Crohn’s disease is inflammatory bowel disease that might affect any section of the gastrointestinal tract starting from the mouth to the anus. Some of the symptoms include weight loss, fever, diarrhea and abdominal pain. Other complications include tiredness, eye inflammation, arthritis, skin rashes, and anemia. Persons suffering from the condition have a greater risk of bowel cancer because of bowel obstruction. The disease is caused due to numerous factors that include bacteria, immune and environmental. The purpose of the paper is to discuss the signs and symptoms, cause, pathophysiology, diagnosis, and prognosis.
Signs and symptoms
The symptoms of the disease are evident even in diagnosis and the onset range between 15 to 30 years. The nature of tissue involvement and gastrointestinal disease are not seen easily; persons suffering from the disease experiences recurrent remission and flare-ups. For those persons who have had surgery, diarrhea is the common symptom and it also dependents on the region in which are is affected. In instances of worsening condition, the individual may make twenty bowel movements per day, frequent bloating and flatulence can add to the symptoms. Primary sclerosing cholangitis also is associated with Crohn’s disease.
Systematic symptoms are evident in the case of Crohn’s disease because it is an inflammatory disease. Growth failure is common in the case of children and inability to maintain growth is the most common symptom in children. Fever is sometimes present, but the temperatures may not be greater than 38.5 0C. In older persons, the person loss weight because they are comfortable when not eating because they lose their appetite. Weight loss is also attributed to malabsorption of lipids or carbohydrates especially when the disease occurs in the small intestine.
Other symptoms are evident such as uveitis, inflammation of the eye due to photophobia and sclera resulting in episcleritis. If untreated, uveitis and episcleritis result in vision loss. In those cases the disease affects the ileum; gallstones risk increases. It is attributed to bile acid resorption resulting in an increase in the ration of bile and cholesterol and hence, increases in gallstones risk. The disease is also associated with rheumatologic disease and is characterized by inflammation resulting in a condition known as enthesitis or arthritis. Arthritis condition may worse leading to sacroiliitis or ankylosing spondylitis. The symptoms of arthritis include loss of joint function, stiff joints, and swollen, warm and painful joints.
The Crohn’s disease sometimes affects the endocrine system, blood and skin and results in skin manifestation on the shins. The disease also increases blood clots, deep venous thrombosis, and breathing problems. Other symptoms include anemia, autoimmune hemolytic anemia, clubbing, and increase of osteoporosis resulting in increased bone fractures risk. It is associated with a decrease in mineral deficiency and also causes neurological complications. The results are depression, headache, peripheral neuropathy, myopathy, stroke, and seizures. These are some of the symptoms that can be used to predict occurrence of the disease.
The causes of Crohn’s disease are a combination of genetic predisposition and environmental factors. Crohn’s disease is a combination of the immune system and genetic risk factors. Each genetic mutation contributes to the risk of the disease and analyzes of genetic data results in innate immune system and occurs when adaptive immune system aims to compensate the shortcomings of another immune system. The disease is genetic and hereditary in nature and is found in point mutations and NOD2. Numerous genetic mutations have been associated with the occurrence of Crohn’s disease.
Immune system is also associated with the Crohn’s disease due to impaired innate immunity. T cell autoimmune disorder is also associated with the condition and also due to Th 17 cytokine and Th 1 response. ATG16L1 gene prevents the body from invasive bacteria attack. It is also acquired that the bacteria that affects the immune system is inborn, but hygiene issues have resulted in the occurrence of the problem.
Crohn’s disease with the help of microorganisms take advantage of the mucosal layer that has been weakened and prevents inability to clear intestinal walls bacteria: these are symptoms of Crohn’s disease. According to the research, it is evident that an umbrella of diseases is associated with the Crohn’s disease, and it is based on antibiotics therapy and tissue degeneration. Immune system is a major problem to the occurrence of the problem and Mycobacterium avium subspecies paratuberculosis that affects the immune system. The disease is also associated with macrophages killing of MAP reduction of adaptive and innate immunity, impairing the immune system that is important for the control of intracellular mycobacterial infection. In addition, the macrophages that has been infected with MAP results in higher production of TNF-α.
