Ostomy

Crohn’s Disease: Causes, Statistics, Symptoms, Nutrition & Stoma Bags

crohn's disease

Crohn’s disease (aka Crohn syndrome, granulomatous enteritis, regional enteritis, Leśniowski-Crohn disease), although first discovered by Scottish surgeon and physician T Kennedy Dalziel, owes its name to Dr. Burrill B. Crohn , who in 1932 published the first relevant study together with his collaborators Gordon Oppenheimer and Leon Ginzburg.

Nearly 90 years later, science has not yet determined what causes Crohn’s disease, and no one can predict how it will develop in a patient. In recent years, however, treatments have been found that effectively fight the symptoms of the disease and some genes that are responsible for it have already been found. The scientific community is generally optimistic that the cause and definitive treatment of Crohn’s disease is not far off.

What is Crohn's disease?

Crohn’s disease was initially thought to be the same condition as ulcerative colitis. The truth is that they are quite similar but they also have big differences. Both of them belong to the inflammatory bowel diseases (IBD).

In patients with Crohn’s disease, the immune system attacks the inner surface of the digestive system (mucosa) causing inflammation, most often leading to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Most often, however, it affects the lower part of the small intestine (the ileum) and the beginning of the large intestine. More specifically, the three main locations for the disease are:

  • The small intestine 30% (Ileal Crohn)
  • The small and large intestine at the same time 30-40% (Crohn Ileocolic)
  • The large intestine 20-30% (Crohn's colitis)

It is extremely rare to occur in the stomach or esophagus.

Crohn's disease affects the entire digestive system

Causes

Dozens of theories have been formulated, but none of them isn’t entirely satisfactory. In recent years it seems that Crohn’s disease is due to a complex interaction of genes inherited by the patient and environmental factors (antigens) such as viruses or bacteria, smoking, taking antirheumatic drugs, adding preservatives to food, changing dietary habits and stress (although recent research shows that stress only contributes to relapse).

What is certain is that something motivates the body’s defenses to attack the inner surface of the digestive system, creating inflammation and all the problems that accompany it.

What the statistics reveal

Global epidemiological studies show that we are more likely to have IBD patients in developed than in developing countries. In 2015 in the US it was found that by then more than three million patients had been diagnosed with an inflammatory bowel disease, ie 1.3% of the adult population.

  • Ο prevalence of Crohn's disease in North America and Europe was 321 per 100,000 people in 2012 .
  • Canada has the highest incidence of Crohn's in the world
  • It is usually diagnosed in young adults between 15 and 35 years old
  • Smokers are twice as likely to develop the disease as smoking exacerbates the symptoms of the disease and increases the likelihood of a flare up
  • It occurs more often in women
  • It occurs more often in Caucasians
  • Crohn's rates are higher in developed countries, urban areas and northern climates
  • 5% - 20% of people with IBD have a first degree relative with a similar disease
  • When both parents are sick, the risk for their children to develop Crohn's disease is 35%

Unfortunately, in Greece we don’t have enough statistical data. The gastroenterology clinic of PEPAGNI was the first in Greece that after a serious study presented official numbers for Crete while according to data of the gastroenterology clinic of PGNL presented by professor of gastroenterology Spyridon Potamianos in 2017, more than 1,000 people across Thessaly suffer by Crohn’s Disease while emphasizing that the number is in fact double since in many cases the disease hasn’t been diagnosed or has been misdiagnosed.

Thanks to their work, it is estimated that in Greece about ten thousand people suffer from Crohn’s disease.

What is the risk of cancer in patients with Crohn's disease?

We now know that Crohn’s disease contributes to the development of cancers of the gastrointestinal tract. The risk is very low initially and increases the longer the length of the affected gastrointestinal tract and the longer the years have passed since the diagnosis. Regular colonoscopy, exercise and a healthy diet minimize the chance of cancer. After all, all studies show that life expectancy in patients with Crohn’s disease doesn’t differ from that in the general population.

Symptoms

The symptoms of Crohn’s disease can range from mild to very severe. It is a chronic condition which means that something is constantly evolving. Thus, there are periods of good health (remission) that alternate with periods when there is an exacerbation of symptoms (relapse or flare-up). In extreme cases, doctors have to deal with a very serious clinical picture with a high fever, a toxic bigot that can even threaten the patient’s life.

The severity, but also the type of symptoms depend directly on the organ of the digestive system that is affected but also on the type of complications (stenoses, abscesses, fistulas). Usually the symptoms appear gradually but may appear suddenly, without any warning signs.

