Definition and causesCrohn's disease is a chronic inflammation of the intestine. The disease can strike anywhere in the gastrointestinal tract from mouth to anus. The most common sites are the bridges between Small intestine and colon, called ileocøkalstedet (in approx. 3/4-dele of cases), and / or colon. In about ¼-section of cases is only the colon affected, and in these cases there may be problems with separating from bleeding colon disease (ulcerative colitis). It brings together the two diseases often underinflammatory bowel disease. Usually, the disease is localized to one or more areas in the intestine, ie. that may be changing areas with sick and healthy bowel. In the affected areas are red and highlighted the intestine, and inflammatory state goes through the whole gut wall. Inflammation-mode leads to the intestine become rigid and coming scarring, which can cause constrictions of the intestine. The cause of the disease is still unknown, but heredity plays a role (at approx. 10% of patients), and first-degree relatives of patients with Crohn's disease is 10 times greater risk of contracting the disease. Moreover, it is felt that the disease may be associated with allergies to certain foods. The disease can strike people of all ages, but age of onset is typically 20-25 years and women are affected more often than men. In Denmark, there are some. 300-350 new cases per year. The number of cases of illness have been increasing rapidly over the last 30 years. Symptoms of Crohn's diseaseThe disease may prove in many ways and in very varying degrees (see the progress and complications). Often the symptoms start creeping. The most common symptoms are:
If the colon is affected:
If the disease is localized to the upper gastrointestinal channel as stomach and gut:
The disease may cause symptoms beyond the intestine, especially in periods of active disease. At around. 25% found ledsymptomer. Usually joint pain in large part, but with a few percent seen Bechterews disease. Some patients also have a number hudsymptomer. Precautions and diagnosisThe above symptoms over time should consult a doctor. If Crohn suspected, taken a series of blood tests that can show inflammation. The diagnosis is made partly by a kikkertundersøgelse, which also takes a tissue (biopsy). First on the clinical picture with symptoms for more than three months, and also if there are abscesses or fistulas. Using binoculars studies, it may be difficult to reach all parts of the intestine, so you can use a new method, which absorbs a small capsule containing a video camera that records a series of images of the entire gastrointestinal tract. So far this method, however, still expensive and difficult. If you suspect tarmslyng (see the progress and complications) made an X-ray with contrast in the intestine. Treatment of Crohn's diseaseCrohn's disease is a chronic disease and treatment are therefore in principle lifelong. The treatment is a combination of medicine and surgery. The medical treatment consists of a combination of adrenal cortical hormones, anti-inflammation and immunosuppressive agents. The treatment may have a number of more or less serious side effects (something we should talk to their doctor about). In addition, antibiotics used in connection with fistulas and abscesses. Treatment with adrenal cortical hormones used by the emergency. The dose can be reduced gradually just to keep the disease in check. The immunosuppressive agents used to keep the disease down in periods between outbreaks. There is to date many immunosuppressive preparations on the market, and it seems no one shall be tried with another. It is not uncommon that you have to change the preparation after a while, then the impact may lessen over time. There is a great research activity in this area, and new, more specific biological agents used increasingly in the treatment of Crohn's disease. If you have tarmslyng if constrictions of the intestine does not improve by medical treatment, or by chronic activity of the disease or frequent relapse may be operated. This is done mostly by, but to remove the affected piece of intestine. Despite improved medical care has up to one third of the patients received colon removed after 20-years of illness. Select and complicationsThe course of the disease is highly variable. Approximately 10% have a tough course with acute tarmslyng. Most of these have to undergo surgery. Other 10% experienced only one or two periods of illness, and is then symptom-free for many years, or maybe a lifetime. The remainder, ie. most people have a chronic course with both periods of activity of the disease and symptom-free periods. There can be many complications associated with Crohn's disease. About 30% develop abscesses and fistulas. In rare cases, go hole in the intestine, possibly due to peritonitis. Tarmslyng as a result of scarring in the intestine after wounds or in the abdominal cavity after surgery, can be found at any point during the course of the disease. After many years with the disease, large parts of the intestine to be destroyed, which can result in diarrhea and reduced removals of nutrients. In addition, there are significantly increased risk of developing both kidney stones and gallstones. Finally, Crohn's disease associated with 5-10 times increased risk of cancer of the intestine than the general population (see tumors in the small intestine), cancer of the colon. About 80% of people with Crohn's disease live a normal life and remain fully professional talent. There is no excess mortality associated with the disease.
This article is formed on the Health Guide on 10.08.06
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