Crohn’s disease definition

Crohn’s disease is an idiopathic, chronic inflammatory bowel disease of unknown cause that commonly affects the terminal ileum but has the potential to affect any part of the gastrointestinal tract. The disease can occur at any age but it is most often diagnosed in adolescents.

Types of Crohn’s disease

It is important to know which part of the gastrointestinal tract is affected.
There are 5 types of Crohn’s disease:

1.    Ileocolitis

It affects the end of the small intestine and the colon.
Symptoms: diarrhea, abdominal cramping, pain in the middle or right lower part of the abdomen

2.    Ileitis

It affects only the ileum.
Symptoms: diarrhea, considerable weight loss, fistulas in the lower-right region of the abdomen

3.    Gastroduodenal

It affects the stomach and the duodenum.
Symptoms: nausea, vomiting, loss of appetite

4.    Jejunoileitis

It affects the jejunum.
Symptoms: abdominal cramps after eating, intense abdominal pain, fistulas

5.    Crohn's (Granulomatous) Colitis

This type affects only the colon.
Symptoms: rectal bleeding, skin lesions, joint pain

Crohn’s disease symptoms

Crohn’s disease symptoms depend on the location of the disease and will vary from person to person. The most common symptoms include:

•     Diarrhea

•     Mouth ulcers

•     Fatigue

•     Altered appetite and weight loss

•     Abdominal pain

•     Rectal bleeding and anal fissures

Crohn’s disease risk factors

Certain risk factors may put at higher risk of developing Crohn’s disease, which includes:

•     Age

•     Ethnicity

•     Family Medical History

•     Smoking

•     Use of NSAIDs

Crohn’s disease Treatment

Treatment depends on the severity of the disease, complications, and the patient’s response that may include:

•     Medications: Anti-inflammation drugs, antibiotics, Anti-diarrheal and fluid replacement

•     Surgery: Colectomy, Proctocolectomy, Bowel Resection, Strictureplasty, Ostomy

•     Nutritional supplements

 
Causes of Crohn’s disease

The exact cause of Crohn’s disease is unknown but some factors may increase the risk of disease:

•     Environmental factors such as Viruses, bacteria, diet, and smoking

•     The individual’s immune system

•     Genetic factors

Crohn’s disease diagnosis

Doctors do not a single test to diagnose the disease. It may need a combination of tests and physical examinations.
The following tests may help in diagnosis:

•     Biopsy

•     Stool and blood tests

•     Sigmoidoscopy

•     Colonoscopy

•     CT scan

Diet Therapy in Crohn’s disease

Doctors may recommend a special diet given via a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition) to treat Crohn's disease. This can improve overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term.
The individual diet should be based on:

•  Symptoms

•  Whether the person is in remission or experiencing a flare

•  Location of disease

•  Presence of narrowing of the small intestine

•  Any prior surgeries

•  Whether there are any specific nutritional deficiencies

Certain foods and beverages can aggravate symptoms therefore patients can try to eliminate them.

•     Limit dairy products if you are lactose intolerant.

•     Eat low-fat foods because fat makes diarrhea worse.

•     Limit fiber because fiber can make symptoms worse.

•     Try to drink plenty of water

•     Eat small meals

•     Go on a low residue diet if you have a stricture.

•     Quitting smoking

Elimination diets are used to determine which foods must be avoided or minimized. When eliminating foods, it is important to substitute other foods, that provide the same nutrients.

Patients may have more problems with some foods such as

•  cabbage family

•  nuts

•  seeds

•  corn and popcorn

•  alcohol

•  Spicy foods

•  Caffeine

•  Fried foods

•  High-sugar foods

 
Fiber

in most patients, consuming fiber can cause abdominal cramping, bloating, and worsening diarrhea. But not all sources of fiber cause these problems. Consuming insoluble fiber can aggravate symptoms.

Lactose

Some people with Crohn’s disease may be lactose intolerant. Dairy products that contain yogurt and kefir may be more easily tolerated as well. Hard cheeses are generally well tolerated because of their minimal lactose content.

High-fat foods

High-fat foods, such as butter, margarine, and cream, may cause diarrhea and gas if fat absorption is incomplete