Crohn’s disease is a chronic, incurable inflammation of the digestive system. The area most affected is generally the small intestine (the last part of the intestine) and the colon. However, the areas that can be affected extend from the mouth to the rectum. Each person suffering from Crohn’s disease may develop different symptoms, making it difficult to diagnose and treat.
What is Crohn’s disease?
What is Crohn’s disease? Crohn’s disease is an inflammatory disease of the digestive tract, often occurring in fits and starts and causing severe pain. As a result of the inflammation, the intestine can no longer absorb nutrients that are essential for the body to function, such as iron, vitamin B12 or zinc. Over time, the affected area will create fistulas and scarring lesions that narrow the diameter of the intestine. This increases the risk of abscess formation and obstruction.
There is no cure for Crohn’s disease. The exact causes of its development are not yet known, but it is thought that genetic and environmental factors influence its onset. Certain factors can also increase the risk of developing it, such as, but not limited to, smoking:
- Taking non-steroidal anti-inflammatory drugs, which weaken the intestinal wall
- Infections. In people with Morbus Crohn’s, the immune system’s reaction is already highly reactive, and is increased in the event of infection.
- Excessive hygiene following sterilisation of food and utensils, especially in infants
- Stress. This is not a trigger, but it can aggravate attacks.
Between 12,000 and 16,000 people suffer from this condition in Switzerland. Fortunately, there are now treatments that can alleviate the symptoms of Crohn’s disease, but without curing it.
How can you recognise its symptoms?
The first symptoms of Crohn’s disease usually appear in childhood or adolescence. These are often abdominal cramps, followed by diarrhoea with the presence of blood and mucus. Other symptoms may also be observed:
- Weight loss due to difficulty in assimilating nutrients through the intestine
- Severe fatigue due to nutritional deficiencies
- Fever
Crohn’s disease can also present symptoms outside the digestive system, causing damage to the eyes, skin or joints. Mouth ulcers may also be observed.
How is the diagnosis made?
It is often very difficult to diagnose Crohn’s disease, because each individual affected may have his or her own symptoms. In some cases, the disease may even develop silently. What’s more, there are many intolerances, allergies and other conditions that can be tested for before Crohn’s disease is diagnosed.
If you are suspected of having Crohn’s disease, the doctor will start by taking a blood sample. This will determine whether or not there is indeed inflammation in your body. If so, you will be scheduled for an endoscopy (and more specifically a colonoscopy). A colonoscopy is the insertion of a tube fitted with a camera through the anus, enabling the specialist to examine the rectum, colon and the last part of the small intestine called the ileum. The procedure requires a little preparation beforehand, but is not painful as it is carried out under general anaesthetic. The specialist will then be able to determine the severity of the lesions and take a biopsy. If you are also suffering from pain in the stomach and oesophagus, the tests may be completed with a gastroscopy to see if the higher areas of the digestive system have been affected.
What treatments are available for Crohn’s disease?
Once a diagnosis has been made and Crohn’s disease has been determined, it’s time to find a treatment. Although there is no cure, you can still live with the condition thanks to various therapies. The drugs administered are designed to calm the symptoms, i.e. reduce inflammation and calm the immune system’s reaction. The main drugs used are
- Corticosteroids are used as an anti-inflammatory during relapses, but only for a short time, as they have significant side-effects.
Immunomodulators, which aim to reduce the reaction of the immune system and therefore the inflammation of the digestive system. - Biotherapy, which involves the artificial administration of antibodies. This inhibits the molecules responsible for activating the immune system. This is a very powerful medication, which is generally used for people who do not respond to other treatments for Crohn’s disease.
- Surgery may also be performed if there is a hernia, abscess or fistula. An operation is also necessary if there is a risk of intestinal obstruction following healing of the tissues.
In a nutshell
Crohn’s disease is a complex condition, which sometimes requires extensive treatment with no cure. However, it is possible to live with it, as long as lifestyle and medication are adapted.
However, sufferers are at risk of contracting other diseases over the years. In particular, the risk of developing colorectal cancer is fairly high. Preventive colonoscopies are carried out regularly (every one or two years).
