Inflammatory bowel disease – Crohn's disease

Crohn's disease can be safely called one of the most serious intestinal diseases, leading to life-threatening complications for the patient. The article discusses the main aspects of the clinic, diagnosis and treatment of this disease.

Causes, clinical manifestations and complications

To date, the exact cause of Crohn's disease has not been determined. However, numerous studies suggest that the appearance of this disease is influenced by genetic factors and autoimmune mechanisms. The infectious nature of this disease is also not excluded.

Crohn's disease can affect the entire digestive tube from the mouth to the rectum. Clinically, it is often manifested by abdominal pain, frequent diarrhea with an admixture of blood and mucus, nausea, vomiting, and bloating. Patients may lose weight, reduce general malaise, weakness, and fever. Some patients develop fistulas of the rectum and anal fissures.

Crohn's disease often also has extra-intestinal manifestations that affect many organs.:

• Eyes (uveitis, conjunctivitis, keratitis).
• Oral cavity (stomatitis).
• Joints (spondylitis, arthritis).
• Skin (erythema nodosum, pyoderma).
• Liver (cholangitis, cholelithiasis, fatty liver disease, etc.).
• Kidneys (pyelonephritis, cystitis, amyloidosis, etc.).

The disease is often accompanied by severe complications requiring immediate surgical intervention, such as colon perforation, peritonitis, gastrointestinal bleeding, structures and intestinal obstruction, and toxic megacolon.

Diagnostic methods and treatment

Crohn's disease is usually diagnosed based on complaints, medical history, physical examination data, as well as data from specific tests and studies.

If Crohn's disease is suspected, the patient is given a colonoscopy. During the examination, the condition of the intestine is visually assessed and a biopsy is taken for histological examination.

The diagnosis can also be confirmed by analyzing feces for the content of fecal calprotectin, as well as by detecting autoimmune markers (ASCA) in the blood.

In some cases, X-ray examinations, ultrasound and computed tomography are performed, mainly to identify complications of the disease.

Magnetic resonance imaging with hydro-contrast has become widespread abroad, which makes it possible to determine the extent of the lesion and the presence of fistulas, however, this study is rarely used in Russian practice.

The treatment of patients with Crohn's disease is a long, complex and time–consuming process that always takes place under the supervision of a specialist. Patients are forced to take medications for life (salicylates, hormones, biologics, immunosuppressants) that allow them to keep the disease under control, but the disease is incurable and, sometimes, immune to therapy. In such cases, the only way out is surgical treatment, including removal of the affected areas of the intestine. Watch the best movies in 4K at 4k-hd.club