Crohn's Disease Symptoms
Crohn's disease - is an inflammatory bowel disease that affects all its layers. Crohn's disease( BC) is caused by damage to all shells that form the wall of the intestine, predominantly segmental lesion, which seizes one or more segments of the digestive tract throughout its entire length. However, most often it is localized in the ileum or large intestine. Morphologically, this inflammatory process is characterized by the presence of granulomas and lesions of local lymphatic formations.
Crohn's disease, also known as regional ileitis, is a chronic inflammation of the intestinal wall, more often the end part of the small intestine or colon. Inflammation captures the deep layers of the intestinal wall, ulcers and abscesses can form. Ulcers can completely destroy the wall, creating abnormal passages( fistulas) in other parts of the intestine, to other organs, for example to the bladder or to the skin. Deep cracks can also develop inside and around the anus. Inflammation can lead to thickening of the intestinal wall and, eventually, to complete blockade of the intestine. Symptoms of Crohn's disease appear in the form of seizures, which alternate with periods of normal health. Some people have only one or two seizures, and then recovery comes;in others, seizures are repeated throughout life.
Cause
diseaseEpidemiological studies conducted in Sweden showed that the primary incidence increased from 3.5 to 6.0 per 100 000 population, and the prevalence of Crohn's disease was 75.2 per 100 000 population. In 25% of the disease is diagnosed in persons under 21 years.
Manifestations of the disease
Crohn's disease is characterized by bloating and rumbling, diarrhea, cramping pain. The patient's weight decreases. Fistulas often form in the anus. The disease is complicated by intestinal obstruction, intestinal constrictions and abscesses. The extraintestinal lesions that are characteristic of Crohn's disease include: inflammatory diseases of the eyes, joint and skin lesions, osteoporosis, liver and bile duct diseases.
In adolescents, Crohn's disease is much more common than in children. There are reports of Crohn's disease in infants. Boys get sick almost twice as often as girls.
Crohn's disease can affect any part of the gastrointestinal tract - from the oral cavity to the anus;while there were no significant differences in the area of the lesion in children and adults. In most patients, the intestine is involved in the process in the form of separate segments, each of which is separated by a segment of the normal intestine. It is noted that if the inflammation is initially localized in the ileum, it may be further spread to the straight line, while the secondary involvement in the process of the small intestine is very rare.
The disease is manifested by cramping pains in the abdomen, diarrhea. Often there are extraintestinal manifestations: fever, lack of appetite, stunting, general weakness, joint pain. When the small intestine is affected, the pain is localized in the periapical and right ileal regions. Possible tenesmus( empty, painful desires for defecation).At children bleedings are observed in 30%, however they never happen massive. Often, bleeding is the first symptom of Crohn's disease. Violation of the integrity of the intestinal wall with the ingestion of its contents into the free abdominal cavity is rare, usually this process ends with the formation of abscesses. Blood in the feces is rare, although in some patients, intestinal bleeding can be very severe. The delay in growth and sexual development is more pronounced than before the disease began. Being one of the features of the disease in children, this symptom occurs in 25-30% of patients.
Absorption of simple sugars, amino acids, fatty acids, vitamins, microelements is broken. The frequency of defecations reaches 3-6 per day, and if the stool is observed more often, this usually indicates a lesion of the large intestine. In some patients, diarrhea is minor, and during an exacerbation of inflammation it can be replaced by constipation.
Symptoms of
blood in stool arthritisDiagnosis of the disease
Diagnosis of the disease with the help of X-ray examination with barium, during which a sign such as "cobblestone pavement" is revealed. There is also a sigmoid and a colonoscopy. Almost always a biopsy is performed( sampling a piece of mucosa for microscopic analysis).
A decisive place in the diagnosis of pathology belongs to the x-ray( double contrast method) and endoscopic( sigmoidoscopy andcolonoscopy) studies. X-ray manifestations are similar in adults and children and do not have a direct correlation with the severity of the clinical course of Crohn's disease.
enemaTreatment of disease
Patients with this diagnosis are prescribed a diet with an increase in the amount of protein, dairy products are recommended to be excluded. From medicinal agents for the treatment of Crohn's disease, drugs of the sulfasalazine group and glucocorticoids are used. Some doctors also prescribe immunosuppressants. Surgical treatment is not aimed at treating Crohn's disease as such, but on combating emerging complications.
Treatment of the disease should be comprehensive, include diet therapy, psychotherapy, a set of selected physical exercises. In the acute phase of the disease, prednisolone and azathioprine are indicated. There are no effective methods of treating Crohn's disease. Surgical treatment is rare, as in 90% of the possible exacerbations of the disease. Indications for surgery for Crohn's disease are cicatricial stenosis and the formation of external intestinal fistula. Due to the inflammation of any segment of the intestine, its narrowing initially develops, which, with resistance to conservative therapy, is transformed into cicatricial stenosis. The index of such a transition is the appearance of a suprastenotic expansion of the proximal parts, which is a sign of decompensation of the contractile capacity of the intestinal wall and a precursor to the development of obstructive intestinal obstruction.
With Crohn's disease of the small intestine, either resection of the affected area or stricturoplasty is performed. The choice of the method of operation is determined by the extent of the bowel disease. Stricturoplasty is possible only with small strictures up to 4-5 cm
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