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Crohns Disease - Medical Malpractice
Crohn's disease is also called regional enteritis and is a type of inflammatory bowel disease. It is unique in that it can affect any part of the gastrointestinal tract, from the mouth to the anus. It commonly affects the small and large bowel, however. No one knows the exact cause of Crohn's disease but it appears to be partly hereditary. It is related to a problem with the immune system such that autoantibodies are formed to digestive tissue. Crohn's disease is, in fact, an autoimmune disease. It involves diseased digestive lining interposed between areas of healthy tissue. A lot of the intestinal tract can be affected or very little of the intestinal tract. The affected intestinal wall becomes swollen and thickened. While Crohn's disease is partly hereditary, there appears to be an environmental component to getting the disease that we do not completely understand.
Crohn's disease can occur at any age but is more common between the ages of 15 and 35. Risk factors for Crohn's disease include smoking, having a family history or being of Jewish descent.
Symptoms of Crohn's disease vary with the area of the colon or intestines involved and the degree to which they are involved. Main symptoms are crampy abdominal pain, fever during attacks, tiredness, pain with stooling, watery diarrhoea, and unintentional weight loss. Other people can actually have constipation, inflammation of the eyes, fistulae between the intestines and the outside or other body areas, liver inflammation, joint pain, mouth ulcerations, rectal bleeding with bloody stools, skin ulcers and swelling of the gums.
Doctors diagnose Crohn's disease primarily through an endoscopy examination and biopsy of tissue which reveals the disease. A barium enema or CT scan of the abdomen can be done to show the presence of changes significant in Crohn's disease. Capsule endoscopy can be done to see if the Crohn's disease is in the small intestines. Upper GI x-rays can show oesophageal, stomach or small intestinal disease. MRI and CT scans of the abdomen may also be helpful in diagnosing the disease of Crohn's colitis. Certain blood tests can be off in Crohn's disease, including C - reactive protein, albumin, the ESR, fecal fat testing, haemoglobin, white blood cell count and liver function studies.
The treatment of Crohn's disease begins with a healthy diet. Some people have certain foods that trigger the disease. These should be avoided in place of foods that do not make the disease worse. The diet should be as well balanced and healthy as possible. You should eat small amounts of food throughout the day, drink plenty of fluids, avoid high fibre foods and avoid greasy and fatty foods. If you do not tolerate dairy, use Lactaid or drink soy milk instead. Common foods for you to avoid include citrus fruit, raw fruit juices, broccoli, cauliflower or spicy foods. You may need specialized vitamins and minerals including iron supplements, calcium, vitamin D and vitamin B12 for anaemia.
You need to reduce stress in order to treat Crohn's disease. Stress and depression can make the disease worse. You may need medications to reduce stress.
Other medications that treat Crohn's disease include loperamide or Imodium for severe diarrhoea. It is available over the counter for the management of loose stools. Ask your doctor or nurse before taking medications for diarrhoea.
Some people get better with fibre supplements like Metamucil or psyllium powder. Methylcellulose can also work as a fibre supplement. You can use Tylenol for milder pain and avoid medications like naproxen, ibuprofen and aspirin as these can make the symptoms worse. Stronger pain medications can be prescribed for you.
Symptom control can be given by using aminosalicylates, corticosteroids, antibiotics for abscesses and biologic therapies, such as Cimzia and Tysabri.
Many people with Crohn's disease need surgery to control symptoms. Bowel resection is the most common surgery employed for Crohn's disease and it removes damaged bowel in cases of bleeding problems, failure to grow, fistulas or severe symptoms. Some patients need the entire large colon removed.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here