Crohn’s disease is a chronic disorder characterized by severe inflammation leading to ulceration of the interior of the intestines. It most often affects the lower part of the small intestine, but it can involve the entire digestive tract, from the mouth to the anus. Unlike ulcerative colitis, which affects the top two layers of tissue lining the intestines, the ulceration in Crohn’s disease involves all four layers of the intestinal wall. When affected areas heal, scar tissue often narrows the passageway. In some cases, the bowel becomes partially or completely obstructed. When an area closes, one or more fistulas- abnormal passageways -may develop that join one part of the intestine to another, or even to another organ.
Causes of Crohn’s disease
There are various theories for causes of Crohn’s disease, but none has been proven. The most popular theory is that the body’s immune system reacts to a virus or bacterium by causing ongoing inflammation in the intestine. People with Crohn’s disease tend to have abnormalities of the immune system, but doctors do not know whether these abnormalities are a cause or result of the disease. Crohn’s disease is not caused by emotional distress.
Symptoms of Crohn’s disease
Rectal bleeding, especially in colonic disease
Obstructive symptoms of colic and vomiting, especially in ileal disease.
Tiredness and shortness of breath if anaemic Bone pain secondary to Osteomalacia if Malabsorption of vitamin D
Excessive bleeding if Malabsorption of vitamin K (rare)
Signs of Crohn’s disease
May be normal
Clubbing of nails
Palpable abdominal mass, particularly right iliac fossa
Anal fissures, fistulae and skin tags
Diagnosis of Crohn’s disease
As the symptoms of Crohn’s disease vary from person to person and can often be confused with those of other illness, such as ulcerative colitis (an inflammatory bowel disease that affects the colon and rectum), diagnosis can take weeks. Doctors start by testing the patient’s blood and feces to rule out other possible illnesses.
The patient may then be examined using an endoscopeâ€”a lit fiberglass tune that is inserted into either the mouth or the anus to study the inflamed digestive tract. This process can reveal ulcers, areas where the digestive track has narrowed, or patterns of “cobblestones,” which are seen where the intestinal wall has thickened and cracked. All these features are typical characteristic of Crohn’s disease.
Doctors can also use endoscope to perform a biopsy, which involves removing tiny bits of the digestive tract of be examined under microscope. If the biopsy shows that the whole thickness of the gastrointestinal wall is inflamed, with deep cracks and pockets where immune cells have collected (called granulomoas), then the patient has Crohn’s disease.
The patient may also be given liquid barium, either by mouth or by infusing it through the rectum. The barium will then shows up on X-rays and reveal certain abnormalities in the digestive tract, such as the regions where the tract has narrowed.
Treatment of Crohn’s disease
Although diet does not cause Crohn’s disease, some patients may be able to relieve their symptoms by changing the type of food they eat. Eating soft, bland foods, and avoiding dairy products, fats, wheat, and spicy and high-fiber food, may help. However, if the patient becomes malnourished, nutrients should be given intravenously.
Drugs cannot cure Crohn’s disease, but they can ease the symptoms. Sulfasalazine pills, which contain a sulfa antibiotic and a drug from the aspirin family, reduce inflammation and also help patients who have recovered from a flare-up to stay in good health. The drug has several side effects and may cause the patients to feel nauseated and dizzy. It can also trigger headaches, anemia, and skin rashes. Patients may be able to moderate at least some of the side effects by first taking the drug in small doses and gradually building up to the full daily dose.
If the intestine becomes very badly inflamed, doctors may prescribe corticosteroids. These drugs are given to patients only when their symptoms are severe, because long-term use can produced bad side effects in some patients.
Some patients respond well to azathioprine and 6-mecraptopurine, two drugs that suppress the immune system. However, these drugs should be used cautiously, since they can lead to nausea, fewer white blood cells, and an inflamed pancreas. Laboratory tests have also shown that high doses of these drugs (much higher than the doses patients receive) can occasionally cause cancer in animals.
Complications of Crohn’s disease
The most common complication is blockage of the intestine. Blockage occurs because the disease tends to thicken the intestinal wall with swelling and scar tissue, narrowing the passage. Crohn’s disease may also cause sores, or ulcers, that tunnel through the affected area into surrounding tissues such as the bladder, vagina, or skin. The areas around the anus and rectum are often involved. The tunnels, called fistulas, are a common complication and often become infected. Sometimes fistulas can be treated with medicine, but in some cases, they may require surgery.
Nutritional complications are common in Crohn’s disease. Deficiencies of proteins, calories, and vitamins are well documented. These deficiencies may be caused by inadequate dietary intake, intestinal loss of protein, or poor absorption (Malabsorption).
Other complications associated with Crohn’s disease include arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, or other disease or the liver and biliary system. Some of these problems resolve during treatment for disease in the digestive system, but some must be treated separately.
Homeopathic treatment of Crohn’s disease symptoms – Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat Crohn’s disease symptoms but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to cure Crohn’s disease symptoms that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of Crohn’s disease symptoms:
Rhus Tox, Arsenic Album, Nux vomica, Colocynth, Sulphur, Bryonia, Pulsatilla, Phosphorous, Natrum Sulph, kali Carb, Ipecauc, Nitric acid, Aloe Soc, Cina, Conium Mac, Lachesis, Cup Met, Podophyllum and many other medicines.
Janet Zand, Allan N. Spreen, James B. La- Smart Medicine for Healthier Living: A Practical A- to Z Reference to Natural; 1999; 223.
Dana K. Cassell, Noel R. Rose- The encyclopedia of autoimmune diseases Page No. 66; 2003.
Miles Witham, Mudher Al-Khairalla- 100 Plus Disease for the MRCP, Part 2; 2008; 62.
David B. Jacoby, R. M. Youngson- Encyclopedia of Family Health; 2004; 443.