Crohn's Disease (Intestinal Inflammation)
Description
A recurrent inflammatory disease affecting the gastrointestinal tract. Sections of the intestinal tract which may be affected include the lower part of the small intestine (ileum) and the large intestine (colon). The lymph nodes that drain these areas and their attachments to the body wall through the mesentery may also be involved. It is an autoimmune disease and is most common in the 15-35 year range. Other risk factors are a family history of Crohn's, Jewish ancestry and smoking.
Symptoms
Crampy abdominal pain, nausea, vomiting, watery diarrhea, joint pain, painful bowel movements, bloody stools, fatigue, black stools (melena).
Tests
A history and physical exam will be performed. Other tests to confirm the diagnosis and identify complications may be done.
- CBC
- Chem 12
- Lipase
- X-Ray
- CT Scan
- MRI
Treatment
Aminosalicylates (5-ASAs) help control inflammation, and can be given rectally or orally. Corticosteroids (prednisone and methylprednisolone) are used to treat moderate to severe Crohn's disease. They may be taken by mouth or inserted into the rectum. Azathioprine or 6-mercaptopurine are immunomodulators and they help reduce the need for corticosteroids and can help heal some fistulas. Antibiotics may be used for abscesses or fistulas. Infliximab (Remicade) and adalimumab (Humira) are powerful anti-inflammatory medications that are used for severe cases. Surgery may be needed for disease that does not respond to medications and for fistulas. For more information contact the National Digestive Diseases Information Clearinghouse at: http://www.digestive.niddk.nih.gov or (800)891-5389. Further information is available at the Crohn's and Colitis Foundation of America at: http://ccfa.org
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