Crohn's Disease

Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract which can affect any part of the gut, from the mouth to the anus, but commonly affects the small and large intestine. It is one of the group of inflammatory bowel diseases (IBD). 

The cause is unknown. 
- Smokers are at an increased risk of developing Crohn's disease. 
- IBD runs in families. Crohn's disease and ulcerative colitis are both associated with certain genetic diseases.

Crohn's disease differs from ulcerative colitis because it causes inflammation deeper within the intestinal wall. Crohn's disease usually occurs in the small intestine, but it can also occur in the mouth, esophagus, stomach, duodenum, large intestine, appendix, and anus. Ulcerative colitis affects only the colon.

Because IBD is inflammatory, it increases the risk of colon cancer due to the constant inflammation and healing process.

Symptoms
Chronic inflammation results in pain, diarrhoea and weight loss, as well as other symptoms. Symptoms and signs vary according to the site of involvement and how much of the gut is involved. 
If the small bowel is involved, patients may get abdominal pain after meals, diarrhoea and weight loss. With large bowel involvement, diarrhoea and rectal bleeding is common. 
Symptoms in Crohn's disease may begin insidiously and the diagnosis is often delayed. Systemic features are common (fever, weight loss, etc) and perianal disease (fissures, fistulae and abscesses) is a frequent early clue to the diagnosis. 
Anaemia may also be diagnosed because of Crohn's disease.

Diagnosis
The diagnosis is made by a combination of x-rays, endoscopy, colonoscopy and biopsies. Exclusion of infective causes of diarrhoes and bleeding is important and hence stool culture and examination may also be performed. A full blood count may also be done to see if the patient is anaemic because of low iron, folate or vitamin B12, plus to look for an increased white cell count, elevated platelets and a high ESR (which may indicate that an inflammatory process is occurring).

Crohn's and SCD