CROHN’S DISEASE

BACKGROUND

Crohn disease is a disorder that can cause diarrhea, belly pain, and other symptoms that affect the digestive tract. The digestive tract is the part of the body and takes in and breaks down food. It includes the mouth, the stomach, and the intestines.

When it is working normally, the body's immune system kills germs and "bad" cells that could turn into cancer. Sometimes, instead of killing only bad cells, something goes wrong and the immune system starts to attack healthy cells. That is called an "autoimmune response." It is what happens in Crohn disease. If you have Crohn disease, your body is attacking the lining of your digestive tract. This causes inflammation, which can lead to sores (ulcers) and bleeding.

The symptoms of Crohn disease can get better or worse at different times. But the condition cannot be cured. Luckily, there are medicines and other treatments that can improve its symptoms.

DISEASE OCCURRENCE IN POPULATION:

There is paucity of valid epidemiological studies on Irritable bowel disease from Asian countries and the results are variable. The incidence of Crohn’s Disease ranges from 0.5 to 1.0 per 100000 person-years. There is no epidemiological study from Pakistan.

RISK FACTORS:

Risk factors for Crohn's disease may include:

• Crohn's disease can occur at any age, but people are likely to develop the condition when they are young. Most people who develop Crohn's disease are diagnosed before they're 30 years old.
• Although Crohn's disease can affect any ethnic group, whites and people of Eastern European (Ashkenazi) Jewish descent have the highest risk.
• Family history: People are at higher risk if they have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn's disease has a family member with the disease.
• Cigarette smoking: Cigarette smoking is the most important controllable risk factor for developing Crohn's disease. Smoking also leads to more severe disease and a greater risk of having surgery. If you smoke, it's important to stop.
• Nonsteroidal anti-inflammatory medications: These include ibuprofen, naproxen sodium, diclofenac sodium and others. While they do not cause Crohn's disease, they can lead to inflammation of the bowel that makes Crohn's disease worse.
• Where you live: If someone live in an urban area or in an industrialized country, they are more likely to develop Crohn's disease. This suggests that environmental factors, including a diet high in fat or refined foods, play a role in Crohn's disease. People living in northern climates also seem to be at greater risk.

SIGN AND SYMPTOMS:

Signs and symptoms of Crohn disease may include the following:

• Rectal bleeding
• Fever
• Weight loss, anorexia
• Nausea, vomiting
• Malnutrition, vitamin deficiencies
• Generalized fatigability
• Bone loss
• Psychosocial issues

DIAGNOSTIC TEST:

There are a few tests that can help diagnose Crohn disease. Doctors use X-rays or scans to look at the upper intestine and a test called "colonoscopy" to look at the lower intestine. During a colonoscopy, the doctor puts a thin tube into your rectum and advances it up into your colon. The tube has a camera attached to it, so the doctor can look inside your colon and the last part of your small intestine.

TREATMENT OPTIONS:

There are many different medicines that help reduce the symptoms of Crohn disease. Almost all of these medicines work by reducing inflammation and the body's immune response. Some medicines treat symptoms when they are at their worst. Other medicines help keep symptoms from starting up or coming back. Doctors sometimes also prescribe antibiotics to people with Crohn disease.

You might have to try a few different medicines before you find the one that works best for you.

Surgery is helpful if medicines do not do enough to control your symptoms or if the medicines cause side effects that you can't stand. Surgery does not cure the disease, but it can help you to feel better and return to normal activities. The 2 most common types of surgery to treat Crohn disease work by:

• Removing of the diseased part of the colon
• Re-opening parts of the colon that have become blocked

PRECAUTIONS:

• Try eating small, frequent meals, instead of a few big ones.
• When patient enjoy a great restaurant meal without irritation or side effects, jot down which items you ordered.
• Manage symptoms of Crohn's disease: enjoy a balanced diet and properportion control
• Smokingcan make Crohn's disease symptoms worse. Now is a good time to quit!
• Enjoy regularexercise, a healthy diet, and enough sleep. And talk to your doctor.
• If taking antibiotics for Crohn's disease symptoms then avoid alcohol, which can worsen some side effects.

REFERENCES:

• https://www.uptodate.com/contents/crohn-disease-in-adults-the-basics?source=see_link
• http://www.jpma.org.pk/PdfDownload/7649.pdf
• http://www.mayoclinic.org/diseases-conditions/crohns-disease/basics/definition/con-20032061