abdominal pain or cramps, often located near the navel or
in the lower right abdomen.
bleeding or blood in the stool.
of appetite and weight.
complications such as joint pain from arthritis, inflammation
of the eyes, and skin lesions.
When To Call Your Doctor
a doctor if you experience symptoms of Crohn disease (especially
lower-right abdominal pain, which may signal appendicitis).
a doctor if you experience black or bloody stools, a swollen
abdomen, or a fever over 101° F.
What Is It?
Crohn disease, also known as regional ileitis,
is a chronic inflammation of the intestinal wall, most commonly
in the final portion of the small intestine or the colon. Less
often, the upper digestive tract may also be affected. The inflammation
involves deep layers of the intestinal wall, where ulcers and
abscesses may form. The ulcers may erode the wall completely,
creating abnormal passages (fistulas) to other parts of the intestine,
to other organs such as the bladder, or to the skin. Deep cracks
may also develop in and around the anus (anal fissures). Inflammation
may thicken the intestinal wall until the passageway becomes
blocked. Symptoms of Crohn disease appear during flare-ups, which
alternate with periods of remission. Some people suffer only
one or two attacks before entering into permanent remission;
others experience recurrent attacks over a lifetime. Crohn disease
is relatively rare, but the incidence among the general population
has been increasing in recent decades.
What Causes It?
The cause of
Crohn disease is unknown.
factors seem to play some role in the development of this disorder.
suggest these possible causes: viral or bacterial infections,
autoimmune disorders, food allergies, or lymphatic obstruction.
there is no known way to prevent Crohn disease.
and physical exam are necessary.
may be taken.
(GI) series of x-rays are taken to view the small intestine.
A barium enema
may be performed. The barium creates a sharp image of the colon
(to inspect the lower large intestine) or colonoscopy (to view
the entire large intestine) may be performed.
A biopsy of
the colon lining is generally taken during the sigmoidoscopy
or colonoscopy to distinguish Crohn disease from ulcerative colitis.
How To Treat It
For mild attacks,
over-the-counter antidiarrheal medications and pain relievers
may be taken.
medications, such as sulfasalazine or corticosteroids, may be
may be prescribed to suppress secondary infections.
corticosteroids or aspirin-like drugs may be used to treat internal
drugs may be prescribed on a long-term basis to quell autoimmune
vitamin or mineral supplements, or vitamin B12 injections, to
replace nutrients lost from poor bowel absorption, may be advised.
In some cases
of extremely severe attacks, periods of intravenous feeding may
be necessary to allow the bowel to rest.
be required to repair blockages, fistulas, or abscesses in the
rectum or intestine.
long-standing cases of Crohn disease, the damaged portion of
the bowel may be removed.
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