CROHN'S DISEASE

Crohn's Disease

Crohn's Disease

The Crohn's disease was named after US Burrill Bernard Crohn (1884-1983), who was a gastroenterologist. Crohn explained its signs in 1932 after studying a variety of indications in patients every one with an Inflamed Terminal Ilium (the piece of the small intestine most far-away from the digestive tract). Crohn's disease is an swelling of the alimentary canal for which the cause is unknown but the features are clearly described. The alimentary canal comprises the esophagus, mouth, intestines, stomach, rectum, and colon. Swelling from the illness can happen anywhere along the canal from the anus to the mouth. It usually starts in the colon or in the lower piece of the small intestine (ilium) (Jessica, 2010). This paper discusses Crohn's Disease with statistics and people at risk, treatment, risk factors and causes etc.

In some cases of Crohn's disease, the underlying layers of intestinal tissue are damaged also, leading to complete perforation (puncturing) of the wall of the intestine. This form of the disease is sometimes called penetrating Crohn's disease. Penetrating disease may cause a serious infection in the abdomen or the formation of fistulas. In Crohn's disease, fistulas are most prone to develop in the part close to the anus, causing the creation of abscesses (pus-filled sores). About 30 percent of patients with Crohn's disease develop fistulas. (Jill, 2007)

[Crohn's Disease]

Statistics and People at Risk

Crohn's is found in both women and men. 20 percent of persons detected with the Crohn's disease have a blood relative with a type of inflammatory bowel disease. Approximately, 500,000 persons in USA are diagnosed with this disease. It is beleived that there are around 500,000 people with Crohn's disease in the United States, with another 500,000 suffering from ulcerative colitis. (Jill, 2007)

Treatment

Treatment for Crohn's disease requires drug therapy, lifestyle changes and, sometimes, surgery. During acute attacks, maintaining fluid and electrolyte balance is the key. Debilitated patients need total parenteral nutrition to give sufficient nutrition and calories whilst relaxing the bowel.

Causes

Lymphatic obstruction and infection among contributing factors

Exact cause unknown

Risk factors

Use of oral contraceptives, nonsteroidal anti-inflammatory drugs, and antibiotics

Smoking

Left-handedness

Immune disorders

History of allergies

Genetic predisposition—10% to 20% of patients having one or more affected relatives; sometimes occurring in monozygotic twins

Adult appendectomy

Pathophysiology

Lymphatic obstruction is caused by enlarged lymph nodes.

Edema, mucosal ulceration, fissures, and abscesses occur.

Crohn's disease involves slow, progressive inflammation of the bowel.

Renal system

Fat malabsorption occurs from loss of functional mucosal absorptive surface.

Calcium is trapped and may cause increased oxalate excretion, which may cause renal calculi to form.

Musculoskeletal System

Ankylosing spondylitis, seronegative arthritis, and sacroiliitis occur as a result of the chronic inflammatory process.

Assessment

Physical findings

Right lower abdominal quadrant tenderness or distention

Possible soft or semiliquid stool, usually without gross blood

Possible abdominal mass, indicating adherent loops of bowel

Perianal and rectal abscesses

Hyperactive bowel sounds

Bloody diarrhea

Diagnostic Test Results

Vitamin B12 and folate deficiency may occur.

Serum potassium, calcium, magnesium, and Hb levels may be decreased.

Occult blood in stools may be present.

Hypoglobulinemia from intestinal protein loss may occur.

Hemoglobin (Hb) level and hematocrit may be decreased.

Treatment

General

Stress reduction

Activity

Reduced

Diet

Avoidance of foods that worsen diarrhea

Parenteral nutrition, if necessary

Adequate caloric and ...