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Crohn's disease

life science Maturity 11-13 Next article →

Crohn's disease is a chronic inflammatory bowel disease (IBD). It causes long-lasting swelling throughout the gastrointestinal tract. This tract includes the mouth, esophagus, stomach, small intestine, and colon.

Distribution of CD 2021
Distribution of CD 2021

While it can appear anywhere, it most commonly affects the colon and the terminal ileum. The terminal ileum is the very last part of the small intestine. This condition is serious because it can lead to many different health problems. It often follows a pattern of flare-ups and remission. Remission is a period when the disease is quiet and symptoms are low.

The exact cause of Crohn's disease remains unknown to scientists. It is believed to result from a mix of environmental, immune, and bacterial factors. These factors act on people who are already genetically susceptible. About half of the overall risk is linked to genetics. Researchers have identified more than 70 genes that may be involved.

NOD2 structure model domain diagram
NOD2 structure model domain diagram

The immune system is meant to protect the gastrointestinal tract. In this disease, the immune system may mistakenly target microbial antigens. These are tiny parts of microbes that trigger an immune response. This creates a state of chronic inflammation. This is not considered an autoimmune disease because the immune system is not triggered by the body itself.

Symptoms of Crohn's disease can vary widely depending on where the inflammation occurs. Many people experience abdominal pain, especially in the lower right abdomen. Common signs include diarrhea, fever, and abdominal distension, which is swelling of the belly.

Aphtha2
Aphtha2

If the inflammation is in the ileum, it often causes large-volume, watery feces. If it is in the colon, it may cause more frequent, smaller bowel movements. In severe cases, a person might have over 20 bowel movements in a single day. Some people also develop perianal issues. These include pain or itchiness around the anus, or complications like abscesses and fistulae.

Crohn's disease can also cause symptoms far away from the digestive tract. This is known as extraintestinal involvement. For example, inflammation can affect the eyes, causing a condition called uveitis. Uveitis is swelling in the interior of the eye that causes pain and blurred vision.

A single EN
A single EN

The disease can also affect the skin, causing rashes like erythema nodosum. It can even impact the liver and gallbladder. Inflammation in the ileum can lead to gallstones because it changes how the body absorbs bile acids. In the kidneys, the disease can cause stones made of calcium oxalate or uric acid. These stones can cause severe pain in the back or abdomen.

In 1932, doctors first described these symptoms at Mount Sinai Hospital in New York. Burrill Bernard Crohn, a gastroenterologist, led the study. He worked with Leon Ginzburg and Gordon D. Oppenheimer.

Histopathology of granuloma of colonic mucosa
Histopathology of granuloma of colonic mucosa

They observed inflammation in the terminal ileum of several patients. However, there is a controversy regarding the name of the disease. While Crohn wrote about his investigation in his memoirs, Ginzburg provided evidence that he and Oppenheimer were the first to study it.

Managing Crohn's disease is a major part of a patient's life. There is currently no known cure for the disease. Doctors use treatments to manage symptoms and prevent relapses. For new diagnoses, a corticosteroid might be used for a short time to improve symptoms quickly. Other medications, such as methotrexate or thiopurine, can help prevent the disease from returning.

Colorectal cancer endo 2
Colorectal cancer endo 2

Smoking is a significant risk factor. Tobacco smokers are three times more likely to develop the disease than non-smokers. Because of this, doctors strongly recommend that patients stop smoking.

Crohn's disease has a significant impact on public health. It affects about 3.2 per 1,000 people in Europe and North America. It is less common in Africa and Asia, but rates in the developing world have been increasing since the 1970s. The disease often starts during adolescence or young adulthood. One in five people with the disease is admitted to a hospital every year. Additionally, about half of all patients will require surgery at some point during a ten-year period. Surgery is often needed to treat abscesses, bowel obstructions, or cancers. Because of the increased risk of cancer, doctors recommend colonoscopies every one to three years, starting eight years after diagnosis.

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File:Aphtha2.jpg
Aphtha2.jpg
File:A single EN.JPG
A single EN.JPG
File:Histopathology of granuloma of colonic mucosa.jpg
Histopathology of granuloma of colonic mucosa.jpg
File:Colorectal cancer endo 2.jpg
Colorectal cancer endo 2.jpg
File:NOD2 structure model domain diagram.png
NOD2 structure model domain diagram.png
File:Distribution of CD 2021.svg
Distribution of CD 2021.svg
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