Patients with Crohn’s Disease is a seldom-understood autoimmune disorder.
Crohn’s Disease, also called Crohn’s colitis, ileitis, or regional enteritis, is a form of chronic inflammatory bowel disease (IBD). It is mostly characterized by ulcerations in the gastrointestinal (G.I.) tract, located anywhere from the throat through the colon (most commonly in the small intestines through the rectum). While Crohn’s Disease is not directly categorized as a neuropathic condition, within 10 years of onset it is common for patients to develop peripheral neuropathy, or other autoimmune/inflammatory-disorder-related damage to joints, bone or tissue. This means nerve damage can become apparent, causing tingling and numbness, difficulty walking, speaking, or swallowing, and sometimes causing severe disabilities or psychological disorders.
Crohn’s induced Migratory Arthritis
Though Crohn’s Disease is medically classified as affecting the G.I. tract, patients suffering from it often experience a host of other problems that are caused by the body’s inflammatory responses over time. It could be a symptom of Crohn’s, or a related to what causes the disease.
|An illustration of the G.I. tract.|
Many Crohn’s patients (usually those experiencing symptoms outside of, or in addition to, the small intestine) develop Migratory Arthritis, which causes the patient’s joints (hips, knees, ankles, wrists, elbows) to become inflamed and painful, seemingly at random, and with no other known stressors. This symptomatic form of arthritis is caused by swelling generated by the body’s T-cells (a form of white blood cell) attacking tissue surrounding the nerves of the joints (in addition to the G.I. tract). Though some patients are prescribed medications to treat these joint pains, the pains are typically lessened or eliminated when the Crohn’s Disease activity recedes (usually by medication and/or altered diets).
Neurological & Psychological Dangers Associated with Crohn’s Disease
Sometimes, Crohn’s may cause Bell’s Palsy, a temporary paralysis in the face, in another link to neuropathic disorders related to the disease. The risk of seizures and tremors is usually increased while symptoms are active. Anyone experiencing seizures or tremors (related to Crohn’s, or otherwise) should immediately inform their physician or neurologist.
Vision may become blurred, “spotty”, or altered, due to Crohn’s inflammatory responses such as uveitis (eye swelling), optic nerve inflammation, or from fluids/proteins being “displaced” or collecting within different areas of the eye. Depending upon the severity, patients experiencing with vision impairment may need additional treatment from an ophthalmologist.
Crohn’s patients may also develop weight loss, eating disorders (such as anorexia) or anemia, due to psychologically or subconsciously vilifying food. These patients may need to seek psychological counseling even after their Crohn’s flare-ups are under control.
Causes & Symptoms
Crohn’s Disease is actually somewhat common, affecting roughly 700,000 Americans today. Its first appearances, symptoms or flare-ups usually occur between the ages of 15 and 35. While the cause of Crohn’s Disease is not fully understood, a family history of the disease will greatly increase the risk of contracting it. Genetic links to the disease include mutations in the hereditary NOD2 gene. Those of Jewish/Eastern European heritage have been studied as being afflicted with Crohn’s more often, and those of African heritage possess a decreased risk.
Environmental factors may also play a part in the onset of Crohn’s. No exact environmental causes have been established, though researchers have discovered risk links between Crohn’s and cigarette smoking, heavy pollution, and certain oral contraceptives. Diets high in fat or refined foods and stress may also aggravate the condition, leading to flare-ups, or worsening the severity of flare-ups.
Crohn’s Disease’s direct symptoms are many, and often cause severe pain.
The disease can cause narrowing of the small intestines, leading to blockages that don’t allow food to pass, causing severe cramping, vomiting, and pain. The ulcers that grow on the surface of the intestines can cause the lining to deteriorate, causing holes that can release bacteria from bowels into the abdominal cavity. This can lead to infection, and if left untreated, can potentially cause death by sepsis. The condition can also prevent normal absorption of nutrients in food, and this could lead to malnutrition. Sometimes if left untreated, lesions can also be visibly apparent on the skin.
Common symptoms of Crohn’s Disease and IBD include:
|Pathogenesis of Crohn’s Disease, courtesy of Hopkins-GI.org. (Click to enlarge image)|
- Persistent diarrhea
- Rectal bleeding
- Urgent need to use the bathroom
- Abdominal cramps and pain
- Sensation of incomplete evacuation
- Constipation (can lead to bowel obstruction)
- Loss of appetite
- Weight loss
- Night sweats
- Loss of normal menstrual cycle
The treatment for Crohn’s Disease starts with prescribing medication to control immune response, limiting the inflammation that causes symptoms. This can both relieve the symptoms, and allow ample time for the affected areas to heal, and also increases periods of remission, sometimes substantially. There may also be an issuance of antibiotics to treat lesions, corticosteroids to treat inflammation, and other medicinal remedies.
Other treatments include a very selective diet, avoiding foods that can get easily clogged, or that contain acidic or spicy elements that can irritate the digestive tract. There will be a large focus on foods with high nutritional content as the body has a hard time absorbing nutrients on its own, and the larger the health content of the food, the higher the chances for good absorption.
In many cases, surgery is required to correct areas that develop fissures or obstructions. It is reported that about 70% of Crohn’s Disease patients need to receive surgery at some point in their lives. The surgery will not cure the disease, rather it treats severe symptoms of it. There is no cure for the condition to date, although there are many efforts currently in motion to find one.
Living with Crohn’s Disease
Many patients fear leaving home when their flare-ups are at their worst, as they so frequently have to use the bathroom, they don’t want to risk not having one nearby.
This can cause problems going to work, maintaining a family, and other daily tasks we take for granted. The emotional toll on patients may also be severe, as humiliation and depression are commonly inflicted onto its sufferers.
There are ways to cope with the disease. Learning as much as possible is the first step to getting a handle on the illness. There are support groups available all across the country as well, to educate patients, and get them in touch with others who are suffering as well, to provide emotional support.
For more information about Crohn’s Disease, Inflammatory Bowel Disease, and treatment and support group information, visit the Crohn’s and Colitis Foundation of America at www.ccfa.org.