Crohn's disease (or Crohn's disease) is an inflammatory bowel disease (IBD: inflammatory bowel disease) that can affect any part of the digestive tract, from mouth to anus, including biliary and pancreatic ducts. The most frequent localization of lesions is the distal ileum, which justifies the term terminal ileitis.
Crohn s disease Signs and symptoms
The clinical features depend on the affected portion of the digestive tract.
Frequently, the disease presents with recurrent episodes of abdominal pain, diarrhea, fever and sometimes the onset is acute with severe pain in a right iliac fossa as appendicitis and / or bowel obstruction.
If localization is dependent ileal you can get a picture of malabsorption with nutritional deficiency and consequent weight loss. The involvement of the colon may be associated with intestinal bleeding.
Causes Crohn s disease
The cause of Crohn's disease is unknown, but there is agreement that in inflammatory bowel diseases (ulcerative colitis also) other factors cause a chronic mucosal immune function in genetically predisposed individuals. These factors involve the celiac bacterial flora and the permeability of the epithelial cells of the intestinal surface.
Crohn s disease Diagnosis
The clinical features (abdominal pain, fever, diarrhea) and some laboratory investigations (inflammatory parameters, anemia) can guide the diagnosis, but it is necessary to perform radiographic studies that show alterations of the coeliac wall and endoscopy with biopsies that show the elements chronic inflammation affecting the entire thickness of the intestinal wall.
Crohn s disease Complications
Local complications are those that occur in the tract affected by inflammation and consist mainly of: perforation of the bowel wall, stenosis (narrowing), occlusion, fistula (communication through adjoining walls) between different segments of the intestine, including bowel and other viscera ( bladder, ureters, vagina.), ...), including intestine and the skin surface; abscesses.
Systemic complications are inflammatory events to occur in other organ's not contiguous intestine: eye (iridocyclitis), joints, skin (pyoderma gangrenosum, erythema nodosum).
Crohn s disease Therapy
The goal of therapy is the induction of remission status by controlling inflammation and resolution of anatomical abnormalities (stenosis, fistula).
Medical therapy is based on the use of anti-inflammatory drugs (aminosalicylates), steroids, immunosuppressants (azathioprine, cyclosporine), monoclonal antibodies (infliximab). Strictures and fistulas may require surgical treatment.