Crohn’s disease is a lifelong condition in which parts of the digestive system become inflamed. It is one type of a condition called inflammatory bowel disease (IBD). Crohn’s disease is named after the American gastroenterologist Burril Bernard Crohn, although the diagnosis of inflammatory bowel disorders is historically well documented and the disease may be named according to the region of the bowel affected e.g. Crohn’s ileitis, which is confined to the ileum, and the more prev alent type, which attacks mainly the large intestine. Crohn’s disease affects both the ileum and the large intestine.
Symptoms of the disease
Symptoms include fever and weight loss in adults and growth retardation in children. There may also be other symptoms, e.g. inflammation of other tissues including the skin and eyes. The disease predisposes some patients to the possibility of malignant growths in the areas affected.
Causes of Crohn’s disease
The causes of the disease are not known with certainty, but probably involve both environmental and genetic inputs. In contrast to the role of hyperimmune activity in, for example, SLE and RA, Crohn’s disease appears to result from innate immune deficiency, possibly caused by a failure of macrophages to secrete certain protective cytokines.
This exposes the patient to infection by opportunistic microorganisms. Patients generally experience periodic remission and relapse, and the aim of treatment is to sustain the periods of remission and prevent or diminish the damaging impact of relapse.
Diagnosis: Diagnosis is confirmed using endoscopy, radiology and biopsy investigation.
Treatment is currently aimed at the treatment of symptoms when they occur and the establishment and maintenance of remission. Traditionally, glucocorticoids (corticosteroids) and 5-aminosalicylic acids have been used to treat inflammation and pain during relapse, and also immunosuppressant drugs such as methotrexate and azathioprine.
More recently, newer biological drugs that inhibit the action of TNF-α, e.g. adalimumab and infliximab, are being used and these have proven, in many patients, to be very effective for inducing and maintaining remission. More recently, it has been reported that naltrexone may be useful for induction and maintenance of remission.