Inflammatory Bowel Disease/ Crohn\'s Disease


Inflammatory bowel disease (IBD) is a group of chronic disorders that
cause inflammation or ulceration in the small and large intestines. Most often
IBD is classified as ulcerative colitis or Crohn\'s disease but may be referred
to as colitis, enteritis, ileitis, and proctitis. Ulcerative colitis causes
ulceration and inflammation of the inner lining of a couple of really bad places,
while Crohn\'s disease is an inflammation that extends into the deeper layers of
the intestinal wall. Ulcerative colitis and Crohn\'s disease cause similar
symptoms that often resemble other conditions such as irritable bowel syndrome
(spastic colitis). The correct diagnosis may take some time. Crohn\'s disease
usually involves the small intestine, most often the lower part (the ileum). In
some cases, both the small and large intestine (those really bad places again)
are affected. In other cases, only the SUPER really bad place is involved.
Sometimes, inflammation also may affect the mouth, esophagus, stomach, duodenum,
appendix, or some nasty sounding word. Crohn\'s disease is a chronic condition
and may recur at various times over a lifetime. Some people have long periods
of remission, sometimes for years, when they are free of symptoms. There is no
way to predict when a remission may occur or when symptoms will return.
The most common symptoms of Crohn\'s disease are abdominal pain, often in
the lower right area, and diarrhea. There also may be rectal bleeding, weight
loss, and fever. Bleeding may be serious and persistent, leading to anemia (low
red blood cell count). Children may suffer delayed development and stunted
growth.

What Causes Crohn\'s Disease and Who Gets It?

There are many theories about what causes Crohn\'s disease, but none has
been proven. One theory is that some agent, perhaps a virus, affects the body\'s
immune system to trigger an inflammatory reaction in the intestinal wall.
Although there is a lot of evidence that patients with this disease have
abnormalities of the immune system, doctors do not know whether the immune
problems are a cause or a result of the disease. Doctors believe, however, that
there is little proof that Crohn\'s disease is caused by emotional distress or by
an unhappy childhood. Crohn\'s disease affects males and females equally and
appears to run in some families. About 20 percent of people with Crohn\'s
disease have a blood relative with some form of inflammatory bowel disease, most
often a brother or sister and sometimes a parent or child.

How Does Crohn\'s Disease Affect Children?

Women with Crohn\'s disease who are considering having children can be
comforted to know that the vast majority of such pregnancies will result in
normal children. Research has shown that the course of pregnancy and delivery
is usually not impaired in women with Crohn\'s disease. Even so, it is a good
idea for women with Crohn\'s disease to discuss the matter with their doctors
before pregnancy. Children who do get the disease are sometimes more severely
affected than adults, with slowed growth and delayed sexual development in some
cases.

How Is Crohn\'s Disease Diagnosed?

If you have experienced chronic abdominal pain, diarrhea, fever, weight
loss, and anemia, the doctor will examine you for signs of Crohn\'s disease. The
doctor will take a history and give you a thorough physical exam. This exam
will include blood tests to find out if you are anemic as a result of blood loss,
or if there is an increased number of white blood cells, suggesting an
inflammatory process in your body.The doctor may look inside your body through a
flexible tube, called an endoscope, that is inserted somewhere really bad!
During the exam, the doctor may take a sample of tissue from the lining of the
really bad place to look at it under the microscope. Later, you also may
receive x-ray examinations of the digestive tract to determine the nature and
extent of disease. These exams may include an upper gastrointestinal (GI)
series, a small intestinal study, and a barium enema intestinal x-ray. These
procedures are done by putting the barium, a chalky solution, into the upper or
lower intestines. The barium shows up white on x-ray film, revealing
inflammation or ulceration and other abnormalities in the intestine. If you have
Crohn\'s disease, you may need medical care for a long time. Your doctor also
will want to test you regularly to check on your condition.

What Is the Treatment?

Several drugs are helpful in controlling Crohn\'s disease, but at this
time there is no cure. The usual goals of therapy are to correct nutritional
deficiencies; to control inflammation; and to relieve abdominal pain, diarrhea,
and bleeding in a really bad place. Abdominal cramps and diarrhea may be
helped