CROHNS
Background
Crohn’s Disease is a chronic inflammatory disease that can affect any area of the gastrointestinal tract. All layers of the intestine may be involved and often there can be normal, healthy sections found between areas of diseased bowel. The disease progression is highly variable and differs from patient to patient. Crohn’s disease affects both men and women equally. It can occur in people of all age groups, but often is diagnosed in people between the ages of 20 and 30. People of Jewish heritage also are at increased risk.
Causes
The exact cause of Crohn’s disease remains unknown. Currently, researchers believe that a number of factors play an active role including diet, stress, our immune system, and heredity.
Symptoms
Signs and symptoms of Crohn’s disease can range from mild to severe and may develop gradually or come on suddenly, without warning. It is also possible to have periods of time with no signs or symptoms (remission). Common signs and symptoms include abdominal pain and cramping, diarrhea, ulcers, blood in the stool, reduced appetite, and weight loss.
Diagnosis
Diagnosis of Crohn’s disease is normally made after ruling out other diseases that associated with similar signs and symptoms such as irritable bowel syndrome, diverticulitis, and colon cancer. To help confirm the diagnosis, one or more of the following may be conducted: blood tests, a fecal occult blood test, colonoscopy, flexible sigmoidoscopy, or endoscopy.
Treatment
There are numerous health challenges for patients managing Crohn’s Disease, including medications and side effect management, proper nutrition, rest, and exercise. Treatment for Crohn’s disease may include drugs, nutrition supplements, surgery, or a combination of these options. While there is no known cure, treatment can help effectively control the disease by greatly reducing the signs and symptoms or even by bringing about long-term remission.
- Anti-inflammatory drugs ( often the first step in treatment)
- Sulfasalazine (Azulfidine)
- Mesalamine ( Asacol, Rowasa)
- Corticosteroids
- May be used short-term in cases with moderate to severe inflammation
- May be used in combination with an immune system suppressor
- Immune system suppressors (suppresses the body’s immune response thus reducing inflammation)
- Azathioprine (Imuran)
- Mercaptopurine (Purinethol)
- Tumor Necrosis Factor Inhibitors
- Infliximab (Remicade)
- Adalimumab (Humira)
- Certolizumab pegol (Cimzia)
- Methotrexate (Rheumatrex)
- Cyclosporine (Gengraf, Neoral, Sandimmune)
- Reserved for patients who haven’t responded well to other medications
- Integrin Inhibitors
- For moderate to severe disease
- May be used after other drugs, including tumor necrosis factor inhibitors, have failed
- Antibiotics
- Metronidazole (Flagyl)
- Ciprofloxacin ( Cipro)
Anti-diarrheals, laxatives, pain relievers, iron supplements, vitamin B-12 shots, calcium, and vitamin D supplements may also be considered or used in addition to the above listed medications.
Diet and lifestyle changes can also be tried. Suggestions include: limiting diary products, trying low-fat foods, eating small meals, drinking plenty of water, and taking a multivitamin. Smoking and stress should also try to be avoided.
Resources
Crohn’s and Colitis Foundation of America (CCFA)
www.ccfa.org
Patient Support Programs
Remicade
www.remicade.com/crohns-disease/patient-support
Humira
www.myhumira.com/Default.aspx
Cimzia
www.cimzia.com/cimplicity/patients.aspx
References
Centers for Disease Control and Prevention. National Institutes of Health. NIDDK. Handout on Crohn’s Disease. NIH Publication No. 06-3410. February 2006.
Mayo Foundation for Medical Education and Research (MFMER). Crohn’s disease. August 9, 2011.
http://mayoclinic.com/health/crohns-disease/DS00104.
