Crohn’s disease - A Review of Symptoms and Treatment

Brian NguyenUniversity of California - Irvine Medical Center, Orange, CA

Background

• Inflammatory bowel disease in large intestine and rectum– May occur in any part of GI tract

• Chronic condition• Onset occurs 16-40 yrs old• Exact cause unknown– Genetic risk factors

Background

• Autoimmune disorder• Immune system attacks normal microbes– White blood cells rush lining– Chronic inflammation

• Similar symptoms to ulcerative colitis– UC affects superficial layers and colon only– CD affects all layers and GI tract

Usually found in ileocecal region (small intestine to large intestine)

Colon with Crohn’s disease Normal colon

Symptoms

• Periods of flare ups• Abdominal pain• Diarrhea• Fever• Weight loss• Anal pain

Complications

• Obstruction of bowel– Swelling or scar tissue

• Ulcers in tract– Can result in fistulas (30%)– Abscess

• Malnutrition– Inadequate intake and absorption

Diagnosis

• Colonoscopy (70% effective)– Visualization of colon and terminal ileum

• Radiological studies– Can help see remainder of small intestine– Highlights inflammation

• Blood tests– Anemia indication for Crohn’s

Treatment

• No “cure” – only symptom relief• Medication– Cortisteroids or anti-inflammatory agents– Immunosuppressive drugs

• Surgery – Remove diseased portion of intestine– Anastomosis connects remaining bowel– 50% patients have recurrence within 5 years

Surgery

Total proctocolectomy with ileostomy

Surgery

Total colectomy with ileorectal anastomosis

Prognosis

• No cure• Higher risk for colon cancer• Long periods of remission