Crohn's disease is called chronic inflammatory bowel disease, which is characterized by the formation of ulcers in the intestinal mucosa, in the place which later grow granulomas form adhesions and strictures, which narrows the lumen of the intestine and interfere with its permeability. Most often Crohn's disease affects the small intestine, namely the iliac colon (terminal ileitis, regional ileitis, ileitis transmural), but can occur throughout the intestine (granulomatous enteritis, granulomatous colitis, regional enteritis, etc.). Furthermore, in this condition, there are multiple extraintestinal manifestation.
Crohn's disease in children has favorite localization in the duodenum and jejunum, often completely affects the small intestine (eyunoileit).
Disease susceptible men and women equally, the average age of onset between 20 and 30 years old. Crohn's disease in children usually occurs in adolescence - 12-12 years.
At the moment, the disease is considered incurable, the goal of the treatment of Crohn's disease - the intestine is able to maintain long-term remission and relief of symptoms during exacerbation, and prevention of complications.
Causes of Crohn's disease
It is still unclear the cause of Crohn's disease. Researchers have isolated a number of factors are important in the mechanism of chronic inflammation of the bowel, but the starting point in the disease process is not known. By contributing factors include:
- Failure of the immune system of the body. The maintenance mechanism inflammation plays an important role autoimmune component, i.e. pathological reaction of the immune system of the organism's own tissues as well as those microorganisms intestine which are not pathogenic and food needed for assimilation:
- Hereditary predisposition. It is known that people with Crohn's disease often relatives suffer from chronic inflammatory bowel diseases such as ulcerative colitis;
- The damaging impact of external factors: unhealthy diet, bad habits, unhealthy lifestyle, infection.
Symptoms of Crohn's disease
Triad main symptoms of Crohn's disease include abdominal pain, chronic diarrhea and weight loss.
Pain in the stomach (abdominal pain) is most often seen at the bottom right iliac region (Crohn's ileitis) is dull, aching in nature. Sometimes the pain is absent, and in the lower right abdomen feels uncomfortable heaviness and distension.
In Crohn's disease often reduced appetite, but even if it is not changed, still marked weight loss, and often quite substantial.
Approximately 30% of patients the symptoms of Crohn's disease are disorders of the anus and rectum: rectal fissures, swelling and irritation of the anus that may cause pain during bowel movements, and mucus and blood from the anus.
Crohn's disease in children has some features of the course. For children, the disease is characterized by severe loss of weight, loss, sometimes full, appetite, developmental delay. One of the symptoms of Crohn's disease in children is a rise in temperature to high numbers, often accompanied by pain in the joints.
Extraintestinal symptoms of Crohn's disease can be misleading in the diagnosis. These include: arthritis, arthrosis, gallstone and kidney stone disease, hepatitis, inflammation of the mucous membranes of the eyes and mouth, and skin manifestations - dermatitis, eczema, rash, and does not heal ulcers.
Diagnosis of Crohn's disease
Diagnosis of the disease is carried out in the presence of characteristic symptoms of Crohn's disease using the following studies:
- Endoscopy. The method consists in the introduction of the instrument into the intestine, which consists of a flexible tube fitted with a camera and a light source with which examines mucosa rectum and colon.
- Fluoroscopy intestine. Using a procedure using a contrast agent that detect neoplasms, granulomas and restriction sites in the small intestine;
- A biopsy of the intestinal mucosa. Fabric for histological examination taken during a colonoscopy. In vitro analyzed changes in the mucosa;
- Laboratory Methods. Carry out general and biochemical analyzes of blood, urine, stool analysis and bakposev and detailed immunological analysis of blood.
Treatment of Crohn's disease
As mentioned above, Crohn relates to an incurable disease at the moment. However, treatment of Crohn's disease is not a must, but should be consistent and constant, to maintain a normal quality of life of the patient. In the absence of adequate treatment for Crohn's disease always has a poor prognosis because it leads to the development of one or more serious complications, and often not only the part of the intestine, many of which have a direct threat to life.
Treatment of Crohn's disease conservative, in the development of complications resorting to surgery.
Drug treatment of Crohn's disease in acute is to apply anti-diarrheal, anti-inflammatory (corticosteroid hormone therapy), antibacterial drugs and drugs that suppress the excessive activity of the immune system (immunosuppressants).
In the period of remission of Crohn's disease treatment is reduced to a diet and maintaining a healthy lifestyle.
Diet for Crohn's disease restricts the use of heavy, coarse food, is irritating to the mucous membrane of the intestine, as well as fats and milk. Recommended easily digestible and digestible food, with limited use of dairy products, for sparing the gastrointestinal tract. It is imperative that the diet in Crohn's disease has been balanced, as this disease is often anemia and deficiency diseases due to poor assimilation of food.
Gastroenterologists recommend individual selection of dishes: in acute austere diet of the first table, then gradual introduction of certain products and monitor the response to their body. Products causing aggravation, are excluded from the diet completely. Diet for Crohn's disease should be observed at all times, throughout their lives. It is especially important to follow these rules in Crohn's disease in children, since otherwise the disease can seriously affect the physical development of all children.
Complications of Crohn's disease
Crohn's disease can cause severe complications, which include: fistula, fistula and diverticula of the intestine, bowel cancer and biliary tract, intestinal obstruction, peritonitis, abscesses bowel, intestinal perforation. Most of these complications require emergency surgery.
Another group of extraintestinal manifestations are complications that can reach any severity.