Crohn's Disease
This is a chronic (long term) form of inflammatory bowel disease that usually affects the lower small intestine (the ileum) or the large intestine (colon), but it can affect the entire gastrointestinal tract from the mouth to the rectum. The most common symptoms of Crohn’s disease are abdominal pain (often in the lower right area) and diarrhoea. Rectal bleeding, weight loss, arthritis, skin problems and fever may also occur. Internal bleeding can sometimes result in anaemia. Children with Crohn’s disease may suffer delayed development and stunted growth. Intestinal blockage may occur as the disease tends to thicken the intestinal wall with swelling and scar tissue. Crohn’s disease may also cause sores, or ulcers, that tunnel through the affected area into surrounding tissues, such as the bladder, vagina, or skin.
Causes
There is no complete agreement on the cause of Crohn's Disease but the most popular theory is that the body’s immune system mistakes certain bacteria and foods for antigens (foreign substances). It attacks these “invaders” by activating white blood cells which then accumulate in the lining of the intestines and trigger chronic inflammation, leading to ulcerations and bowel injury. Some research suggests that high levels of a protein produced by the immune system, called tumor necrosis factor (TNF), are present in people with Crohn’s disease.
Tests
Blood tests can check for anaemia (to identify internal bleeding) and a high white blood cell count (to identify inflammation). A stool sample can help to diagnose bleeding or infection in the intestines. An upper GI series may look at the small intestine with the use of a barium meal (a chalky solution that coats the lining of the small intestine before x rays are taken, revealing inflammation or other abnormalities in the intestine). A visual examination of the colon could involve either a sigmoidoscopy or a colonoscopy. For both of these tests, the doctor inserts a long, flexible, lighted tube linked to a computer and TV monitor into the anus. A sigmoidoscopy allows the doctor to examine the lining of the lower part of the large intestine, while a colonoscopy allows the doctor to examine the lining of the entire large intestine. The doctor may also do a biopsy, which involves taking a sample of tissue from the lining of the intestine to view with a microscope.
Treatment
Medication and surgery are both options that need to be weighed up very carefully. An approach that involves diet, herbal medicine, stress management and other possibilities is unlikely to create any problematic side effects and may be sufficient to bring the condition under control.
