Crohn’s disease: symptoms, diagnosis and treatment

Crohn’s disease is a chronic intestinal inflammation. The entire intestinal tract can be affected by the inflammatory processes. The American doctor Burril B. Crohn discovered the disease in 1932. In the Netherlands, approximately 20,000 people have Crohn’s disease. The condition mainly starts in young people and never goes away. The disease can flare up again at any time.

Symptoms

  • Appetite decreases
  • Nausea
  • Yield
  • Unexplained weight loss
  • (Chronic) diarrhea
  • Constipation
  • Fever
  • Fatigue
  • Stomach ache
  • Anemia

Crohn has an erratic disease course. Patients can feel well for months or years and then suddenly become critically ill. The complaints usually do not all occur at the same time. Crohn’s disease is accompanied by periods of severe inflammation in the intestines. They can return at any time.

Diagnosis

If Crohn’s disease is suspected, the patient is referred to the hospital. In most cases, the patient visits a gastroenterologist (gastroenterologist). Various tests are needed to determine whether Crohn’s disease is present. Blood tests can be used to determine whether inflammatory processes are active. Bacterial infections can be ruled out by performing a stool test.

Endoscopy

In most cases, an endoscopy follows to map the condition of the intestines. You can choose between a sigmoidoscopy (examination of the rectum and the curvy part above the rectum) or a colonoscopy (examination of the entire large intestine). The small intestine is viewed via a double balloon endoscopy or endoscopy. A virtual colonoscopy maps the small intestine using an MRI or CT scan. This does not require a tube to be inserted into the intestines.

Camera pill

Doctors can view the inside of the intestines by swallowing a camera pill. The patient swallows a capsule containing a small camera that records the gastrointestinal tract. The camera pill leaves the body through the feces.

Therapy

Crohn’s disease is mainly treated with medications. However, this medication cannot cure Crohn’s. Treatment focuses on reversing the symptoms of Crohn’s and reducing inflammation. The medication can also ensure that new areas of inflammation do not have a chance to develop. There is no standard treatment for patients with Crohn’s. Every patient responds differently to medication. That is why it may take a while before the right medication works. The dose that a client is prescribed can also differ per patient. If someone with Crohn’s is symptom-free, the client can use a small dose of the medication in question. This is
called a so-called maintenance dose.

Types of medicines

Mesalazine preparations
Mesalazine preparations are moderate anti-inflammatory agents. These ensure that inflammation in the intestines decreases. New outbreaks of inflammation are also prevented.

Corticosteroids
Corticosteroids are strong anti-inflammatory drugs. This medication is mainly used during a flare-up of inflammation. Corticosteroids have serious side effects and should therefore only be used for a short period of time.

Immunosuppressants
Immunosuppressants suppress the body’s immune system. This means that inflammation is less likely to develop.

TNF Blockers
TNF Blockers also fall under the group of immunosuppressive medications. TNF blockers stop the formation of the substance TNF. Research shows that TNF is a possible cause of Crohn’s inflammation. TNF blockers are very expensive medications and are often only prescribed if the other medications do not work.

Antibiotics
Antibiotics are not often prescribed for Crohn’s, because antibiotics only help against bacteria. If there is so-called overgrowth by bacteria, antibiotics are used.

Anti-diarrheals
Many patients with Crohn’s disease suffer from (chronic) diarrhea. Anti-diarrheal medications can help to combat this. Anti-diarrheals only help to combat the symptoms.

Operation/ostomy

Surgery is not often chosen for Crohn’s disease. In extreme cases, surgery is required. This is the case when scar tissue causes narrowing or fistulae. In extreme cases, the intestinal passage is blocked. These are then surgically removed. If the intestine is seriously damaged, part of the intestine or the entire intestine may sometimes be removed. A stoma is then created where the stool enters. The stoma can be temporary or permanent.

Difference between Crohn’s disease and ulcerative colitis

Crohn’s and ulcerative colitis are very similar and cause approximately the same symptoms. The main difference is that Crohn’s disease can affect the entire gastrointestinal tract (from tongue to butt). Ulcerative colitis only occurs in the large intestine. The inflammation of ulcerative colitis also never extends beyond the inner part of the intestine. This is often the case with Crohn’s disease.

Complications

Many serious complications can occur with Crohn’s disease. If the disease lasts for a long time, the intestines will work less well, causing many vitamins and minerals to no longer be absorbed. This causes complications such as unwanted weight loss and loss of appetite. Inflammations can further develop into fistulas (unnatural connections between organs) and strictures. Patients with Crohn’s are more likely to develop colon cancer. In addition, Crohn’s patients can also suffer from disorders of the skin, eyes and joints.