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Crohn s Disease

  1. Symptoms of Crohn’s disease
  2. Diagnosis
  3. Treatment


    Crohn’s disease (CD) is a chronic pathology of nonspecific granulomatoses character, damaging all parts of the gastrointestinal tract mouth, esophagus, stomach, duodenum, all divisions of the small intestine and colon, including the sigmoid and rectum part. BK accompanied by inflammatory process. The disease pathologically affects how the individual components of the digestive tract and entire gastrointestinal tract.


    Quite often, affected ileal part of the small intestine (terminal part), and is called terminal ileitis. In the second place, the simultaneous failure of the small and large intestine. The defeat of the isolated nature distributed individually to the small intestine, and rarely in the esophagus, duodenum and stomach.

    According to historical records, this disease has been thoroughly examined by a physician, B. B., Kron, final medical data when Crohn’s disease became known, it 1932. Granulomatous colitis, enteritis, esophagitis, gastritis, ileitis, proctitis, sigmoid is a group of items relate to Crohn’s disease. Unfortunately, the etiological factor, which complicates the treatment process.

    It is known that hvoroba crown, in close contact or in parallel, developing the inflammatory disease type ulcerative colitis. The process involves the immunological system produces antibodies antigen aggressive order. They are creating a pathological pattern with multiple granulomatous ulcers, accompanied by bleeding. Remission and relapse are two components of Crohn’s disease.

    Region prevalence according to the statistics of special boundaries does not and Crohn’s disease can hurt every person having a predisposition to it. The disease affects the adult population and children. Typically, the pathology begins to manifest itself at the age of 20 35 or 50 65. In childhood Crohn’s disease runs hard and with a lot of complications. For continentaa spread, the first place is Africa and Eastern countries. Not passed pathology Krona and United States of America as well as Europe.

    Pathophysiological data

    The inner mucosa of the gastrointestinal tract in early lesions covered with numerous small, scattered, superficial erosions createrootpane, i.e. aphthous ulcers. With the development of pathology aphthous ulcers become large size the breadth and depth of the intestine, involving the submucosal and muscle layers. All these changes lead to scarring and narrowing of the lumen of the intestinal space. Force of intestinal peristalsis decreases, attacking the stagnation of food and gas that continue to be goes into full blockage or obstruction.

    Through the perforation of deep ulcers lead to internal bleeding and peritonitis. There are local abscesses, they occur subsequently, penetration of the intestinal contents into the nearby organs and tissues. Acute pain in the abdomen, vomiting, spastic colic, high temperature, the absence of the chair, fainting etc. are the indications for emergency surgical intervention.

    Fistula is very characteristic of this disease, especially when the affected part of the bowel is within the hollow organ. Enteric-vesicular, intestinal-rectal, intestinal, vaginal and cutaneous intestinal fistulas are very common when Crohn disease. The contents of the intestine in the form of fecal matter, gases and sukrovichnye of sereznostyu stand out through the exit opening of the fistula, all this joins secondary infection, pus appears. Anal fistulas around the sphincter is complicated by the suppurative process.

    The factors that cause Crohn’s disease

    What causes Crohn’s disease is unknown till date. As the study of pathology was put forward by the three main scientific hypotheses

    • immunological
    • hereditary
    • the influence of the external environment.


    Immunological theory

    Bacteria, viruses and fungal infection affecting the gastrointestinal tract, activate macrophages which in turn destroy these pathogenic factors causing the disease. The protective system of the body is inflammatory reaction, which is caused by the toxic waste products of bacteria, germs and viruses. Macrophages ingest and neutralize all the toxins and microbes, afterwards the healing or recovery of the damaged area, the remission of the disease. But it is nonsense immune guard devours and completely harmless to human body substances, and bacteria involved in the digestion process, thus, ulcers and other damage.


    Hereditary theory

    With many years of study of Crohn’s disease were found damaged at the genetic level, these genes are able to independently solve some of the germs, viruses and bacteria have destroyed. If mutationist these genes the situation is compounded and they contribute to the development of inflammatory bowel disease and granulomatous pathology Chart. This process is hereditary, this means that is passed down from generation to generation.


    The influence of the external environment

    External factors act as a provocation or catalyst for the launch of Crohn’s disease. The list of these factors includes

    • products
    • the infectious-inflammatory process
    • long use of drugs
    • alcohol, nicotine and drugs
    • heavy metal poisoning and chemical substances
    • radiation.

    Symptoms of Crohn’s disease

    The symptoms depend on the severity of the disease and manifests itself differently, in the early form, symptoms are milder, with severe symptoms bright.


    The early form of this is when Crohn’s disease symptoms and clinical picture, which occur in the following instances

    • spasms and contractions in the affected region of the gastrointestinal tract, the pain is mild
    • disorder stool (diarrhea) with a frequency of 15 times and more streaks of blood in the stool
    • inappetence due to intoxication
    • loss body mass the suction surface of the intestine is destroyed by erosion and granulomas and nutrients don’t enter the body
    • fever toxins inflammatory reaction and secondary infection increase the temperature
    • many ulcers and so on.


    In severe Crohn’s disease to the above symptoms is added the following

    • unbearable pain
    • high temperature up to 40 degrees
    • bowel obstruction
    • the appearance of abscesses and fistulas
    • in the anus appear purulent discharge and maceration of the skin, appearing granulomas resemble hemorrhoids.


    In the course of the disease is classified into the following stages

    • easy
    • average
    • heavy
    • inactive.


    The nature of BC is

    • stable
    • progressive
    • constantly recurrent.

    Diagnosis

    When colitis, enteritis, ileitis, and other diseases of the digestive tract accompanied by spastic pain and bleeding, and the etiology is unknown, it is the place to be Crohn’s disease the diagnosis of which is

    • assembled medical history
    • analysis of feces, urine and blood
    • gastrofibroscopy
    • rektomanoskopii
    • colonoscopy
    • x-rays of the gastrointestinal tract using barium sulfate
    • Ultrasound of the gastrointestinal tract
    • the histological data.

    Treatment

    After the establishment of the final diagnosis the treatment of Crohn’s disease consists of the following steps

    • localization infectious-inflammatory process
    • stabilization of the repetition frequency of exacerbation
    • maintain remissionem period
    • immune suppression.


    Drug therapy

    • aminosalicylate drugs Sulfasalazine
    • antibiotics Ciprofloxacin, Metronidazol
    • kortikosteroidnye drugs Prednisolone
    • immunosuppressants Azathioprine.

    When Crohn’s disease treatment which is indicated above, is accompanied by a tumor that prescribers preventing the destruction of the tumor, such as Infliximab.

    The curative treatment is surgical intervention.