What is Crohn's Disease: Symptoms, Causes, Management And Treatment


 Page contents

1What is Crohn's disease?                                                 2 symptoms

3 Causes and risk factors                                                   4 Multiples

5 Diagnosis                                                                        6 treatment

7 protection                                                                       8 Alternative therapies

Crohn's disease is a chronic inflammation of the digestive system in general from the mouth to the anus.

This inflammation spreads to all layers of the intestinal wall in a non-sequence manner, and is characterized by the presence of uninfected areas that are healthy and normal, and may be replaced by infected ones.

The peak of onset of Crohn's disease is usually in the third decade of life.

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Crohn's disease patterns

Crohn's disease is characterized by four different types and different clinical forms, as follows:

1. Inflammatory picture

It appears as aches in the lower right side of the abdomen accompanied by diarrhea, fever, and weight loss.

2. Obstructive picture

It is characterized by aches and flatulence after eating, constipation, nausea, vomiting, and weight loss.

3. Picture of hidden covered perforation

It appears with symptoms similar to those characteristic of appendicitis, or diverticulitis, and with the development of a fistula.

4. Connection of an intestinal loop with another organ

Then the patient complains of secretion from the opening to the skin to the urinary tract, or the sexual tract, and signs of infection may also appear, and laboratory examination in such a case indicates chronic inflammation, where the red blood cells are deposited very quickly in the examination of erythrocyte sedimentation rate (Esrerythrocyte sedimentation rate). , or anemia occurs, or a deficiency of proteins.

Disorders caused by disease outside the intestine

Crohn's disease may also include problems with organs outside the intestine, such as:

  • Dermatitis.
  • pain in the joints.
  • Eye problems.
  • kidney stones.
  • gallstones;
  • Various disorders of the liver.

Crohn's disease increases the risk of developing large bowel cancers, such as colon cancer or small bowel cancer.

Crohn's disease symptoms

Symptoms associated with Crohn's disease may range from mild to very severe, and these symptoms may appear gradually and suddenly without warning.

Here are some of the symptoms that characterize Crohn's disease:


Inflammation caused by Crohn's disease causes cells in the affected areas of the intestinal walls to secrete too much water and salts, and since the intestines cannot fully absorb this excess fluid, diarrhea occurs.

Acute intestinal cramps also contribute to the production of very soft stools, and in less severe cases stools may be softer than usual and at a higher rate than usual, but people who suffer from acute Crohn's disease may have to defecate about 12 times a day, which negatively affects the quality of Sleep and daily activities.

Abdominal aches and cramps

The inflammation and wounds that result may cause the intestinal wall to swell to the point where scars are formed, and this may negatively affect the movement of the contents of the intestine, which may cause pain and cramps.

uncomfortable feeling

Moderate Crohn's disease causes mild to moderate discomfort, and the more severe the condition, the more severe the aches and may be accompanied by nausea and vomiting.

blood in stool

Food moving through the intestines may cause bleeding from the inflamed areas, or it may cause the intestines to bleed themselves. In such a case, blood marks may appear in bright red on the edges of the toilet bowl, or in bright red with the stool, but the blood may be hidden and not visible.


Crohn's disease begins as small, scattered wounds on the surface of the intestinal walls, and eventually these wounds turn into large ulcers that penetrate deep, and sometimes pass through the walls of the intestine, and ulcers may also appear in the mouth that resemble Oral Candidiasis.

Loss of appetite and weight loss

Abdominal pain, cramps, and inflammation in the intestinal wall may affect appetite, digestion, and food absorption.

fistulas and abscesses

Inflammation resulting from Crohn's disease may travel through the intestinal wall to other internal organs, such as: the bladder or cervix, connecting them, and this connection is called a fistula. This may also lead to the formation of an abscess, which is a swollen wound filled with With pus, the fistula can penetrate through the skin.

Fistulas are especially common in the area of ​​the anal opening, and then it is called a perineum fistula.

Other symptoms

People with advanced Crohn's disease may have the following symptoms:

  • fever.
  • Tired.
  • arthritis.
  • ophthalmia.
  • Skin problems.
  • Inflammation of the liver or bile ducts.

Growth delays and impediments to sexual development in affected children.

The course of Crohn's disease varies from person to person, and there may be long periods without any symptoms, or other frequent periods of abdominal pain and diarrhea that may sometimes be accompanied by fever or bleeding.

Crohn's disease causes and risk factors

There is not yet a clear reason for renewed inflammation in Crohn's disease, and researchers are not confident that stress or nutrition are the main culprits, although both causes may worsen Crohn's symptoms.

Causes of Crohn's disease

Here are the most important causes of Crohn's disease:

Immune system reactions

It is very likely that a specific virus or bacterium is the cause of Crohn's disease. When the immune system tries to counter the invasion of prokaryote organisms, the reaction is inflammation in the digestive system. Tuberculosis (mycobacterium avium subspecies paratuberculosis - MAP), a type of bacteria that causes intestinal diseases mainly in cattle.

Researchers have found that this germ is carried in the blood of the majority of people with Crohn's disease, and it is also present in people with ulcerative colitis, but there is no conclusive evidence so far that this germ is the cause of Crohn's disease, and some researchers believe that a specific genetic defect It provokes an abnormal reaction to the germ in certain people.

