Crohn’s Disease
Frequently Asked Questions

What Is Crohn’s Disease?

Crohn’s disease is a chronic inflammatory condition, affecting the entire wall of the digestive tract and can develop anywhere from the mouth to the anus. It affects 90% of the ileum (last part of the small bowel).There are several theories about the origin of this disease.

Incidence Of Crohn’s Disease

Crohn’s disease affects 5 in 100,000 people and usually involves more than one person in a family. Both men and women can develop it and there are two peaks of higher incidence one from 15 to 35 years and the second is between 50 and 60 years.

How Does Crohn’s Disease Affect The Bowel?

Crohn’s disease affects the bowel as segmental lesions, and they are seen as discontinuous. The normal intestinal segments are interspersed. In the intestinal lumen is narrowing (stenosis) due to the healing of ulcerative lesions. Cracks can be found between the folds of the mucosa that tend to penetrate deeply into the wall thickness resulting in fistula formation into adjacent viscera, skin or into a blind cavity. There may be localized abscesses or perforations.

Can Other Organs Be Involved?

Crohn’s disease can affect other organs, causing extra intestinal complications such as arthritis, mouth ulcers, eye inflammation, osteomalacia or decreased bone density, anemia, weakness, lack of protein, immune deficiency due to loss of essential fatty acids and zinc. These complications should be equally treated.

Symptoms Of Crohn’s Disease

Characteristic symptoms of Crohn’s disease are diarrhea, fever and abdominal pain in the lower right quadrant that is often confused with appendicitis. Furthermore, other specific symptoms usually appear according to the location of the lesions (fat loss in the feces, melena or blood loss in the stool, weight loss, kidney stones, etc. Symptoms usually appear after periods of stress and disappear for a certain period until an outbreak occurs again.

Diagnosis Of Crohn’s Disease

Diagnosis of Crohn’s disease is complex and often confused with other intestinal diseases that cause chronic diarrhea such as ulcerative colitis or irritable bowel syndrome. While there are distinctive aspects, it is important to make a differential diagnosis carried out by a specialist such as a gastroenterologist. For proper diagnosis, it takes into account the patient’s symptoms and should be performed a digestive endoscopy and biopsy to study tissue lesions. Small bowel Crohn’s disease requires a small bowel barium x-ray series for diagnosis. Certain blood tests are conducted with the aim of studying the severity of the disease.

Treatment Of Crohn’s Disease

There is no cure for Crohn’s disease. The medication is administered to help control symptoms. Anti-inflammatories are used like prednisone, antidiarrheal and antispasmodic according to patient tolerance, corticosteroids and immune-suppressants. Furthermore, patient may be supplemented with calcium, iron, vitamin B12, zinc and folic acid. In case of resistance to treatment is evaluated surgery as an option for improving the quality of life.

What Operation Might I Have?

In some cases, Crohn´s disease treatment may include surgery. According to symptom severity and location of them, surgery could be assessed. It involves removal of the affected area. Most often it is necessary for a colostomy or ileostomy, which is a “pouch” through which the patient removes the feces. This is because usually the ileocecal sphincter, that is the one that regulates the passage of intestinal contents, is usually removed. If there abscesses it is also necessary to drain them.

Who Should Do My Surgery?

A surgeon who specializes in the management of inflammatory bowel diseases is the right person to carry out the surgery. Surgery as a treatment for Crohn’s disease should not be performed by any surgeon. The members of the Colorectal Surgical Society of Australia have this expertise.

Is More Than One Operation Likely?

In about 30% of patients with Crohn’s disease, colectomy is required in the first three years after diagnosis due to inability to control the disease. Of the total patients who have surgery, about half need a second operation at some point.

What About The Future?

Patients who have undergone surgery for Crohn’s disease generally have a good quality of life. They can do sports; raise a family, work. In contrast, Ulcerative Colitis patients are monitored more frequently and in the long run because they have increased risk of progressing to colon cancer.

History

In 1932 at the Mt. Sinai Hospital in New York, Drs. Crohn, Ginzburg and Oppenheimer described 14 specimens of chronic inflammation of the small bowel which they named regional iletis. In 1960 Drs. Lockhart-Mummery and Morson from St. Mark’s Hospital, London published a detailed account of the surgical pathology of this condition affecting the large bowel. The inflammation may affect any part of the gastrointestinal tract is now known as Crohn’s disease.

Long Distance Telephone Appointments

If you are not local to the clinic, Michelle can conduct telephone appointments with you very easily. So if you are anywhere in North America, you can now successfully receive high end, specialized help for your Crohn’s disease or ulcerative colitis. If you are local to the clinic in Hamilton, Toronto or Mississauga Ontario – by all means come in for your appointment. If not, telephone appointments are very popular and convenient.