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Crohn’s Disease

Crohn’s disease is a chronic inflammatory condition involving the GI tract. Although Crohn’s disease may affect any part of the GI tract from mouth to anus, the most commonly affected area is the terminal ileum (the very last part of the small intestine before it joins with the colon or large intestine).

The exact cause of Crohn’s disease is not known, however it is thought that it results from interaction between the body’s immune system and normal bacteria in the GI tract. Crohn’s disease is not contagious but it can run in families. Crohn’s disease can affect any age group but is most common in young adults between the ages of 16 and 40. Crohn’s disease and a similar condition called ulcerative colitis are collectively termed inflammatory bowel disease (IBD).

Although there is no “cure” for Crohn’s disease, it can generally be treated or controlled with medications and in some cases, surgery. It may recur at various times over ones life.

What are the symptoms of Crohn’s disease?

Symptoms of Crohn’s disease may vary depending on the part of the GI tract that is affected. The most common symptoms include cramping, bloating, abdominal pain, diarrhea, fever, and weight loss. Bleeding per rectum may occur. Other symptoms may include anal pain, drainage, ulcers or fissure.

Crohn’s disease may also affect other organ systems such as the joints, mouth, eyes, and skin. Joint pain may arise due to inflammation of the joints (arthritis) and may affect the peripheral (arms and legs) or axial (spinal column and pelvis) joints. While peripheral arthritis generally improves as the Crohn’s flare is controlled, axial arthritis or it’s severe form Ankylosing spondylitis may persist and cause chronic disability. Mouth ulcers (canker sores), blurred vision, eye pain or sensitivity to light, and skin conditions may also occur during a flare but generally resolve when Crohn’s is in remission. If you notice any of these symptoms, bring it to your doctor’s attention sooner rather than later.

How is Crohn’s disease diagnosed?

A gastroenterologist or colorectal surgeon may make the diagnosis of Crohn’s disease after evaluating your clinical history in combination with endoscopy (upper endoscopy or colonoscopy) and imaging tests.

How is Crohn’s disease treated?

Crohn’s disease can generally be treated with medication such as corticosteroids (prednisone), anti-inflammatory agents (aminosalicylates), immune modulators (6-mercaptopurine and azathioprine), or a number of biologic agents (infliximab, adalimumab, certolizumab, golimumab, natalizumab, or vedolizumab). Antibiotics with immune-system effects (metronidazole) may sometimes be useful in patients with anal disease. These medications may have a number of side effects that should be monitored closely by your prescribing physician.

What if I need surgery?

In more severe cases of Crohn’s disease surgery may be recommended. In fact, up to 75% of patients with Crohn’s disease eventually need surgery. Emergency surgery is sometimes required for perforation of the intestine, narrowing or blockage causing a bowel obstruction, or significant bleeding. Less urgent reasons for surgery include abscess formation, fistula (an abnormal connection between the intestine and your skin), or continuation of symptoms despite maximal medical therapy. If you need surgery, a conservative approach is always taken with the primary goal being to perform a limited resection of the affected portion of your intestine. Surgery is not a cure for Crohn’s disease but often provides long-term relief of symptoms.

In some cases, depending on the medications you are taking (steroids and immunosuppressive medications which can impair surgical healing), your overall health and nutrition, and the indication for surgery (i.e. perforation) an ostomy may be necessary. In most cases, the ostomy is temporary and can be reversed at a later time when you have healed from surgery. Make an appointment for a consultation with Dr. Zaghiyan in her office in Los Angeles to discuss your condition and to receive a personalized approach to the treatment of your particular problem.



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