What is Crohn’s disease?
Crohn’s disease is a serious inflammatory disease of the digestive tract. When we say inflammatory disease, we probably mean a non-microbial inflammatory disease. Crohn’s disease can affect any part of the digestive system, but most often it involves the end of the small intestine called the terminal ileum and the beginning of the large intestine called the cecum, which is shown as the marked area in the picture. Rarely, the skin, joints, eyes, lungs, liver, biliary tract and pancreas may also become ill.
The main symptoms are diarrhoea, cramping abdominal pain, sometimes bleeding and fever. In addition, loss of appetite, weight loss can be seen and may cause developmental delay in children. The presence and degree of complaints may vary from person to person. It is a disease that significantly reduces a person’s quality of life.
Crohn’s disease is a chronic disease. Therefore, no treatment method can completely cure the disease, but it is possible to control the disease and increase the quality of life.
How common is the disease? It may not be possible to give an exact figure for our country, but according to world data, it is a disease that can be seen in 1-7 of 100,000 people. It is more common in developed northern countries. It occurs equally in men and women. It occurs in all age groups, but it is most common before the age of 30. However, it is possible to see the disease after the age of 60-70.
Is Crohn’s disease a genetic disease? It is known that the disease is more common in some races and that more than one individual in some families has the disease. Some genetic variability has been demonstrated in patients with Crohn’s. However, today, there is no genetic indicator that shows whether the disease will develop in individuals in the family of an individual with Crohn’s disease.
What are the symptoms of Crohn’s disease? The most common and early symptom of the disease is diarrhea with abdominal pain. Abdominal pain occurs after meals, around the navel or in the underbelly area. Anorexia, weight loss, growth retardation in children and unexplained fever are other symptoms that can be seen. When anal region is involved, pain, abscess, and discharge can be seen in the anus. Sometimes these complaints can be seen without abdominal pain and diarrhea. In this case, diagnosis can be difficult. Depending on the area of the disease, patients may also develop complaints about the skin, joints, eyes, lungs, liver and pancreas.
How is Crohn’s disease diagnosed? The patient’s typical complaints suggest the disease, and in some patients, it may be possible to diagnose with the patient’s history. However, a series of examinations are required to confirm the diagnosis and/or to see which areas of the disease are involved and the severity of the disease. Colonoscopy with blood tests are tests performed in every patient. In some patients, stool examination, gastroscopy, examination of the small intestine, computed tomography or MRI are sometimes necessary investigations. The gastroenterologist should decide which examination should be performed in which patient.
Which drugs are used in the treatment of Crohn’s disease? Since there is no cure in Crohn’s disease, that is, there is no cure for the disease, the aim is to control the patient’s complaints. Because; Suppressing inflammation, ensuring wound healing, controlling fever, diarrhea and abdominal pain, and reducing the risk of surgery are the expected goals of treatment. For these purposes, aminsalicylic acid compounds (Salozoprin, Salofalk, Asacol etc.), cortisone, antibiotics and immune system regulators (azathiopurine, 6-mercaptorurin, metorexate and the like) are frequently used drugs. Infliximab (Remicade), which has been used in recent years, is a very effective drug that should be used in selected cases.
Who should treat a Crohn’s patient? Crohn’s patient must be treated and followed up by an experienced gastroenterology center or gastroenterologist. Because in this disease, the problem cannot be solved by writing a prescription to the patient. It is very important to make treatment changes when necessary and without losing time, and to know all the properties of all drugs used. Because the drugs used have significant side effects. For this reason, the physician following the patient should not only be knowledgeable but also experienced in this regard.
What is the place of surgery in the treatment of the disease? Most patients may require surgical treatment throughout their lives. However, since surgical treatment does not cure the disease, patients are tried to be avoided as much as possible. In cases where surgery is absolutely necessary, avoiding it may cause increased problems. Therefore, when the need for surgery arises, this situation should be evaluated jointly by a gastroenterologist and a surgeon experienced in Crohn’s disease.
What is the importance of lifestyle and diet in the disease?
In Crohn’s disease, there is a lack of fluid, nutrients, vitamins and minerals due to reasons such as decreased appetite, impaired absorption in the intestines and diarrhea. For this reason, it is important that patients are well fed and this situation should be taken into account during their treatment.
Diet is believed to have no significant role in disease. However, during the active periods of the disease, it is appropriate to avoid foods high in fiber (such as raw vegetables and fruits) and spices. It is believed that Crohn’s patients are more lactose intolerant (milk intolerance) than normal people. Therefore, if the patient describes complaints such as abdominal pain, gas, diarrhea or bloating after drinking a large glass of milk, it would be appropriate to avoid milk and dairy products.
Another issue that Crohn’s patient should pay attention to is avoiding smoking. Smoking causes exacerbation of the disease and difficulty in controlling it in Crohn’s patients.
Can a patient with Crohn’s have children?
The presence of Crohn’s disease in both mother and father-to-be does not completely eliminate productivity, but this probability may decrease during the active period of the disease. Therefore, pregnancy should be planned and in the period when the disease is under control. The father-to-be should have stopped certain medications for a certain period of time before a planned pregnancy. Such a precaution is not required for most drugs for the expectant mother, but this may vary depending on the drug being used. Occurrence or exacerbation of the disease during pregnancy increases the risk of miscarriage and premature birth.
