What You Should Know About Crohn’s Disease
13 Dec 2009
How would you feel at 18 years of age if suddenly diagnosed with Crohn’s Disease (CD)? It would be devastating news. Unlike other well-known diseases you would know nothing about this trouble and even the name sounds ominous. But you would not be alone. Crohn’s Disease is not a household word and in spite of its importance receives little research dollars.
Crohn’s Disease affects 600,000 people in North America. Normally it strikes those between 20 to 35 years of age, with another peak in the 50s but no age is immune to this disorder. Smokers are three times more likely to develop this disease.
There’s no sex bias as it affects both equally. In about 20 percent of cases a blood relative has some form of inflammatory bowel disease. Those of Jewish heritage have an increased risk and African Americans less likely to develop this trouble.
Patients suffer from recurrent episodes of abdominal pain, bloody diarrhea, fever and weight loss. Geographically it can affect any part of the gastrointestinal tract, from mouth to the anus. But most commonly involves the lower part of the small bowel, called the ileum.
There are several theories about what causes Crohn’s Disease. Some researchers believe CD is an auto-immune disease in which the body’s defenses become confused and begin attacking its own cells. But whatever the reason, the bowel’s wall becomes repeatedly inflamed with often no rhyme or reason as to when these attacks occur.
Initially it may be difficult to know whether the patient suffers from Crohn’s Disease or ulcerative colitis which primarily affects the large bowel. But blood tests, x-ray and colonoscopy examinations will eventually determine the diagnosis.
The most common complication is blockage of the intestine. Repeated episodes of inflammation cause swelling and scar tissue and narrowing of the bowel. In some cases the inflammatory response may be so intense that perforation of the intestine occurs and tunnels develop between the bowel, vagina, bladder or skin. And fissures or small tears may occur at the anal area.
So a diagnosis of Crohn’s Disease, whether at 18 years of age or older, causes a major readjustment in one’s life. As one young girl said to me "If I’m out on a date I’m often thinking where is the bathroom if I need one and how do I tell him I have this problem?"
Others say these repeated attacks place a strain on their relationship. That it’s the uncertainty of recurrences and how hard it is to plan ahead.
Patients with Crohn’s Disease must get to know their disease and start a food dairy to ascertain what foods cause trouble. But at the same time careful not to develop a food phobia as food does not cause CD nor does it cure it. And above all else they must not let this disease become their entire life.
Some patients discover that if they consume lesser amounts of food there’s a decreased chance of bowel problems. This can be dangerous as it can lead over time to malnutrition and that’s the last thing a patients with Crohn’s Disease needs. For instance, intestinal bleeding can lead to iron deficiency anemia.
It’s also important to make sure that patients with CD have sufficient amounts of vitamin B12. Since vitamin B12 is absorbed at the end of the small bowel where CD often strikes this vitamin may be lacking. And since many patients with CD cannot tolerate lactose it’s important they receive adequate amounts of calcium and vitamin D.
Treatment depends on the severity of the disease. Cortisone and drugs to suppress the immune system may limit the inflammatory response. But sometimes multiple surgeries are needed to remove inflamed portions of intestine.
Researchers are trying many different approaches to curing this disease. But as I talked to them one point stood out. They are terribly short of funds. It may be that discussing bowel problems is embarrassing conversation compared to discussing heart and other diseases. Society has always been sensitive about talking about bathroom habits and no doubt this phobia carries over into a lack of funding.
