Crohns and Colitis
Crohns disease is a term we commonly hear but what exactly is it and how are more than 80,000 Australians living with this disease?
Collectively known as Inflammatory Bowel Disease (IBD), Crohn’s Disease and ulcerative colitis are Iife long gastrointestinal disorders that commonly present themselves in children, adolescents and adulthood. Ulcerative colitis affects the large intestine (colon) whereas Crohn’s disease can occur in any part of the intestines.
The conditions are becoming more prevalent, more severe and more complex and are being diagnosed in more and more very young patients.
During a disease flare, inflammation in the colon, rectum and gastrointestinal tract can become so severe that sufferers need to be hospitalised and/or require surgery.
The conditions are largely unpredictable with significant variation in the degree and pattern of symptoms affecting each patient. The relapsing and chronic nature of the disorder has broader impacts on a person’s emotional, physical, and social wellbeing. Patients may also develop complications that are potentially life threatening, with links between IBD and increased risks of colorectal cancer as well as the adverse side effects of treatment.
Causes
No one knows for certain yet what causes IBD but it is believed to be a combination of genetic, environmental and immunological factors.
Exposure to environmental triggers – possibly viruses, bacteria and/or proteins – prompts the immune system to switch on its normal defence mechanism (inflammation) against a foreign substance.
In most people, this immune response gradually winds down once the foreign substance is destroyed. In some people (possibly those with a genetic susceptibility to IBD), the immune system fails to react to the usual ‘switch off’ signals so the inflammation continues unchecked.
Prolonged inflammation eventually damages the walls of the gastrointestinal tract.
Crohns
Crohn’s disease can involve any part of the gastrointestinal tract from the mouth to the anus but most commonly affects the small intestine and/or the colon. There may be areas of healthy intestine between areas of diseased intestine. Within a diseased section, Crohn’s disease can affect all layers of the intestinal wall (i.e. not just the lining). This can lead to the development of complications that are specific to this condition:
- strictures (intestinal obstruction or narrowing of the intestinal wall)
- abscesses (boils) and skin tags (swollen lumps or ‘flaps’ of thickened skin occurring just outside the anus)
- fistulae (abnormal channels connecting different loops of intestine to itself or to other body organs)
- fissures (ulcerated tears or cracks in the lining of the anal canal) malabsorption and malnutrition
Symptoms
Every person responds differently to IBD. The severity of symptoms will vary from time to time and from person to person. IBD is not a progressive disease (it does not necessarily get worse over time). Rather, flare-ups can range from mild to severe and back to mild again. Some people will experience periods of relief from symptoms in between flare-ups.
We cannot predict how long a person will stay free from symptoms, or when their next flare-up will occur. Some flare-ups settle down quite quickly with treatment. Other times, it may take months for a person’s symptoms to respond to treatment.
IBD interferes with a person’s normal body functions. Signs and symptoms can include:
- pain in the abdomen
- weight loss
- diarrhoea (sometimes with blood and mucus)
- tiredness
- constipation
- malnutrition
- nausea
- delayed or impaired growth in children.
Treatment
The type of treatment for IBD depends on whether you have ulcerative colitis or Crohn’s disease. Treatments may include:
- medication to reduce the chances of flare-ups
- steroid (cortisone) medication
- medication to reduce the activity of the immune system
- corrective surgery for complications.
Diagnosis
Doctors use a variety of tests to diagnose IBD. These include blood tests, faecal (bowel motion) examination, x-rays, colonoscopy and gastroscopy. In some cases, computed tomography (CT) scanning, magnetic resonance imaging (MRI) and ultrasound many be used.
If you have any concerns or require more information on IBD our doctors at Elm Rd. are here to help and advice.
Please make an appointment today.