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Pathologic Conditions

Crohn's Disease

Crohn's disease is an inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract from the mouth to the anus.

Symptoms of Crohn's disease

The most common areas of the gastrointestinal tract affected by Crohn's disease are the last parts of the small and large intestines.

Signs and symptoms of Crohn's disease can range from mild to severe. They usually appear gradually, but sometimes they can appear suddenly, without any warning.

When the disease is active, signs and symptoms may include:

Diarrhea: Diarrhea is a common symptom in patients with Crohn's disease. Intense intestinal cramps also contribute to the formation of soft stools.

Fever and fatigue: Many patients with Crohn's disease have a low-grade fever, which may be due to inflammation or infection. They may also feel tired and without energy.

Abdominal pain and cramps: Inflammation and ulcers can affect the normal motility of the gastrointestinal tract resulting in pain and cramps. Nausea and vomiting may also occur.

Blood in stool: There may be bright red blood in the toilet bowl or darker blood mixed with the stool. There may also be bleeding visible only under a microscope.

Mouth ulcers: There may be ulcers in the oral cavity of patients with Crohn's disease.

Decreased appetite and weight loss: Abdominal pain and inflammatory reaction in the intestinal wall can affect both the patient's appetite and his ability to absorb nutrients.

Perianal disease: There may be pain near or around the anus.

Patients with severe Crohn's disease may also experience:

  • Inflammations of the skin, eyes, and joints
  • Inflammation of the liver or bile ducts
  • Developmental delay or delay in sexual maturation (in children)
Causes of Crohn's disease

The exact cause of Crohn's disease remains unknown. It was believed that diet and stress were the causes, but now we know that although these factors can make the disease worse, they do not cause it. A number of factors, such as heredity and various immune system dysfunctions, are likely to play a role in the onset of the disease.

Immune system: It is possible that a virus or microbe may be the cause of Crohn's disease. When the immune system tries to fight the invading microorganism, a pathological immune response causes the immune system to attack the cells of the gastrointestinal tract.

Heredity: Crohn's disease is more common in family members suffering from the disease. However, most patients with Crohn's disease do not have a family history of the disease.

Risk factors for Crohn's disease

Risk factors for Crohn's disease may include:

Age: Crohn's disease can occur at any age, but most often occurs in young people (under 30 years).

Race: Although Crohn's disease can affect any race, whites and Jewish people are at higher risk.

Family history: There is a greater risk of developing the disease when a close relative (parent, brother, child) suffers from the disease.

Smoking: Smoking is the most important controlled risk factor for Crohn's disease. Smoking also leads to a more serious form of the disease and a higher risk of surgery.

Non-steroidal anti-inflammatory drugs: These include ibuprofen, naproxen, diclofenac, and others. Although they do not cause Crohn's disease, they can lead to inflammation of the bowel, making Crohn's disease worse.

Environment: Environmental factors, such as a diet high in fat or processed foods, play a key role in Crohn's disease. People living in northern climates or in urban and industrial areas are at greater risk of developing Crohn's disease.

Complications of Crohn's disease

Crohn's disease can lead to several complications:

Inflammation: Inflammation of the intestinal wall can lead to scarring and narrowing of the bowel or fistulas.

Intestinal obstruction: Over time, significant mechanical impairment or complete arrest of the passage of contents through the intestine can occur, resulting in the blockage of the bowel.

Ulcers: Chronic inflammation can lead to ulcers anywhere in the digestive tract, including the mouth, anus, and perineum.

Fistulas: Sometimes ulcers can spread through the intestinal wall, creating fistulas, ie abnormal connections between different parts of the body. Fistulas can develop between the intestine and the skin or between the intestine and another organ. The most common fistulas form in the anal area (perianal).

Anal fissures: These are small stretch marks in the mucosa or skin around the anus

Malnutrition: Diarrhea, abdominal pain, and cramps can make it difficult for both a Crohn's patient to eat and for the gut to absorb nutrients. Anemia due to low iron and vitamin B12 is also common.

Colon cancer: Crohn's disease, which affects the large intestine, increases the risk of colon cancer.

Other health problems: Crohn's disease can cause other health problems such as anemia, osteoporosis, gallbladder, or liver disease.

Risks of Crohn's disease medications: Some drugs that work by blocking certain functions of the immune system are associated with an increased risk of developing cancers such as lymphoma and skin cancer. They can also increase the risk of infections. The intake of corticosteroids has been linked to an increased risk of osteoporosis, fractures, cataracts, glaucoma, diabetes, and high blood pressure, among others.

Laboratory tests for the diagnosis and monitoring of Crohn's disease

EnteroScan® IBS / IBD: It includes many different and important tests to investigate inflammatory bowel disease (Crohn's disease and ulcerative colitis).

TrophoScan®: Food Intolerance Control: It includes the most common foods that can trigger the symptoms of inflammatory bowel disease.

Additional tests that may be needed: These include ASCA IgA and ASCA IgG ancillary tests and pANCAs for the differential diagnosis of Crohn's disease from ulcerative colitis. Laboratory tests for inflammation may also be needed, as well as basic screening for deficiencies due to malabsorption and the side effects of medication. (Due to the malabsorption but also the removal from the diet of different food groups, very often there are deficiencies in vitamins and micronutrients). Vitamin Basic Profile, Vitamin Comprehensive Profile, Micronutrient Elements Profile

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