Crohn’s Disease

Simone Thomas
Housatonic Community College

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What Is The Main Pathology For This Disease? Who Primarily Gets It And Why?

Crohn’s disease is an inflammatory bowel disease, which causes inflammation of the

digestive tract, that can lead to abdominal pain, severe diarrhea, fatigue, weight loss and

malnutrition. Inflammation caused by Crohn’s disease can involve different areas of the digestive

tract in people (Mayo Clinic, 2018). The inflammation caused by Crohn’s disease often spreads

deep into the layers of affected bowels tissues. As a result, this occurrence can be both painful and

debilitating, and sometimes may lead to life-threatening complications (Mayo Clinic, 2018).

Importantly to note, while there’s no known cure for Crohn’s disease, therapies can greatly

reduce its signs and symptoms and even bring about long-term remission. With treatment, many

people with the disease are able to function well. In some people with Crohn’s disease, only the

last segment of the small intestine is affected. Whereas in others, the disease is confined to the

colon. The most common areas affected by Crohn’s disease are the last section of the small

intestine and the colon (Mayo Clinic, 2018). Crohn’s disease is often inherited. About twenty

percent of people with Crohn’s disease may have a family member with either Crohn’s or

ulcerative colitis. In addition, Jewish people of European descent are at greater risk for the disease

(Web MD, 2018). While Crohn’s disease can affect people of all ages, it is primarily an illness of

the young, Most people are diagnosed before age 30, but the disease can occur in people in their

60s, 70s, or even later in life (Web MD, 2018).

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 How Is This Disease Diagnosed And What Are The Necessary Laboratory Findings

Specific To This Disease?

A patient with Crohn’s disease can be diagnosed when a doctor review his/her medical

history. A gastroenterologist who is a specialist may perform a colonoscopy or sigmoidoscopy to

obtain bowel tissue for analysis. An upper endoscopy may also be done to look at the esophagus,

stomach and the first part of the small intestine, the duodenum. A further look through the small

intestine can be done with capsule endoscopy, which uses a small, pill-sized camera that is

swallowed (Web MD, 2018). A doctor can order several blood tests, including blood counts, which

often white blood cell counts a sign of inflammation, and low red blood cells counts a sign of

anemia from blood loss are present. Stool samples can be used to rule out infections as the cause

of diarrhea. Special X-rays, such as CT scan or MRI can be used to view the upper and lower

gastrointestinal tract to confirm the location of the inflammation (Web MD, 2018).

The computerized Tomography are mainly used to detect complications of the disease,

including abscesses, fistulas, and intestinal blockages. A CT scan can also help to rule out other

conditions that cause symptoms similar to those associated with Crohn’s disease and ulcerative

colitis, such as appendicitis (Crohn's & Colitis Foundation, 2010). A patient may be asked to

consume oral contrast for the CT scan, which may cause diarrhea. An intravenous contrast may

also be injected into the patient’s vein in the arm prior to the test; as this contrast may rarely be

toxic to the individual kidneys. Hence, the patient may be asked to get a blood test to check the

kidneys function before the CT scan to ensure normality (Crohn's & Colitis Foundation, 2010).

There are further test can be done to conclude an individual diagnosis, such as a leukocyte

scintigraphy, which is a white blood cell scan. The main characteristic of Crohn’s disease is

inflammation in the gastrointestinal tract. White blood cells are attracted to sites of inflammation

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and this test can view where the white blood cells are attracted to the sites of inflammation. The

test can even tell how much inflammation is present. Therefore, blood is taken from the arm, and

white blood cells in the sample are tagged with a harmless amount of radioactive substance. The

blood is the injected back into the individual body, and a special camera is used to see where the

radioactive white blood cells travel (Crohn's & Colitis Foundation, 2010).

An Endoscopic Ultrasound is a relatively new technique in which an ultrasound probe

attached to an endoscope is used to look deep below the lining of the intestines. In the settings of

Crohn’s disease, the Ultrasound is most often used to look at fistulae in the rectal area, which is a

complication of Crohn’s disease. A fistula is an abnormal channel that can occur between different

parts of the intestine, such as the bladder and vagina. These channels can easily become infected,

so it’s critically important for the doctor to detect and treat the patient (Crohn's & Colitis

Foundation, 2010).

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 Are There Any Significant Signs And Symptoms Common To This Disease? Are

There Similar Disease’s That Might Get Confused With This Disease? Compare And How

You Would Rule In Or Out The Difference’s Between The Different Diseases Similar To

This One.

Crohn’s disease symptoms range from mild to severe. They may vary over time and from

different persons, depending on what part of the gastrointestinal tract is inflamed. And because

symptoms vary from person to person, the way a doctor can gauge a flare-up of symptoms is

relative to what is normal for the patient (Mayo Clinic, 2018).

There are numerous symptoms associated with Crohn’s disease, such as; frequent diarrhea,

rectal bleeding, unexplained weight loss, fever, abdominal pain and cramping, fatigue and feelings

of low energy, and reduced appetite. Importantly to note, that Crohn’s can affect the entire

gastrointestinal tract from the mouth to the anus, and can be progressive, hence symptoms could

get worse. Crohn’s disease is unpredictable. Over time a individual symptoms may change in

severity, or change altogether. He or She may go through periods of remissions- when a few or no

symptoms. Or symptoms may come on suddenly without warning (Mayo Clinic, 2018).

