Chrone’s Disease Essay, Research Paper

Crohn’s Disease

(Regional ileitis)

Intro (use part or all of this if your need it for the introduction)

Crohn’s disease is named after the physician who described the disease in a paper written in 1972. It is also called Morbus Crohn’s, Granulomatous enteritis, Regional enteritis, or Terminal ileitis.

Attacks of Crohn’s disease affects patients in their teens or early twenties, and tends to recur throughout the individual’s life. It is usually chronic, with recurrent periods, and also periods of remission.

———————————————————————-

Crohn’s disease, also referred to as regional ileitis, is a chronic, long term, inflammatory disease that affects the digestive tract. The cause of Crohn’s disease is unknown. It can affect the digestive system anywhere between the mouth and the anus, but usually affects the final section of the small intestine, the ileum. Inflammation of the inner lining of the colon and rectum is caused by Ulcerative Colitis, while Crohn’s disease is an inflammation that extends into the deeper layers of the intestinal wall. Crohn’s disease can also affect the also affect the colon, the regional lymph nodes, and the mesentery (outside covering of the intestines). The disease can be aggravated by a bacterial infection. It begins with the development of patches of inflammation on the intestinal wall, which can spread from one part of the digestive tract to another. It sometimes only develops in one place and does not spread any further. The inflammation causes the thickening of the intestinal wall, which sometimes causes an obstruction in these areas, or scar tissue, which narrows the passageways.

The symptoms of Crohn’s disease sometimes act like an appendicitis attack. The ileum is usually involved in Crohn’s disease, and is located next to the appendix. Abdominal right-sided tenderness and pain, appetite and weight loss, possible diarrhea, bloody stools (sometimes), fever, abdominal distention, nausea, vomiting, and a general sick feeling. Crohn’s disease also can cause growth retardation in children.

Crohn’s disease can also appear as periodic cramps with diarrhea, and may or may not involve the obstruction of the bowel. Poorly digestible fruits and vegetables can plug the already narrowed segment of the intestine and cause an obstruction. Diarrhea may be the result from the obstruction because of poor absorption of nutrients, excessive growth of bacteria in the small bowel, or inflammation of the large intestine. The result of this could be blood in the stools, or rectal bleeding. Hemorrhages from Crohn’s disease are rare, but they do occur.

Complications of the disease may occur in areas related to the intestinal disease (i.e., bowel perforation, abscesses, fistulae, cancer of the bowel, and intestinal hemorrhage). Or complications may occur in areas not related to the intestines (i.e.; tender, raised, reddish shin nodules; inflammation in the joints, spine, the eyes, the liver, and the bile ducts that drain the liver).

In one-fourth of all cases, the symptoms appear only once or twice, and the disease does not come back. If they recur, they will come back every few months or every few years for the rest of your life, with periods of remission. If Crohn’s disease continues for years: it will gradually deteriorate the bowel functioning, there will be a risk of poor absorption of nutrients, severe bleeding could cause iron-deficiency, or it could possibly increase your risk of cancer of the intestine.

If you have chronic abdominal pain, with the mentioned symptoms, your doctor will check you for Crohn’s disease. This involves a series of tests starting with a blood test for anemia, which could indicate bleeding in the intestines. Another test is called a colonoscopy (a flexible, lighted tube linked to a computer and TV monitor, called an endoscope), is inserted through the anus. Later, the doctor may run upper gastrointestinal series, a small intestinal study, and a barium enema intestinal x-ray to determine the extent of the disease. If you have Crohn’s disease your doctor will want to give you regular check-ups to diagnose your condition, and you may be a candidate for surgery. Crohn’s disease cannot be cured by surgery, but it can be helped.

Epidemiology studies of Crohn’s disease have been conducted in many countries. They yield some important insights into the disease. These include:

+ There is strong evidence that Crohn’s disease is caused by an environmental agent.

+ Incidence of Crohn’s disease is increasing in most parts of Europe and North America.

+ Crohn’s disease is beginning to make an appearance in parts of the world that have not experienced it before.

The cause of Crohn’s disease is unknown, although there is a genetic tendency to develop this disease and environmental factors are also thought to play a part. Crohn’s disease may occur at any age but is most common in young adults, with most people first affected during their teens or twenties. Small proportions (15 percent) of patients contract the disease after they are 50. Crohn’s disease is found mainly in Europe, North America, and Australia.

Individual studies on the epidemiology of Crohn’s disease have been conducted, mostly confined to one city, country or region of a country. Only three countries have conducted national surveys on the prevalence and incidence of Crohn’s disease. These are Japan, Slovakia and Yugoslavia. There is insufficient data to develop a complete picture of the global prevalence or incidence of Crohn’s disease.

Several studies studied ethnic subgroups of populations. In these studies, people whose country of origin has a low or zero prevalence of Crohn’s disease have a much higher prevalence of the disease when they migrate to a country that has high prevalence of the disease. For example, Moroccans living in Belgium, West Indians living in England and Asians living in England are as much at risk of developing the disease as the indigenous populations of those countries. This provides strong evidence that a factor in the environment is involved in causing Crohn’s disease. Further evidence that an environmental factor is involved is provided by studies that show that the pattern of relapse of Crohn’s disease changes through the year. In this study, it was found that there was a higher rate of relapse in the autumn and winter months.

Studies show that the annual incidence of the disease has increased. Annual growth rates between 2 and 14 percent have been recorded. In some cases these growth trends have been maintained for periods of up to fifty years. For example, in Cardiff, Wales, the annual incidence of Crohn’s disease grew from 0.18 per 100,000 in 1934 to 8.3 per 100,000 in 1985, a forty six fold increase in 51 years. Historically, Crohn’s disease has been pictured as a disease that affects mostly white populations. However, non-white migrants to Europe and North America are at a much greater risk of developing the disease than they are in their country of origin. Also, the disease is beginning to make itself known in populations where it has never been seen before, such as in Chinese people in Hong Kong, Chinese people in Singapore and Arab people in Kuwait. A recent study in Japan found a statistical correlation between the growth in incidence of Crohn’s disease and the increasing consumption of animal proteins, with the highest correlation figure being associated with increased consumption of milk.

Crohn’s disease is on the rise in children. One study, in South Glamorgan, Wales, found that the annual incidence of Crohn’s disease in children was increasing by over nine percent per year. This has also been reported in southwest Sweden.

References

Brendan’s Crohn’s Disease Home Page, (1999, February) [Online database]. Available:

http://www.geocities.com/CollegePark/union/3819/index.html, [1999, May 28].

Crohn’s Disease, Health Library, (1999) [Online database], Available: http://www.thriveonline.Com/health/Library/illsymp/illness151.html, [1999, June 2].

Crohn’s Disease, National Digestive Diseases Information Clearinghouse, (1999, January) [Online database]. Available: http://www.niddk.nih.gov/health/digest/pubs/crohns/html,

[1999, June 2].

Finkel, A. and Kunz, J., (1987), The American Medical Association Family Medical Guide. New York, NY: Random House, Inc.

Medical Sciences Bulletin, (1992, October) [Online database]. Available: http://pharminfo.Com/pubs/msb/nih_crohn.html, [1999, June 2].

Welcome to the Crohn’s Disease Site, (1999, May) [Online database]. Available:

http://www.angelfire.com/ga/crohns/index.html, [1999, May 28].

“Crohn’s Disease,” Microsoft Encarta 98 Encyclopedia. 1993-1997

Microsoft Corporation. All rights reserved.

“The Epidemiology of Crohn’s Disease,” Alan Kennedy

http://www.iol.ie/ alank/CROHNS/epidem.htm