Dr. Vishal P.

Bhatt
 Definition
• Crohn’s disease is an idiopathic inflammatory
bowel disease chracterized by transmural
non caseating granulomatous inflammation.
 Location
Any where in the gut from mouth to anus.
Most common:
• Ileo-colic (50%).
• Terminal ileum (30%).
• Right colon (20%).
ETIOLOGY
• Causes of Crohn’s Disaese Genetics FACTOR
• Smoking has been shown to increase the risk of the
return of active disease, or "flares"
.• Hormonal contraception is linked with a dramatic
increase in the incidence rate of Crohns disease.
Immune System-Crohns disease is thought to be an
autoimmune disease
Pathophysiology
• Biopsies of the colon are taken to confirm the diagnosis.
• Crohns disease shows a transmural pattern of
inflammation, showing entire depth of the intestinal wall.
• Ulceration is an outcome seen in highly active disease.
• Inflammation is characterized by focal infiltration of
neutrophils, a type of inflammatory cell, into the
epithelium.
• These neutrophils leading to inflammation or abscess .
Gastrointestinal Symptoms• Abdominal pain,diarrhoea,
flatulence, bloating, perianal discomfort .
• People who have had surgery often end up with short
bowel syndrome of the gastrointestinal tract.
• Ileitis results in large volume watery feces & colitis
result in a smaller volume of feces of higher frequency.
• In severe cases, an individual may have more than 20
bowel movements per day and may need to awaken at
night to defecate.
• The mouth may be affected by non-healing sores
(aphthous ulcers).
Systemic Symptoms
• Up to 30% of children with Crohns disease have
retardation of growth.
• Among older individuals, Crohns disease may manifest
as weight loss related to decreased food intake.
Extraintestinal Symptoms
• Crohns disease also increases the risk of blood clots;
painful swelling of the lower legs can be a sign of deep
venous thrombosis.
• Difficult breathing may be a result of pulmonary
embolism.
Medication•
Antibiotics use to reduce inflammation .
• Prolonged use of corticosteroids has significant side.
• Alternatives include aminosalicylates alone, though only
a minority are able to maintain the treatment, and many
require immunosuppressive drugs.
Lifestyle Changes
• Dietary adjustments, proper hydration and smoking
cessation reduce symptoms.
• Consume balanced diet with proper portion control &
eat small meals frequently instead of big meals.
• Do regular exercise and take enough sleep.
• Identifying foods that trigger symptoms.
Surgery
• Crohns cannot be cured by surgery.
• Surgery required in case of obstructions, fistulas and/or
abscesses, or if the disease does not respond to drugs