An overview of Crohn’s Disease

The pharmaceutical commercial shows happy people hurriedly bypassing public toilets that presumably they were unable to do before taking this drug. The announcer claims this medication controls the symptoms of Crohn’s disease. I ran to the computer.

Not surprising, the first symptom listed about Crohn’s disease is diarrhea, thus the reference in the ad. Other symptoms include crampy abdominal pain, nausea, fever, loss of appetite, weight loss, fatigue and, at times rectal bleeding.

Crohn’s disease (CD) belongs to a group of conditions known as inflammatory bowel diseases (IBD) not to be confused with irritable bowel syndrome which also affects the gastrointestinal system. Ulcerative colitis is an IBD but is not the same as Crohn’s despite the similarity of symptoms. We can discuss both of these another day.

CD was named after Dr. Burrill B. Crohn who published the “landmark” paper describing the disease in 1932. His colleagues, Drs. Gordon Oppenheimer and Leon Ginzburg apparently had no objections to Crohn getting the privilege of having this disease named for him, or maybe they tossed a coin.

It’s estimated that around three million Americans have CD with an equal number of men to women sufferers. “The disease can occur at any age, but Crohn’s disease is most often diagnosed in adolescents and adults between the ages of 20 and 30,” Crohn’s Colitis Foundation says.

Although studies have shown a genetic component associated with the disease, CCF says that it’s impossible to predict who might get Crohn’s disease. And, even though it’s more common in Caucasians, the rates of the disease have been increasing among Hispanics and Asians in recent years.

“No one knows exactly what causes Crohn’s disease. Also, no one can predict how the disease – once it is diagnosed – will affect a particular person,” CCF says. “Some people go for years without having any symptoms, while others have more frequent flare-ups, or attacks. However, one thing is certain: Crohn’s disease is a chronic condition.”

There are five types of Crohn’s disease. “The symptoms and potential complications of Crohn’s disease differ, depending on what part of the GI tract is affected. While symptoms of Crohn’s disease can vary from person to person, the type of Crohn’s you have impacts the symptoms and complications you may experience,” CCF explains.

Ileocolitis is the most common form. It affects the end of the small intestine, known as the terminal ileum, and the large intestine, also called the colon. Sym-ptoms include diarrhea and cramping; pain in the middle or lower right part of the abdomen, and significant weight loss.

Ileitis affects only the ileum (third portion of the small intestine). The symptoms are the same as ileocolitis but complications may include fistulas (abnormal connection between different body parts) or abscess in the right lower quadrant of the abdomen.

Gastroduodenal Crohn’s disease affects the stomach and the beginning of the small intestine. Nausea, vomiting, loss of appetite or weight, are the primary symptoms.

Jejunoileitis (no, I can’t pronounce it) is characterized by patchy areas of inflammation in the upper half of the small intestine which is called the jejunum. This causes mild to intense abdominal pain and cramps after eating, diarrhea and the possibility of fistulas forming in severe cases.

Crohn’s (Granulomatous) Colitis only affects the colon (large intestine). Symptoms may include diarrhea; rectal bleeding; disease around the anus, including abscess; fistulas and ulcers. Skin lesions and joint pains are more common in this form of Crohn’s than in others.

“The first step to diagnosis and treatment is a standard physical exam of your body,” CCF says. “Your doctor will speak to you and ask questions about your overall health, diet and nutrition, family history, and your daily routine.”

Based on this examination, your healthcare provider may order a series of tests to rule out other potential causes for your symptoms. Tests may include stool tests to exclude infection and detect inflammation; blood tests, colonoscopy and upper endoscopy (which may include a biopsy), and bowel imaging (CT and/or MRI).

The two basic goals of treatment are to achieve remission and, once that is accomplished to maintain remission. Treatment will be tailored to you and your symptoms and it just might include the medication that I saw on that commercial.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.