Enteroadherent E. coli specific strains have been linked to the disease. The strain is common in people with CD resulting in making of biofilms when compared to non-AIEC strains correlating with invasion and adhesion indices of neutrophils. It blocks the autophagy at the step of autolysosomal that allows for intracellular survival of indication and bacteria of inflammation. Inflammation drives dysbiosis and AIEC proliferation in the ileum without considering the nature of the genotype. Replication of the AIEC strains induces the secretion of TNF-α, which is large in amounts.
The environment also contributes to the occurrences of the disease especially in the industrialized world. An increased intake of milk protein, animal protein and high levels of omega fatty acids is associated with the Crohn’s disease. Smoking also contributes to the occurrence of the disease and hormonal contraception, which acts like smoking as been associated with the disease. Therefore, lifestyle and environmental factors have played a major role in advancing the occurrence of the disease.
To confirm the diagnosis, biopsies are usually taken through the use of colonoscopy. The pathology indicates the extent and pattern of inflammation are informing in the depth of the disease especially on the intestinal wall. When the disease is very active, ulceration can occur. Skip lesions occur when there is an abrupt transition between the areas that are not affected and the ulcer. Through the use of the microscope, mucosal inflammation is seen through the use of biopsies when focal infiltration of neutrophils into the epithelium. The infiltration results in abscess and inflammation that continues affecting the immune system of the affected person.
Diagnosis/Techniques for Research
Different methods are used to diagnosis of Crohn’s disease but the process is challenging, and numerous tests are required before making of appropriate diagnosis. Even if all the technologies are employed, diagnosing Crohn’s disease is not 100% assured. Classification is one of the strategies to determine the disease since there are three distributions of gastrointestinal Crohn’s disease, which are colic, ileocolic and ileitis. It affects the intestine differently. Other methods that can be used to diagnose the disease include endoscopy allowing identification of disease pattern. Radiologic tests allow checking of the small intestines and blood tests that reveals anemia.
Crohn’s disease has no cure and the best approach is management of the problem. The symptoms of the problem can be controlled through dietary changes, lifestyle changes, medication, moderate exercise and activity, reduction of stress and changes to eating habits. Some of the lifestyle changes to address the symptoms problems include smoking cessation, proper hydration, elemental die and dietary adjustments. Instances of acute treatment allow the use of medications such as antibiotics to reduce the inflammation. In addition, if the symptoms are in remission, the appropriate strategy is to use medications that are aimed at recurrence of symptoms. The intestine sometimes is blocked and surgery is used only to solve this problem. In addition, alternative medicine has been used as an alternative or complementary therapy. These alternative medications include nutritional supplements, herbal medicine, fish oil, probiotics and dieting. Furthermore, acupuncture and homeopathy wherein acupuncture treats inflammatory bowel disease while homeopathy is used to treat the disease through clinical trials. Moreover, these numerous options work in complementary manner and aims at alleviating the pain of the disease or addressing the symptoms.
Crohn’s disease is a condition that is chronic and does not have a cure. The condition is characterized by changes in episodes from being cool, and then the symptoms flare up. The mortality rate of the disease is very low if the persons attend treatment or medication assistance to achieve weight management. The problem usually reoccurs, and the most appropriate strategy is a management of the condition. The disease also has numerous complications with the intestines that include abscesses, fistulae, and obstruction. The level of these conditions differs based on the extent of the disease.
In conclusion, Crohn’s disease affects the gastrointestinal linings from the mouth to anus. It is an inflammatory disease that affects the immune disease and does not have specific medication but can only be managed. The disease has numerous signs and symptoms that include extra-intestinal, systematic and gastrointestinal. The causes include genetics, immune system, and environmental factors. The diagnosis includes blood tests, radiologic tests, endoscopy, and classification.