2. What is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel
disease that affects the intestines.
The intestine become irritated and swollen causing
pain, diarrhea, and ulcers.
3. What are the symptoms?
Belly pain
Diarrhea
Mouth sores
Weight loss
Blood in stool
Ulcers
Inflammation in the
liver
Arthritis
Loss of appetite
Bowel blockage
Fever
Tears in the anus
Delayed growth
Vomiting
Nausea
Bowels can thicken
with scar tissue
4. What causes the disease?
Heredity/Genetics
Viruses or bacteria that can trigger an abnormal
immune reaction
Could be due to an initial immune deficiency
5. Pathology
Gross appearance
Transmural, predominantly submucosal inflammation characterized by a
thickened colonic wall
Cobblestone appearance on endoscopy
The bowel wall may be entirely encased by creeping fat of the mesentery, and
strictures may develop in the small and large intestine
The mucosa may demonstrate long, deep linear ulcers that appear like “railroad
tracks” or “bear claws.”
Normal mucosa may intervene between areas of inflammation, causing “skip
areas” characteristic of the disease
Histologic
transmural inflammation, submucosal edema, lymphoid aggregation, and
ultimately fibrosis
Pathognomonic: the noncaseating granuloma, a localized, well-formed aggregate
of epithelioid histocytes surrounded by lymphocytes and giant cells; found in 50%
of resected specimens
7. What are the risk factors?
People of all ages are affected by this disease
The same number of men are affected as women
The age for diagnoses is between 20 – 30 years old
Caucasian are more likely to be affected than any other
ethnic group.
Environmental factors can play a role- people who live in
urban or industrial areas
Smokers
8. Crohn’s Disease is a systemic condition causing
extraintestinal manifestations effecting 25%
More common
joint pain
skin rash
oral ulcers
gall stones
liver disease
eye problems
growth retardation in
children
Other less common
anemia
blood clots
kidney stones
nerve damage
lung disease
pancreatitis
pericarditis
menstrual irregularities
severe gingivitis
osteoporosis
9. Diagnosis
Rule out infectious causes
Differentiate from UC by extra-colonic involvement
(e.g. oral, anal)
Characteristic radiographic findings:
skip lesions, contour defects, longitudinal and
transverse ulcers, a cobblestone-like mucosal
pattern, strictures, thickening of the haustral margin,
and irregular nodular defects
10. What is the treatment ?
Mild to moderate treatment usually is treated with an antibiotic
Some of the newer antibiotics come in capsules but are in lower
dosage.
Moderate to severe treatment is treated with a steroid or even surgery.
The steroids can be taken as a suppository, by injection, foam, and
orally. The form is determined by the severity or location of the
condition.
Other Medication:
Anti-diarrhea
Laxatives
Pain relievers
Strong Iron Supplements for intestinal bleeding
Special Diets
11. Effects of Treatment can cause:
Susceptibility to infection
Weight gain (particularly increased fatty tissue on the face and upper trunk and
back)
Rash
Loss/Excess hair growth
High blood pressure (hypertension)
Accelerated osteoporosis
Cataracts and glaucoma
Diabetes
Wasting of the muscles
Menstrual irregularities
Upper gastrointestinal ulcers
Numbness
Skin disorders / Acne
12. Coping with Crohn’s Disease
Avoiding stress by: exercising, relaxation and breathing techniques.
Limit the amount of dairy products
Low fat food
Eating high fiber food – passes through the intestines easily than fatty
foods
Eating smaller meals
Drinking plenty of fluids
Having a dietitian
Take multivitamins