Crohn's Disease

After meeting someone who lives with this condition (affecting the digestive system), and during work experience sitting in on a patient who also has Crohn's Disease, I decided to make it the topic of my next post:

Crohn's disease is a rare condition which causes inflammation of parts of the digestive system, most commonly the small intestine (ileum) or the colon. Because of the variety of places that can become inflamed (from the mouth to the anus), there can be a huge variety of symptoms. Symptoms can also be very mild or non-existent in times of remission, but then have a sudden flare-up of immense pain. Recurring diarrhoea is a common symptom of Crohn's, as is weight loss and abdominal pain. Weight loss can be caused by the fact that pain reduces appetite, or that the intestine doesn't absorb as much food due to the inflammation. Less common symptoms include fever and vomiting.

So what causes this rare, sometimes painful, sometimes unnoticeable condition? The truth is, it's still unknown. There is evidence to suggest, as with many other conditions, that smoking plays a role. Genetics also seem to play a factor, as does whether or not the individual has had a previous infection of the digestive system. Perhaps most interestingly however, is that Crohn's is a "disease of the rich". It's far more prevalent in modern, Western societies than in poorer countries. It's also become increasingly more common since the Second World War, which suggests the environment plays a part as well. There's also some evidence to suggest that the immune system causes Crohn's Disease. In Crohn's, a special antibody (TNF) is sent into the digestive system by the immune system to kill all bacteria, even the "friendly" bacteria that are beneficial to us. Supposedly, it is this killing of friendly bacteria that can cause Crohn's.

Crohn's Disease is a chronic condition and at present there isn't any cure. Treatment is focused on relieving the symptoms. Medication is normally given, such as steroids or hormones to reduce inflammation. Immunosuppressants can also be used to reduce inflammation, however this makes the patient more vulnerable to other infections and diseases. Controlling diet can also help (there's some evidence that suggests spicy foods cause flare-ups). For many people with Crohn's, surgery is needed to treat the symptoms and repair any lasting damage caused by the disease. Surgery is needed if an anal fistula, a common complication where a channel develops between the anal canal and the skin, occurs.

There is no specific method or test for diagnosing Crohn's, but there are tests that can rule out other conditions causing the symptoms, such as blood tests, stool samples and whether or not there is a history of Crohn's disease in the family.

Crohn's disease is an example of something in Medicine that is not fully understood - currently there is no cure and the cause is unknown. Due to the lack of a specific test, diagnosis is a long procedure and the condition can also cause no discomfort, then suddenly flare up. The fact that there's so much unknown about this condition makes it more interesting, but also highlights the fact that there's still so much more to learn about humans and the conditions that can affect them.