inflammatory bowel disease that affects the intestines , symptoms , causes, pathology, risk factors etc

1. Department of Pathological Anatomy and Forensic
Medicine
Topic :- Crohn’s Disease

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

6. Crohn’s Disease affects:

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

13. Resources
 Yahoo Health
http://health.yahoo.com/digestive-overview/crohn-s-disease-topic-overview/healthwise--uf6004.html
 Health Central
http://www.healthcentral.com/ibd/irritable-bowel-syndrome-000103_1-145.html
 National Digestive Disease Information
Clearinghouse
http://digestive.niddk.nih.gov/ddiseases/pubs/crohns_ez/index.htm
 Mayo Clinic
http://mayoclinic.com/health/crohns-disease/DS00104