  • Diarrhea
  • Constipation
  • Abdominal pain, usually lower right
  • Fatigue
  • Decreased appetite and weight loss
  • Fever
  • Pain or dryness in the anal area (due to fistulas and abscesses)
  • Bleeding during defecation
  • Red eyes (iridocyclitis)
  • Rash (nodular erythema)
  • Irritation in the oral cavity (sore)
  • Inflammation of the liver or gallbladder
  • Musculoskeletal pain and arthritis
  • Menstrual disorders
  • Delayed development in children
symptoms of Crohn's disease

Because the lower part of the small intestine (ileum), which is very close to the appendix, is usually affected, the initial diagnosis is often wrong as the disease resembles acute appendicitis. However, there are symptoms that are not related to the intestine and their association with the disease is being studied by gastroenterologists and surgeons.

As bad as it sounds, it doesn’t mean that all patients with Crohn’s disease will have serious complications. Usually, the symptoms are in relapse even for a long time without bothering them at all. Unfortunately, there is no way to predict how long someone will be completely well and when they will have a relapse.

Diet for Crohn's disease

The following dietary tips are usually given by doctors without any specific food or drink being blamed for recurrent episodes of Crohn’s disease.

Prefer

  • Cheese
  • Yogurt
  • Eggs
  • Almond milk
  • Fatty fish
  • Chicken and turkey
  • Avocado
  • Potatoes
  • Cooked carrots

Avoid

  • Alcohol
  • Butter, mayonnaise, margarine
  • Coffee, tea, chocolate
  • Corn
  • Fried foods
  • Foods rich in fiber
  • Nuts
  • Raw fruits and vegetables
  • Red meat and pork
  • Spicy foods

In general, the diet should be adequate in nutrients. Although there seems to be an issue with plant-based foods without being banned, there is usually no problem when they are well cooked.

Of course, each person is different and it would be good to identify what types of foods cause problems and avoid them. In any case, don’t forget that your doctor is the most appropriate advisor in everything that has to do with the disease.

Of course, when Crohn’s disease is accompanied by anorexia, poor absorption and diarrhea the body loses fluids, nutrients, vitamins and minerals. In addition to a good and balanced diet, it is often good to add dietary supplements and vitamins in your diet.

Treatment

Every doctor has a different therapeutic approach to similar cases of Crohn’s disease due to the complexity of the symptoms, so the therapeutic techniques initially aim at relieving the patient by smoothing the inflammation and keeping the disease in remission.

Medication

The disease is initially controlled with medication, both to reduce symptoms in the event of a relapse and to maintain remission intervals.

  • Cortisone (during disease flare up)
  • Azathioprine
  • Mesalazine
  • Antibiotics to control possible infections
  • Biologic medicines
  • Special dietary preparations

Surgical treatment

It can and should be avoided, especially in the early stages of the disease, but when the medication fails or there are serious side effects, complications and acute abdominal signs, then surgery is required.

During the operation, the most affected part of the intestine is usually removed and joined to the rest of the healthy intestine. In other cases, parts or even entire organs of the gastrointestinal tract are removed and a stomais created.

  • Stenoplasty
    It is performed when there are narrowings in small parts of the small intestine, enlarging the narrowings without removing the bowel.
  • Excision
    Removal of the parts of the intestine that show lesions and joining the healthy parts together.
  • Proctocolectomy and ileostomy
    Removes the entire colon and rectum as well as the end of the small intestine creating a permanent stoma (ileostomy). A special bag (ileostomy bag) is placed on it, into which the small intestine waste is now led instead of passing through the colon and ending in the anus.
  • Ileoanal anastomosis
    Because the rectum is often unaffected even when the colon is severely diseased and needs to be removed in its entirety, it is possible for the ileum to join at the upper end of the rectum.
  • Partial colectomy
    Creating a colostomy usually in the lower left part of the abdomen when only the lower part of the intestine is affected.
  • Temporary ostomy: ileostomy or colostomy
    The ileum or colon is inserted into the abdominal wall and openings are made to empty the contents of the bowel into ostomy bags until the bowel has healed. Then a new operation is performed to remove the ostomy.

Crohn's disease: Stoma bags

A stoma is a surgically created opening in the abdomen that is used to drive bowel movements into a bag (aka ostomy bag). Such an operation and the colostomy and ileostomy bags may initially cause fear but in fact they are there to relieve you of the serious symptoms of Crohn’s disease..

In recent years, leading medical manufacturers such as B Braun have developed ostomy bags, making them completely discreet, comfortable and safe, enabling millions of people worldwide to continue their lives normally.

Crohn's disease colostomy-ileostomy bags - EOPYY and free samples

EOPYY allows all patients with Crohn’s disease to try any colostomy or ileostomy bag of B. Braun completely free of charge.

Traumacare is always by your side to give answers to every question and to help you with all the prescribing procedures and of course, to help you make the best and most economical choice with the aim of your comfort and above all your safety.

Just fill in your details and we will contact you immediately or call us for more information.



    You can also always seek advice and help from HELLESCC, the Association of People with Crohn’s Disease and Ulcerative Colitis in Greece.

    Related Posts

    Leave a Reply

    Your email address will not be published. Required fields are marked *