Crohn's disease

Crohn's disease is a chronic inflammatory intestinal disease that causes recurring lesions anywhere in the gastrointestinal tract. It particularly affects young people who present episodes of stomach symptoms such as diarrhoea, abdominal pain, fever, blood in faeces or fistulas. Crohn's disease can cause various health problems that may result in changes to the patient's personal, social and family life.

Description

Symptoms

Changes in health directly depend on:

The organic symptoms of the chronic evolution, such as abdominal pain or fever.
Treatment: its efficacy, side effects, consequences of surgery or the need for an ostomy.
And how each person experiences it according to their personality, culture or religion.

All these changes may make the patient feel their quality of life is getting worse and that they should see their doctor often.

Caring for patients with this disease requires a multidisciplinary approach centred around their needs in order to avoid repeat visits. For this reason patients are treated in specialised unit, such as the Crohn’s-Colitis Unit at Vall d’Hebron Hospital.

The disease manifests as flare-ups. In other words, there are periods when symptoms are active and the patient feels unwell (“flare-ups”) and others when the disease calms down (“periods of remission”).

The most common symptoms during a flare-up are:

Gastrointestinal symptoms: abdominal pain, diarrhoea or blood and/or mucus in faeces.
Non-gastrointestinal symptoms: anaemia, skin lesions, swelling of the joints or oral aphthae.

Who is affected by Crohn’s disease?

The incidence rate of Crohn's disease is 1-10 patients/100,000 people a year and its prevalence is 300 per every 100,000 people. It can appear at any age, but is most common in young adults aged 20-40. It affects men and women equally, and factors leading to a predisposition to the disease include smoking, first degree family members with the disease or changes to the faecal microbiota.

Diagnosis

Diagnosis is based on the doctor's assessment of the combined symptoms and subsequent complementary tests that identify and locate lesions in the intestine.

The most important test is the colonoscopy, which consists of inserting a flexible tube into the rectum to see inside the intestine, and through which biopsies can be obtained. Radiological tests can also be used such as MRI or CT scans. The results of the biopsies are used to confirm diagnosis.

Typical treatment

Recovery begins with pharmacological treatment, which has vastly improved in recent years, and adopting a healthy lifestyle.

There are several treatment options such as corticosteroids, immunosuppressants, and biological agents, which are used depending on the activity and location of the disease, and taking into account any complications that may arise. Once treatment is agreed it is very important not to stop it, as this would result in a relapse and lack of control over the disease.