Crohn's disease ... treatment varies according to the infection

Crohn's disease ... treatment varies according to the infection

Crohn's disease ... treatment varies according to the infection
Crohn's disease ... treatment varies according to the infection

Crohn's disease belongs to an inflammatory bowel disease that chronically affects any part of the digestive system and spreads to all layers of the intestinal wall; It is characterized by the presence of uninfected areas, healthy and normal, but may be replaced by infected ones.

This disease affects both males and females, and there is no clear cause of infection, but there are some factors that increase the risk of infection, such as genetics or due to a problem in the immune system that attacks the beneficial bacteria in the intestine, so white blood cells accumulate in the lining of the intestine, which Which leads to inflammation and the occurrence of ulcers. Some also attribute the cause of infection to diet and smoking.

The problem of this disease is that it disrupts the normal functions of the intestine, which leads to swelling and thus blocks a passage inside the intestine, in addition to the development of ulcers, which damages the layers of the intestinal wall, and contributes to the loss of the ability to absorb nutrients from foods and leads to an abnormal development known as As a fistula from one part to another part of the intestine, or from the intestine to adjacent tissues such as the bladder. It is difficult to fully recover from this disease, as it is a chronic disease that comes in the form of attacks from time to time, and the period of the attack may be long or short; The seriousness of the disease lies in the occurrence of obstructions, ulcers or bleeding and the formation of fistulas or anal fissures and perforation of the intestine; One of the risks is that in the long run, the incidence of cancer increases.

The form of the disease varies according to the location that affects the patient. It may affect the alimentary canal, stomach, duodenum, small intestine, or colon, in addition to the exit hole; Accordingly, the methods of treatment vary according to the site of the injury.

*** Symptoms

Symptoms that accompany Crohn's disease may range from mild to very severe, and may appear gradually or suddenly. But the different form of the injury and the affected part also makes the symptoms different, including digestive and non-digestive symptoms. Digestive symptoms of Crohn's disease are severe abdominal pain, diarrhea that is mucous and accompanied by pus or blood, intestinal obstruction, lack of appetite, anal fistulas, or bleeding in the exit.

Non-digestive symptoms may include:

  • Fatigue, degeneration and fever.
  • Weight loss.
  • Thrush in the mouth, anus or in the genitals.
  • Delayed growth in children.
  • Arthralgia.
  • Skin manifestations.
  • Kidney and gallbladder stones.
  • Liver problems.

*** Disease complications

The different forms of the disease affect many functions of the digestive system and thus leave behind many complications depending on the affected part. Complications of Crohn's disease include:

  • Intestinal obstruction: The small intestine is often blocked, which is one of the most serious complications, and leads to abdominal pain, persistent vomiting, and inability to defecate.
  • Intestinal perforation: This leads to leakage of the intestinal contents and thus leads to inflammation and severe pain in the abdomen. Some cases require immediate surgical treatment.
  • Intestinal stenosis: Chronic inflammation leads to the formation of scars and narrowing of the intestine, especially the small intestine. Intestinal stenosis also leads to intestinal obstruction and abdominal pain.
  • Fistula: It is an opening or a pathway that connects one member to another. Fistulas are caused by persistent infections and ulcers in the intestine. Many Crohn's disease patients have fistula.
  • Abscess: a collection of inflammatory secretions somewhere. In the case of Crohn's disease, the abscess may collect in the abdominal cavity or pelvis, where inflammation leaks from the intestine into the abdominal cavity or pelvis and the abscess collects.
  • Bleeding: Bleeding may be severe in some patients and lead to blood loss.
  • Malabsorption: Due to chronic inflammation and ulcers that may be present in the intestine, the intestine loses its function and malabsorption occurs. Calcium deficiency may cause osteoporosis, or several vitamins are deficient.
  • Colorectal cancer: but fewer cases of ulcerative colitis.

*** Diagnosis

The beginning of the diagnosis is first with the clinical examination of the patient and listening to his complaint, with knowledge of details about the nature of the pain, its duration, the nature of the stool, and whether he suffers from diarrhea at some point; Then he moves to examine him carefully, looking for signs of disease, such as temperature, heart rate, and blood pressure. He also examines the abdomen, rectum, and others. The doctor then proceeds to order some necessary tests and x-rays for a more accurate diagnosis of the condition.

  • CBC blood test to determine if there is an increase in white blood cells, which arises when there is an inflammatory state in the body.
  • Inflammation indicators in the blood: (ESR- erythrocyte sedimentation rate) and C-Reactive Protein (CRP-C), which are often elevated in case of inflammation.
  • Examination of serum albumin, whose concentration is reduced in case of chronic inflammation.
  • Antibodies in the blood: Because IBD is an autoimmune disease, autoantibodies may be present in the patient's blood.
  • Stool test to look for the presence of inflammatory cells in the stool.
  • Colonoscopy enables the doctor to view the lumen of the colon, in order to diagnose Crohn's disease. During endoscopy, a sample is extracted for examination under a microscope in the laboratory. Colonoscopy also helps stop bleeding and widen the narrowing.
  • Endoscopy of the upper gastrointestinal tract helps diagnose Crohn's disease of the upper digestive tract, or treat its complications.
  • Biopsy: To extract a sample from the affected organ and then examine it under a microscope in a laboratory. The test is considered the best, most specific, and most accurate in diagnosing disease. Crohn's disease cannot be diagnosed without a biopsy.
  • Imaging tests, the most important of which are computerized tomography (CT- Computerized Tomography), during which the abdomen is photographed. Special substances may be swallowed or injected to reflect the bowel or colon. Changes characteristic of IBD, such as inflammation of the intestinal wall, narrowing of the intestine, or fistula, are seen.

*** Methods of treatment

There is no cure for Crohn's disease that is right for everyone, but lifestyle changes are necessary, and patients respond to treatment differently with a combination of medications, nutritional therapy, and in more severe cases, surgery. Therefore, there is no clear or definitive way to treat Crohn's disease, but The treatments that are available today allow controlling, preventing, or even reducing episodes of the disease. Treatment in the case of Crohn's disease is divided into three sections: nutritional therapy, drug therapy, and finally, surgical treatment in some advanced cases.

As for the drug treatment, it contains a number of drugs such as anti-inflammatory, and the last drug contains cortisone, an immune system suppressant, an antibiotic and an anti-diarrheal; The attending physician determines the doses to be adopted daily, with the need for periodic follow-up and the necessary examinations to determine the response of the case to the treatment.

For nutritional treatment, the patient should eat a diet rich in calories and protein materials, and meals should be light and multiple throughout the day, with the need to stay away from fatty and fatty foods due to the difficulty of digestion, and should eat foods low in fiber and increase fluid intake to avoid dehydration. White cheese, skimmed milk, rice, white bread, biscuits, boiled potatoes, pasta without sauce, fish meat, chicken without skin, soups without vegetables are allowed.

Among the foods that should be avoided are hot spices because they increase inflammation, raw almonds, because the hard peels lead to inflammation of the lining of the intestines and colon, peels of fruits, cucumbers and tomatoes contribute to the suffering of Crohn’s patients, yellow corn and all whole grains, which lead to episodes of severe inflammation, Fried food of all kinds.

During an attack of inflammation, you should refrain from foods that contain a lot of seeds, such as strawberries, berries, tomatoes and some baked goods that are hard and difficult to digest, and refrain from anything containing caffeine as well as chocolate. In advanced cases that do not respond to nutritional and drug treatment, the doctor resorts to Surgical treatment to remove the damaged part of the intestine when the intestine is narrow, obstructed or severely inflamed.

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