Most researchers believe that people with Crohn's disease develop it as a result of the wrong reaction of their immune system to a certain type of germ that is permanently present in the intestine.

genetic causes

About 20% of people with Crohn's disease have parents, siblings, or children who also have Crohn's disease, and a mutation in the gene called Nod2 (NOD2 / CARD15) has been found in the majority of patients, which is the factor responsible for the emergence of initial symptoms at the age of Early, in addition to the high probability of recurrence after surgical treatment, researchers continue to investigate the genetic changes that occur that may be responsible for the emergence of Crohn's disease.

Factors that increase the risk of Crohn's disease

Crohn's disease affects both men and women, and risk factors include:


Crohn's disease may appear at different ages, but it is more likely that the initial symptoms begin to appear at an early age, and most patients are diagnosed between the ages of 20-30 years.


Although white people are more likely to develop Crohn's disease, Crohn's disease can occur in other ethnic groups as well.

family history

The risk of Crohn's disease is greater for people who have a first-degree relative with Crohn's disease, as a sibling with Crohn's disease increases the odds 30 times.

living location \ address

Long-term living in an urban area, or close to an industrial area increases the risk of Crohn's disease, and since this disease is more prevalent among residents of large cities and industrial areas, this may be an indication that the environmental factor is one of the factors that cause Crohn's disease.

Also, people who live in the Northern Hemisphere are more likely to develop Crohn's disease than people who live in other regions.


Food rich in fat, or processed food, may also be an additional influencing factor.


Smokers are more likely to develop Crohn's disease than non-smokers, and in patients who smoke, treatments are less effective and may even worsen Crohn's disease.


Although its effects have not been fully proven, research supports a relationship between isotretinoin and ulcerative colitis.

Crohn's disease complications

Crohn's disease can lead to several complications, including:

  • Intestinal obstruction.
  • sores;
  • fistulas;
  • Malnutrition caused by internal fistulas.
  • Inflammation of external fistulas and abscess formation.
  • Cancer of the large intestine, but it is often rare.

Crohn's disease diagnosis

Crohn's disease is diagnosed by:

  1. X-ray: where the end of the small intestine appears narrow and ulcerated, and sometimes a fistula may appear as well.
  2. Colonoscopy: It is possible to see the characteristic ulcers, noticing the lack of succession of wounds, and the characteristic injury in the end small intestine.
  3. Taking samples from the affected tissues for microscopic examination: through which acute and chronic inflammatory filtrate can be seen, including giant cells that characterize the disease.

Crohn's disease treatment

Treatment is carried out using one of the following methods:

1. Aminosalicylate

It is the norm to start it when Crohn's disease is still mild to moderate, and it is taken orally at a dose of 4 grams per day, and if the patient's body responds well, the maintenance treatment should be continued to maintain the situation at the same dose.

In the event that this treatment fails, it is necessary to move immediately to treatment with steroids (steroids).

2. Steroid therapy

Crohn's disease is treated with oral or intravenous steroids, depending on the severity of the disease. In light of the many side effects of prednisolone and other steroids, research is ongoing to develop a steroid with fewer side effects.

Budesonide is a synthetic steroid. Budsonide 9 milligrams per day and prednisolone 40 milligrams daily were found to be equally effective in treating Crohn's disease, but with fewer side effects.

When steroids fail to treat Crohn's disease, or when the patient becomes dependent on it, the transition to treatment with drugs that neutralize the effectiveness of the immune system, such as: Azathioprine, and the rate of induction of remission is about 75% within 3 months .

In addition to their success in initial treatment, the drugs are also effective in reducing steroid dose, as well as in closing fistulas and keeping the disease remission.

3. Antibiotics

The effect and effectiveness of antibiotics in the treatment of Crohn's disease has been proven beyond any doubt. Metronidazole has been shown to be effective in treating injuries around the anus in Crohn's disease in the large intestine and in maintaining postoperative remission.

The usual dose of it is 20 mg / kg per day, this amount is intolerable among a large number of people who suffer from nausea and a metallic taste in the mouth, which makes treatment with this drug difficult.

The antibiotic ciprofloxacin has also been shown to be effective when the disease is active in treating wounds around the anus.

4. Other medicines

Most of the trials that investigate the effect and efficacy of new drugs that control the immune system have been conducted and tested on Crohn's disease. Of interest in recent years has been a series of publications documenting the therapeutic success of the chimeric monoclonal antibody against Tumor necrosis factor (TNF), which has biological effects that could be very important in the treatment of inflammatory bowel diseases, such as : Secretion of modifiers, recruitment of inflammatory cells, activation of the coagulation system, and a role in the production of granulomas.

Double-blind, controlled trials demonstrate efficacy of mono-antibody to TNF given intravenously at a dose of 5 mg/kg or as 3 injections over several weeks, and treatment may achieve remission in patients with steroid-resistant Crohn's disease and bridging fistulas.

Crohn's disease prevention

There is no way to prevent Crohn's disease, but there are some ways to reduce symptoms, such as:

  • Eat healthy food, and stay away from foods rich in fat.
  • Quit Smoking.

Alternative therapies

In fact, Crohn's disease cannot be cured with herbs, but the following herbs may help relieve symptoms:

  • turmeric;
  • Chamomile.
  • Wormwood
  • Aloe Vera.

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