Crohn's disease (regional enteritis) Causes and Risks:
The cause is unknown, but genetic factors seem to play a role. Chronic ulcerative colitis occurs in the same families. Inflammation frequently occurs at the end of the small intestine where it joins the large intestine, but it may affect any area of the digestive tract. The intestinal wall becomes thick, and deep ulcers may form. The disease may occur at any age, but adolescence and early adulthood are the prevalent age groups. Risk factors are family history of Crohn's disease or Jewish ancestry. The incidence is 7 out of 10,000 people.
Prevention:
There is no known way to prevent this disorder.
Symptoms:
Additional symptoms that may be associated with this disease:
Signs and Tests:
An abdominal examination may reveal a mass (aggregation of cells) or tenderness.
- tests that show findings of Crohn's disease
- positive stool guaiac
A stool culture may be done to rule out other possible causes of the symptoms.
This disease may also alter the results of the following tests:
Treatment:
Medications may control the inflammatory process. Antibiotics are prescribed to treat abscesses and fistulas, if present.
Changes in the diet may improve symptoms (consult your health care provider or dietician). An adequate intake of calories, vitamins , and protein is important. Foods that worsen the diarrhea (or other symptoms) should be avoided--specific food problems may vary from person to person. People who have blockage of the intestines may need to avoid raw fruits and vegetables. Some people difficulty digesting lactose (milk sugar) and need to avoid milk products.
Surgical treatment of complications such as an obstruction (blockage) may be necessary.
Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See gastrointestinal disorders - support group .
Prognosis:
This is a chronic disease characterized by periods of improvement followed by the deterioration of symptoms. There is an increased risk of small bowel or colorectal carcinoma .
Complications:
- fistulas may occur to the bladder, vagina , or the skin
- bowel obstructions
- nutritional deficiencies
Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms worsen or do not improve with treatment or if new symptoms develop.
This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.
This lower abdominal X-ray shows narrowing (stenosis) of the end of the small intestine (ileum), caused by Crohn's disease. Crohn's disease typically affects the small intestine, whereas ulcerative colitis typically affects the large intestine. A solution containing a dye (barium), was swallowed by the patient. When it passed into the small intestines, this X-ray was taken (lower GI series).
Clubbing results from chronic low blood-oxygen levels. This can be seen with cystic fibrosis, congenital cyanotic heart disease, and several other diseases. The tips of the fingers enlarge and the nails become extremely curved from front to back.
Erythema nodosum consists of red to reddish purple hard (indurated) nodules which are painful to the slightest touch. These are most commonly seen on the shins (as pictured), but may occur on the thighs or elsewhere. They often occur in association with a group of widely varied diseases such as tuberculosis (TB), sarcoidosis, coccidioidomycosis, SLE, other fungal infections, and some drugs.
Erythema nodosum usually occurs in association with specific infections, inflammatory conditions, or medications. It consists of painful, hot, red skin lumps, usually over the shins. People with erythema nodosum should be evaluated for other disease processes.
Pyoderma gangrenosum on the side and back: This is a poorly understood disease of the skin, often seen in association with autoimmune diseases that cause wasting (loss of tissue mass) and debilitation. Some of these diseases include inflammatory bowel diseases such as Crohn's disease or ulcerative colitis, rheumatoid arthritis, and others. Classic lesions of pyoderma gangrenosum are enlarging ulcers with undetermined or loose edges associated with an autoimmune mechanism.
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