Crohn´s disease or Inflammatory Bowel Disease, is a chronic (slowly developing, long-term), recurrent disease characterized by inflammation of any portion of the digestive tract from the mouth to the anus and usually involves the terminal part of the small intestine, the beginning of the large intestine (cecum), and the area around the anus. Crohn disease is also sometimes called regional enteritis or ileitis. Crohn's is known for its unpredictable flares and remissions. About one-third of all Crohn´s disease cases involve only the small bowel, especially the ileum.
About half of all cases involve the small bowel and colon, and about 20 percent of all cases affect the colon alone. The precise cause of Crohn's disease remains unknown. Our best understanding is that Crohn's disease results from an abnormal immune response in the intestinal tract, triggered by unknown environmental factors. There is no clear evidence that diet is involved in causing Crohn's disease. Because of the varying locations of involvement and severity of disease, Crohn's disease may present with a variety of symptoms and signs. The first symptoms of Crohn´s disease are often abdominal pain and diarrhea.
Pain is felt in the area of the navel or on the right side. Joint pain, lack of appetite, weight loss, fatigue and fever are common. Sometimes Crohn's disease affects the skin around the anus. A variety of sores in the anal area such as skin tags, fissures (cracks), fistulas (abnormal openings from bowel to skin surface near the anus), and abscesses may occur. Less commonly, other organ systems outside the gastrointestinal tract may be affected by Crohn's disease. These include the eyes (iritis, uveitis), liver (PSC), skin (erythema nodosum, pyoderma gangrenosum), and kidney (kidney stones). Treatment focuses on relieving symptoms of the disease by inducing and then maintaining remission.
This is accomplished by prescribing medicines that reduce the inflammation in the intestinal tract. Common drugs used to treat Crohn's disease are aminosalicylates, steroids, antibiotics, anti-TNF agents, and immunomodulators. The cornerstone for inducing remission in severe Crohn´s disease continues to be oral or intravenous corticosteroids. Another category of drugs often used in Crohn's disease is the topically acting 5-aminosalicylates. Antibiotic agents, helpful in perianal and/or colonic Crohn's disease. Immunomodulatory drugs such as azathioprine (Imuran, Azasan), 6-mercaptopurine (Purinethol), or methotrexate are often effective in maintaining remission of Crohn´s disease.
These medications are used long-term and require monitoring to prevent adverse effects. They work by changing the way certain inflammatory cells in the intestinal lining respond to inflammatory triggers. Usage of anti-inflammatory drug that blocks the action of a specific molecule called tumor necrosis factor (TNF), a key mediator of the inflammatory process in Crohn's disease. Other medications known as biologicals, emerge as viable therapies for Crohn's disease in the future.