Crohn’s disease is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus.
Signs and symptoms may include abdominal pain, diarrhea (which may be bloody), fever, and weight loss. Other complications and symptoms include anemia, skin rashes, arthritis, inflammation of the eye, and tiredness. Bowel obstruction can commonly occur and there is a greater risk of bowel cancer.
The exact cause of Crohns disease is not understood. It is a type of immune response and theories include an infection or autoimmune process.
There are no medications or surgical procedures that can cure Crohn’s disease. Treatment options help with symptoms, maintain remission, and prevent relapse. Steroids, anti-inflammatory medication and newer drugs called biologics are all useful. Stopping smoking can help in remission and prevent relapse. One in five people with the disease are admitted to hospital each year, and half of those with the disease will require surgery for the disease at some point over a ten-year period. Checking for bowel cancer via colonoscopy is recommended every few years, starting eight-ten years after the disease has begun.
Crohn’s disease is historically been more common in the developed world. It tends to start in the teens and twenties, although it can occur at any age. Males and females are equally affected.
Surgery for Crohn’s disease Surgery has a limited but important role in Crohn’s disease. Patients with Crohn’s disease may need surgery for perianal disease or abdominal disease causing obstruction or fistulation. Plyps or cancers may nee intervention.
Perianal disease is extremely challenging and must be managed by an experienced surgeon. Recurrent fistulation and complex disease is common.
Minimally invasive surgery is available for Crohn’s abdominal complications and is recommended if possible. There is a significant risk of repeat surgery and laparoscopic surgery can reduce adhesions and improve recovery.
Crohn’s disease that affects the ileum may result in an increased risk for gallstones. This is due to a decrease in bile acid resorption in the ileum and the bile gets excreted in the stool. As a result, the cholesterol/bile ratio increases in the gallbladder, resulting in an increased risk for gallstones.