Crohn's disease: symptoms and treatment
Crohn's disease is a pathological condition in which certain parts of the intestine are affected, most often diagnosed in the lower parts of the small intestine and / or in the large intestine.Table of contents:
Types of Crohn's disease
In medicine, the disease under consideration is classified according to several factors. First of all, the differentiation takes place according to the type of disease:
- The acute form of Crohn's disease - the duration of the disease is more than 6 months, the clinical picture is not very pronounced.
- The gradual onset - the development of only symptoms lasts more than 6 months, at the outset, Crohn's disease generally is asymptomatic.
- Chronic form of Crohn's disease - pathology is present constantly, can progress or stop in its development, and if remission periods are noted, they last less than 6 months.
- Recurrent course - the symptoms occur repeatedly with a clear regularity, since the periods of remission are 6 months.
Doctors can determine and in what form the Crohn's disease occurs - there are 5 of them in general, each of them will have distinctive features of clinical manifestations.
- Granulomatous colitis is the formation of multiple granules of small sizes in the walls of the large intestine.
- Granulomatous proctitis - the formation of multiple neoplasms of a tumor-like nature in the walls of the rectum.
- Acute ileitis is an inflammatory process localized in the ileum.
- Ejunoelitis with small bowel obstruction syndrome - the inflammatory process proceeds in the ileum and jejunum.Stool masses move through the intestines with difficulty.
- Ejunoelitis is a chronic type with a violation of the function of absorption - an inflammatory process in the small intestine.
Crohn's disease may also have a different localization - this fact also makes it possible to classify the pathology in question. In this case, Crohn's disease will be divided into only two types:
- Type 1 - pathological lesion is detected only in one part of the small intestine, can be found in the area of the small intestine transition to the thick or any segment of the thickGuts.
- Type 2 - the pathological process does not have a clear localization and can affect several parts of the small or large intestine.
Causes of Crohn's disease
Modern medicine can not distinguish any precise, unambiguous reasons for the development of the pathology in question.Doctors can only differentiate some of the factors that, according to statistics, trigger the development of Crohn's disease. These include:
- viral and bacterial infections of a protracted nature, proceeding with the absence of any treatment;
- weighed down by heredity;
- decreased immunity, which occurred against the backdrop of severe diseases - for example, with oncology.
Symptoms of Crohn's disease
The clinical picture of the pathology in question can be variable - it depends on which part of the intestine the inflammatory process is localized, in what form the course of Crohn's disease takes place( fulminant, gradual, acute, chronic, etc.).In general, all symptoms of Crohn's disease are divided into two groups:
Such symptoms of Crohn's disease do not always appear, but often there is a place - doctors usually pay attention to such atypical signs in the last turn. The extraintestinal symptoms of Crohn's disease include:
- pathological lesion of soft tissues of the oral cavity( gums) - formation of ulcers on the mucosa;
- liver damage - skin is colored yellow;
- general weakness;
- joint damage - inflammatory processes in them, recurrent bouts of pain syndrome;
- kidney damage - urination becomes frequent, there is pain in the lumbar region;
- lesions of the skin - the patient marks the appearance of long non-healing wounds;
- decrease in body weight without any apparent cause;
- decreased visual acuity;
- hyperthermia - increased body temperature.
Symptoms of this group directly indicate that the pathological process develops in the intestine - they are so pronounced. Intestinal symptoms of Crohn's disease include:
- abdominal pain - they can have a different character from blunt / prolonged to sharp / cutting;
- disorders of the stool - they are often expressed by diarrhea( diarrhea), feces may contain mucus and a minimal amount of blood;
- inflammation of the anus area - the patient complains of severe pain while sitting, during the act of bowel movement.
Diagnosis of Crohn's Disease
In general, the pathology in question is diagnosed rather heavily - its symptoms are too similar to those of other diseases of the organs of the gastrointestinal tract.Therefore, the patient should seek help from a doctor - he will conduct a full examination.
The following manipulations apply to the diagnosis of Crohn's disease:
- Survey of the patient - how often there are characteristic symptoms of Crohn's disease, are there any definite periods of exacerbations( for example, spring or autumn), is there any connection between the appearance of the symptoms of the pathology in question and the eating habits or consumption of alcoholic beverages.In addition, the doctor must find out whether there were diseases of the gastrointestinal tract, or specifically Crohn's disease from someone from the next of kin.
