escherichia coli, have been associated with Crohn's disease.

What are the symptoms of Crohn’s disease?

    Symptoms of Crohn’s disease can vary depending on the location of inflammation within the gastrointestinal tract. Common symptoms include:

  • Pain: The severity and location of pain can vary, with many experiencing discomforts in the lower right abdomen.
  • Ulcers: Raw areas in the gut may bleed, leading to blood in stools.
  • Mouth ulcers: These are frequent symptoms of Crohn’s disease.
  • Diarrhoea: From mild to severe, diarrhoea may contain mucus, blood, or pus, often accompanied by an urge to defecate with little result.
  • Fatigue: Many individuals with Crohn’s disease experience significant tiredness, often accompanied by fever.
  • Changes in appetite: Periods of appetite loss may occur, leading to weight loss.
  • Anaemia: Blood loss from ulcers or inflammation can result in anaemia.
  • Rectal bleeding and anal fissures: Cracks in the skin around the anus can cause pain and bleeding.

    Additional complications may arise during symptom flares, including arthritis, uveitis, skin inflammation, and liver or bile duct inflammation. In females, Crohn’s disease may present with irregular menstruation, iron deficiency, and discomfort or pain during sexual intercourse due to inflammation near the anus or vagina. While Crohn’s disease does not typically impact fertility, active disease and post-surgical recovery may pose challenges to conception, increasing the likelihood of preterm delivery or caesarean section and low birth weight in infants.

When to see the doctor

    If you notice persistent alterations in your bowel habits or experience any of the symptoms associated with Crohn's disease, it's essential to consult your healthcare provider. Look out for signs such as:

  • Abdominal pain
  • Presence of blood in your stool
  • Nausea and vomiting
  • Diarrhoea that persists for more than two weeks
  • Unexplained weight loss
  • Fever accompanied by any of the symptoms above

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