Crohns Disease
Crohns disease is a type of inflammatory bowel disease that can involve the entire gastrointestinal tract from mouth to anus. It typically occurs in a patchy manner and can cause ulceration, strictures and transmural (all layers) inflammation of the small and large bowel resulting in perforation, obstruction or fistulae. If the anus is affected, fissures, fistula and chronic discharge may be present.
A disordered Immune system
Unlike a typical infection where bacteria or viruses trigger inflammation, the exact cause of Crohns disease remains unknown. However, a combination of factors likely plays a role, including:
- Genetics: Having a close family member with Crohn’s disease increases your risk.
- Immune System: A malfunctioning immune system mistakenly attacks healthy tissues in the digestive tract.
- Environmental factors: Smoking is a significant risk factor, while diet and gut bacteria may also play a role.
Inflammation
Crohn’s disease can affect any part of your digestive tract, from the mouth to the anus, though it most commonly targets the small intestine and colon. The inflammation caused by Crohn’s can cause various issues, including:
- Ulcers: These develop in the lining of the digestive tract, leading to pain and bleeding.
- Narrowing (strictures): Inflammation can thicken the bowel wall, narrowing the passage and causing difficulty passing stool.
- Fistulas: Abnormal tunnels can form between the digestive tract and other organs like the skin, leading to drainage of pus.
Symptoms
Crohn’s disease can manifest through a range of symptoms, including:
- Abdominal pain and cramping, especially after eating
- Diarrhea, often bloody
- Urgent need to have a bowel movement (urgency)
- Weight loss and fatigue
- Fever and chills
- Rectal bleeding
- Mouth sores
Diagnosis
There is no single test to diagnose Crohn’s disease. Doctors typically rely on a combination of:
- Medical history and physical examination: Discussing your symptoms and a thorough examination can provide clues.
- Blood tests: These can reveal signs of inflammation or anemia.
- Stool tests: These can check for infections or blood in your stool.
- Imaging tests: X-rays, CT scans, or MRIs can visualize inflammation or blockages.
- Endoscopy: A thin, flexible tube with a camera is inserted into your digestive tract to directly visualize inflammation and ulcers.
Management
Unfortunately, there’s no cure for Crohn’s disease. However, various treatment options can help manage symptoms and achieve remission (periods with minimal to no symptoms). These include:
- Medications: Anti-inflammatory drugs, immunosuppressants, and antibiotics are commonly used.
- Dietary changes: Focusing on easily digestible foods and avoiding those that trigger symptoms can be helpful.
- Surgery: In severe cases, surgery may be necessary to remove damaged sections of the bowel or address complications. The decision to operate is always made by the patients physician and surgeon in consultation. It is very important that the surgeon is familiar with all aspects of Crohn’s Disease and is skilled in the full range of available surgical techniques. Members of CSSANZ have these skills, and they are trained in the long term support and follow-up of patients who have surgery for Crohn’s disease.
Further Reading: https://www.healthdirect.gov.au/crohns-disease