Celiac disease and Crohn’s disease are both diseases that deal with inflammation of the

intestines. Because abdominal pain and diarrhea are symptoms of both diseases, differentiation

between Crohn’s disease and Celiac disease can be difficult without the right diagnosis. It is often

left to blood tests as well as endoscopy, and biopsy to determine which disease is present (Celiac

Disease Foundation, 2017).

Blood test for Celiac disease and IBD test for different characteristics allowing doctors to

distinguish between the two based on results. Unlike Crohn’s disease, celiac disease symptoms

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usually disappear when patients adhere to a gluten-free diet. Celiac disease means the body can’t

digest gluten, a protein in many grains like wheat, rye and barley. If an individual eats gluten, it

makes the immune system attack the small intestine. A condition that cause the immune cells to

fight against the body and are called autoimmune disorders (Web MD, 2018).

Crohn’s disease, on the other hand, is an inflammatory bowel disease. It’s also an

autoimmune condition, but doctors don’t know what causes it. This leads to inflammation, which

is characterized by swelling, redness, or tenderness in the lining of the digestive tract. It can also

trigger inflammation in other areas of the body, like eyes and joints (Celiac Disease Foundation,

2017).

A doctor can rule out the difference between Crohn’s and Celiac disease, by asking the

patient about the symptoms being experience and taking a family health history. The doctor may

recommend blood tests. While not always accurate, blood tests can sometimes show the difference

of the two diseases. If the doctor suspects Celiac disease, a Endoscopic biopsy is done to further

rule out the disease. With Crohn’s a number of different tests is done to diagnose the disease. For

example, colonoscopy, endoscopy, CT scan or MRI (Celiac Disease Foundation, 2017).

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 Is There A Genetic Component To This Disease? And What Is The Like Hood That

It Will Be Inherited?

The inheritance pattern of Crohn disease is unclear because many genetic and

environmental factors are likely to be involved. However, Crohn disease tends to cluster in

families; about 15 percent of affected people have a first-degree relative, such as parent or sibling

with the disorder (Genetics Home Reference, 2019).

Therefore, Crohn’s disease is hereditary, the chances of a family member having it is about

50 %, if a previous family member had the disease. Current theories suggest that genetics,

environment, diet, blood vessel abnormalities, and even psychosocial factors cause Crohn’s

disease (Genetics Home Reference, 2019). At least 200 genetic variations have been identified that

affect the risk of developing Crohn’s disease. These appear to modulate risk via the immune

system, and through changes to the bacterial balances in the intestines (Gene Food Feed Your

Genetics, 2018).

Many of these genes are located on chromosomes 5 and 10. Mutations in four genes

(ATG16L1, 1L23R, IRGM, and NOD2) have gained the most attention, with variants in NOD2

on chromosome 16, the first to be linked to an increased risk of developing Crohn’s disease.

Around 30-50% of people in the Western hemisphere carry a disease-causing mutation in at least

one allele of NOD2, and people who have two mutated alleles have a 20 to 40 fold increased risk

of developing Crohn’s disease (Gene Food Feed Your Genetics, 2018).

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 How Is This Disease Commonly Treated In The Medical Community And What Is

The Prognosis After Treatment?

Treatments for Crohn’s disease are wide raging and include a mix medications, treatments,

and surgery. Some of the most common medications are antibiotics (ciproflaxin and

metronidazole. They help to heal the sores Crohn’s disease cause and even get rid of harmful

bacteria in the intestines that kick start Crohn’s inflammation (Web MD, 2018). Some doctors

might prescribe anti-inflammatory drugs corticosteroids and oral 5-aminosalicylates(5-ASA).

These drugs help to ease inflammation. Nutrition therapy also plays a vital role in treating the

disease. A patient doctor might prescribe a special liquid diet to replace nutrients and give the

patient’s bowel a rest, especially if they’re getting ready for surgery. The doctor might combine

enteral nutrition, which is given through a feeding tube or parenteral nutrition, which goes into a

vein (Web MD, 2018).

Importantly to know, there is no cure for Crohn’s disease, and there is no one treatment

that works for everyone. The goal of medical treatment is to reduce the inflammation that triggers

the signs and symptoms. Treatment is also to improve long-term prognosis by limiting

complications. In the best cases, this may lead not only to symptom relief, but also to long-term

remission (Mayo Clinic, 2018). It can be challenging for someone to live with Crohn’s disease,

but when patients control their symptoms with treatments, they can expect to live a long life.

Staying on top of symptoms, communicating with a healthcare professional, and maintain good

treatment can help keep complications under control, including complications that are life-

threatening (Mayo Clinic, 2018).

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 References

(2010, 5 31). Retrieved from Crohn's & Colitis Foundation:

https://www.crohnscolitisfoundation.org/resources/diagnosing-crohns-uc.html

(2017, 8 13). Retrieved from Celiac Disease Foundation: https://celiac.org/about-celiac-disease/related-

conditions/crohns-disease/

(2018, March 8). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/crohns-

disease/symptoms-causes/syc-20353304

(2018, 6 21). Retrieved from Web MD: https://www.webmd.com/ibd-crohns-disease/crohns-

disease/qa/who-gets-crohns-disease

(2018, 3 26). Retrieved from Gene Food Feed Your Genetics: https://www.mygenefood.com/crohns-
disease-genetics/

(2019, 4 30). Retrieved from Genetics Home Reference: https://ghr.nlm.nih.gov/condition/crohn-

disease#inheritance

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