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Crohn’s disease was discovered in 1932 by Dr. Burrill B. Crohn, Dr. Leon Ginzburg, and Dr. Gordon D. Oppenheimer. In this disease there is an abnormal immune response. This means the white blood cells infiltrate the intestinal lining, causing chronic inflammation. These cells then lead to tissue damage, and in Crohn’s disease it affects all layers of the intestines.
It is not clear what causes this disease. Researchers have theories that it could be genetic; but only 20 to 25% of patients have members of their family with Crohn’s or ulcerative colitis. They also believe it involves a complex interaction of the genes the patient inherited, the immune system, and something in the environment. At this moment they have no more than theories to give because of the lack of consistency. Although, they do not know what causes this disease they do know what can cause flare ups. Some things that cause flare ups are: high-fiber foods, milk and milk products, fried foods, greasy foods, larges meals, and stress.
Symptoms of Crohn’s disease tend to be painful or discomforting. They include: loose, watery or frequent bowel movements, crampy abdominal pain, fever, rectal bleeding, loss of appetite, weight loss, fatigue, joint pain, skin problems, and vomiting. These symptoms can change from person to person not everyone will experience each one. This disease can only be fatal if it is not taken care of. Eventually the white blood cells will eat through then intestines if not taken care of.
How Crohn’s is diagnosed is by a series of tests. There is not one that can prove it. Some of the tests include: lab tests, x-rays, endoscopy and pathology tests, barium x-rays of upper and lower GI tract, cameraoscopy, colonoscopy, biopsies are obtained, and examinations of stool.
At this time Crohn’s does not have a cure; it only can be put into remission. This means that you will always have Crohn’s and it could come back at anytime. Some ways to put Crohn’s into remission are: Aminosalicylates, immune modifiers, remicade, emotional environment, and diets.
Aminosalicylates, which are an anti-inflammatory drug, are taken orally usually used for moderate to mild symptoms. Corticosteroids, like prednisone, budesonide, and methylprednisolone are taken orally or rectally, suppress the immune system and are used to treat moderate to severe cases.
Immune modifiers which are: azathioprine (imuran), 6-MP (purinethol), methotrexate, infliximab (remicade). These drugs help decrease corticosteroid dosage and also to heal fistulas. It also helps maintain disease in remission.
In 1998, remicade came to the market for moderately to severely active Crohn’s in patients who have had an inadequate response to conventional therapy. Remicade is an antibody that binds to tumor necrosis factor (TNF), a protein in the immune system that plays a role in inflammation. TNF is produced by white blood cells and is thought to be responsible for many symptoms and tissue injury. Surgery is usually the last step when medication can no longer control symptoms, or when there is an intestinal obstruction or other complications. In most cases, the diseased segment of bowel and any associated abscess is removed. Then the healthy two ends are joined together. While this may relieve symptoms, Crohn’s is still present just not active and it could come out of remission at any time.
Emotional factors are cause of flare-ups with patients with IBD. Body and mind are inseparable and are interrelated in complex ways. The patient should try to be in a relaxed environment because the flare-ups could be increasing abdominal pain or diarrhea. This could lead to inflammation.
Diet in some patients could be come necessary. In some patients certain foods cause flare-ups. There is no reason why and the doctor cannot tell you what to avoid. They can try but it is all experimental. Keep tabs on what food is consumed and then if it flares-up that’s something that should be avoided.
The human immune system is what Crohn’s disease basically is. Once the patients immune system is “on” is can’t be turned “off” properly. This is what causes the symptoms and inflammation to IBD (inflammatory Bowel Disease). The main goal is to regulate the person’s immune system better with medical therapy. If all else fails surgery. CCFA-sponsored research has led its progress to immunology. Some scientists believe that the interaction of an outside agent with the body’s immune system may trigger the disease, or such an agent that may cause damage to the intestinal wall, initiating or accelerating the disease.
Crohn’s disease is still fairly new and they are still researching. New medications are out on the market all the time. Though they cannot find a cure it is in the future. Not understanding is the hardest part. Once a medication is found for the patient that works it’s a world of difference.