- Inspection of the patient - the doctor feels the stomach and determines the presence or absence of tension of the abdominal wall, soreness in the navel.
- Laboratory tests:
- blood tests - biochemical, clinical.This allows to identify anemia, liver pathology, inflammatory processes in the pancreas and / or other organs of the digestive system;
- general urine analysis - a doctor should pay attention to the color and consistency, the transparency of urine, its density, because it is these indicators that will indicate the level of functioning of the kidney and urinary system;
- analysis of feces for the presence of blood in it - the same analysis is also called stool for "concealed blood," this laboratory test is advisable only if the specialist at the examination / examination of the patient suspects the development of internal intestinal bleeding;
- feces analysis for calprotectin fecal - this substance is the determinant of the presence of pathological processes in the intestine: if its values exceed the norm, this means the progression of the inflammatory process;
- coprogram is also a laboratory study of feces that helps isolate undigested food residues in the biomaterial, the presence of fat and coarse dietary fiber.
- Instrumental studies:
- esophagoduodenal gastrophygia - a specialist assesses the condition of the walls of the esophagus, stomach and duodenum.During the procedure, a tissue fragment is taken from the walls of the organs under investigation( biopsy) to exclude malignant neoplasms;
- ultrasound examination of the abdominal cavity - assesses the condition of the gallbladder, pancreas, kidneys, intestines;
- video endoscopy - examination of the intestinal wall with a miniature video camera, which is enclosed in a capsule( the patient swallows it and within a day the doctors receive all information about the functioning of the intestine);
- Colonoscopy - a specialist examines the condition of the large intestine with a special tool;
- Irrigoscopy - X-ray examination of the intestine with contrast agent;
- computed tomography of abdominal organs.
Treatment of Crohn's Disease
Usually, treatment of the pathology in question is performed by therapeutic methods, making up the right diet and diet, but in some cases, the doctor can prescribe and prompt surgery.
As a rule, the choice of medications for diagnosed Crohn's disease is done in a strictly individual order - much depends on the stage, shape and severity of the pathology in question. But there are certain general recommendations for the conduct of drug therapy - for example, there is a list of medications:
- sulfasalazine is a combined preparation that forms the basis of all therapy for Crohn's disease;
- hormonal drugs - reduce the activity of spreading the inflammatory process;
- leukotriene receptor antagonists - restore and strengthen the immune system;
- antibacterial drugs( antibiotics) - extremely rare.
If the therapeutic methods of treatment do not give a positive result, the patient's condition worsens or remains unchanged, then doctors consider it advisable to perform surgery.
In the course of surgical intervention, specialists simply remove the bowel area affected by the pathological process.In the rehabilitation period, the patient is prescribed antibacterial and anti-inflammatory drugs.
Very important is the correction of the diet - Crohn's disease implies some restrictions and even exceptions in the menu.
It is strictly forbidden to enter into the menu:
- eggs of chicken and quail - raw, boiled, fried;
- fatty meat and fish;
- whole milk, salted / smoked / sharp cheeses;
- white cabbage, radish and radish;
- sauces are sharp and fatty, including - mustard, mayonnaise;
- any carbonated drinks and kvass.
Allowed to be used as food:
- Low-fat meat varieties - rabbit, beef, chicken, turkey;
- any cereals and pasta, cooked on vegetable broth or water without the addition of butter;
- dairy and diet sausage;
- no-good baked goods, dry biscuits, dried wheat bread.
All patients with diagnosed Crohn's disease should be prescribed vitamin-mineral complexes, especially in severe cases, patients should be given intravenous amino acids.
With the progression of Crohn's disease, violation of treatment regimen or non-compliance with the diet, complications may develop:
- perforation of the wall of the intestine that is prone to the pathological process;
- appearance of abscesses( abscesses) directly in the intestine;
- intestinal bleeding;
- formation of fistula;
Crohn's disease is a well-studied pathology, doctors perfectly understand and know which methods of treatment will be effective for the patient.Only strict adherence to all appointments of specialists will enable the patient to lead a normal life during long-term remissions.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category