Crohn's Disease: What, Who and Why
What is Crohn's Disease?
Crohn's disease is chronic (long lasting or recurrent) disorder causing
inflammation or ulceration of the digestive tract.
The most common area affected by Crohn's disease is the section of the
digestive tract called the ileum (end of the small intestine that joins
the large intestine) and the large intestine (colon). Inflammation can
also occur anywhere in the gastrointestinal (GI) tract from the mouth
to the anus. Crohn's disease affects all layers of the
intestinal walls
causing ulcers. The disease can also spawn openings called
fistulas. These fistulas usually occur around the rectal area
and sometimes drain mucus or pus.
Crohn's disease, along with its cohort Ulcerative Colitis (affecting
only the colon and rectum), is considered an inflammatory bowel disease
(IBD). Once beginning, the disease is characterized by
periods of activity and inactivity or remission.
A brief overview of symptoms includes extended bouts of diarrhea,
nausea, fever, abdominal cramping or pain. These
symptoms can lead to a loss of appetite which is frequently followed by
weight loss.
The severity of Crohn's varies greatly between individuals.
Many people have only mild symptoms while others can have complications
that in rare cases can be life threatening.
The inflammation caused by the disease sometimes affects the
intestine's ability to absorb nutrients from food.
This can lead to deficiencies in important vitamins including B12 and
Folic Acid. Crohn's can increase the risk of kidney stones,
gallstones, and some forms of anemia (decrease in amount of hemoglobin
in red blood cells).
There is no known cure for Crohn's disease. There are several
medicinal and surgical treatments used to control the disease with a
goal to keep the patient in a state of remission.
Named after an American gastroenterologist, Burril Bernard Crohn, who
in
1932 was the first to describe the then unknown disease along with his
two colleagues Dr. Leon Ginzburg and Dr. Gordon D.
Oppenheimer.
Who gets Crohn's Disease?
Estimates on the number of people in the United States that are
affected by Crohn's vary from 300,000 to 600,000. A few
estimates even claim as many as 1 million Americans have an IBD.
Crohn's disease is an equal opportunity disorder affecting men and
women equally, although some statistics show women as having a slightly
higher risk.
People of European (Caucasian) and Jewish decent are 4 to 5
times more likely to be diagnosed then other ethnic groups.
Rates among
those of Hispanic and Asian decent are lower than those of European and
African heritage. Other factors seem to play a part in
causing higher rates,
including living in urban areas and living in northern
climates. People of the industrialized nations of
North America and Europe also have higher rates.
Crohn's disease can be diagnosed at any age but most commonly
during adolescence and early adulthood, typically between the
ages of 15 and
35. The disease is rare in early
childhood. There are potentially 100,000+ children
under the age of 18 in the US suffering from an IBD.
There appears to be a genetic link as the disease is more common in
those having relatives with Crohn's disease. Approximately
20% of those diagnosed have a blood relative with an IBD. If
that relative is a sibling then the risk of developing Crohn's is 30
times higher than the general public.
Rates are higher in smokers than in nonsmokers.
Why? What is the cause of Crohn's Disease
The cause of Crohn's disease is still unknown. One of the
most popular theories is that in a patient with Crohn's disease the
immune system reacts abnormally mistaking bacteria, an unknown virus,
or other substance occurring in the bowel as being a foreign
invader. The immune system's job is to attack and
remove these 'foreign' objects. This causes an
increase in white bloods cells in the lining of the intestines which
leads to the inflammation associated with
Crohn's.
Once the immune system has been 'turned on', the message
to switch it off appears to
not be thrown, causing your body to attack itself.
Some scientists theorize that the disease may be caused by infection
from a type of bacteria called mycobacterium. Other studies
have suggested that diets high in fatty, sweet, or refined foods may
play a role. To date there has been no evidence that the
disease is caused by infection or diet.
Although once thought to be a factor, research has ruled out stress,
tension, and anxiety as causes for an IBD. Stress and anxiety are not
the
cause of Crohn's but high levels of either may aggravate symptoms.
Crohn's disease is not contagious.
A gene called NOD2/CARD15 has been identified as having mutations more
frequently in people with Crohn's disease. When this mutation
occurs, it inhibits the body's ability to recognize harmful bacteria.