Crohn’s disease

Crohn’s disease belongs to the inflammatory bowel disease group, which also includes Ulcerative Colitis. The average incidence of the disease in Europe is about 5 per 100,000 population per year.

The disease can involve chronic inflammation of any section of the digestive system. Most often the inflammation is localised to the terminal segment of the small intestine (ileum) and the initial part of the large intestine.

Symptoms

Characteristics of Crohn’s disease are phases of disease exacerbation and remission. Depending on the location of the lesions, there is a different clinical picture.

The most common symptoms are:

• diarrhoea
• fever
• tiredness
• abdominal pain, often mistaken for pain associated with appendicitis
• blood in the stool
• anaemia
• decreased appetite resulting in weight loss
• pain in the mouth accompanied by ulcers and sores
• pain/discomfort in the anal area

However, these symptoms are non-specific, as they often occur with other diseases as well.

 When the symptoms mentioned above are present (especially weakness, fever and sudden weight loss), you should see your family doctor and a gastroenterologist.

Causes and risk factors

The exact cause of Crohn’s disease is not known.

The disease can manifest itself at any age, but the peak incidence is estimated to be between the ages of 15 and 40.

Treatment and complications

Currently, there is no effective treatment for patients with Crohn’s disease. Current treatments seek to induce and maintain remission with few side effects and improve the patient’s quality of life.

The most common drugs used are those that affect the immune system:

• 5-aminosalicylic acid derivatives
• Steroids
• Purine analogs
• Methotrexate
• Biological drugs – infliximab, adalimumab, ustekinumab, vedolizumab

Often due to abnormalities associated with the disease, surgical treatment is required.

Diet and supplementation of nutritional deficiencies associated with dehydration, malnutrition and anaemia also play an extremely important role.

The main complications associated with Crohn’s disease are anaemia, skin disease, osteoporosis, arthritis, liver disease and colon cancer. In order to minimise the likelihood of complications, it’s important to consult a doctor, perform appropriate tests (such as blood tests and colonoscopy) and follow the doctor’s recommendations. Currently, biologic drugs appear to be an extremely effective method of improving patients’ quality of life and reducing the risk of developing complications.