Crohn’s disease (CD) is a chronic disease that affects the gastrointestinal (GI) tract. It was presented and named for the first time at the beginning of the 20th century. It affects mainly young adults, but can develop at any age. The ongoing hypothesis is that Crohn’s disease is caused by a combination of genetic predisposition and environmental factors. The symptoms of the disease can include bloating, diarrhea, severe abdominal pain, ulcers, fistulas, and abscesses. The diagnosis of CD is determined by blood tests, colonoscopies, and biopsies. At this time, there is no known cure for Crohn’s disease. The physician’s main focus is to have the disease go into remission, and to prevent any relapses, or flaring up of symptoms. The three main ways the symptoms of CD are controlled are: lifestyle changes, medication, and surgery.
Some examples of lifestyle changes include dietary modifications, exercise, stress reduction, and getting enough sleep. While there are not any foods that can cause damage to the intestines, there are some that can exacerbate the symptoms of CD. Patients may want to avoid foods that are high in fats, greasy, or spicy. Dairy and alcohol products may make cramping and diarrhea worsen and should be avoided if possible (Hou) (NIDDK). Most physicians will advise their patients to exercise on a regular basis to help control some of the primary and secondary symptoms. Exercise also helps reduce stress, and can lead to better sleep (Garrett) (Ng). Most patients with Crohn’s disease deal with some sort of stress on a daily basis. Learning how to manage that stress improves the quality of life they live with the disease (Garrett).
Lifestyle changes on their own are not enough to battle and manage the disease. Patients will need to take some medication to combat inflammation, infection, and in some cases, the immune system. Acute treatment is implemented for inflammation and any infections that fistulas, abscesses, and ulcers have caused. Medications that are prescribed include anti-inflammatories, corticosteroids, and antibiotics. Steroids are used for short-term treatment, since long-term use can lead to serious side effects (NIDDK). More severe cases of Crohn’s disease, or patients that need to be dependent on steroids, are prescribed Azathioprine, or 6-mercaptopurine. These medications are immunosuppressants, and help stop the immune system from being active, allowing the body to recover from the constant attacks that come with autoimmune diseases (Hanauer) (NIDDK). Once the disease has entered remission, treatment enters the maintenance phase. It is the goal of the physician and patient that remission is obtained for as long as possible.
Surgery is used as a last resort when treating symptoms of CD. It does not cure the disease, only helps in eliminating problematic areas. Surgery is performed when parts of the intestines are experiencing partial, or full blockage due to scar tissue that has built up from ulcers, fistulas, or abscesses (Hanauer). The surgery only allows short-term relief, as the disease usually comes back at the site of resection (NIDDK).
Even though Crohn’s disease was brought to the scientific attention in the early part of the 1900’s, research on the disease didn’t pick up until the 1970’s. Research continues to be ongoing since more diverse populations are starting to show susceptibility to the disease. New therapy treatments are being researched daily. Some promising studies include treating the interleukin-12 response (which triggers inflammation) with antibodies (Mannon), and also treating GI diseases, including Crohn’s disease, with the inoculation of helminthes (Summers). Crohn’s disease is a predominantly Western culture disease, where helminthes are rare, unlike in less developed countries. The hypothesis is that exposure to helminthes may help prevent Crohn’s, or at least help in the maintenance of the symptoms (Summers). What the future holds for Crohn’s disease is unknown, but with the disease becoming more prevalent in cultures worldwide, quality of life for afflicted patients, and research in the field, look to be promising and ongoing for years to come.