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Crohn’s Disease: An Overview

Esha Shahzad and Eman Ammar

1st Year MBBS, Islamabad Medical and Dental College, Islamabad, Pakistan

Key points
  • Introduction to inflammatory Bowel disease and Crohn’s disease
  • Causes and symptoms
  • Diagnosis
  • Prevention and control

Introduction

Crohn’s disease is an inflammatory autoimmune condition directly affecting the gastrointestinal tract, especially the colon. It is a type of Inflammatory Bowel Disease (IBD). In 2019, there were approximately 4.9 million cases of IBD worldwide, with China and the USA taking the lead in the highest number of cases. 1

Causes and symptoms

The cause of Crohn’s is not fully known but mainly attributed to genetic, environmental, and immune factors. Common symptoms include:

  • Lesions extending from mouth to anus.
  • Diarrhea.
  • Abdominal pain.
  • Rectal bleeding.
  • Weight loss.
  • Fatigue.

Diagnosis

Patients presented with the aforementioned symptoms should refer to a Primary Care Physician who will proceed to conduct a physical examination of the anorectal region.1 Diagnosis is confirmed by techniques such as endoscopy and cross-sectional imaging.2

Prevention and control

Since the nature of the condition is autoimmune, a definite treatment is unavailable. However, there are measures that the person can take to manage the inflammation and intensity of symptoms. Some common treatments include:

  • Higher intake of dietary fiber has been shown to alleviate symptoms.

  • Lifestyle changes such as quitting smoking, stress management, and regular exercise can help improve symptoms.3
    • Figure 1: Impact of Lifestyle Factors and IBD.
  • Exclusive enteral nutrition (EEN) diet therapy is a nutritionally liquid formula used as the primary source of nutrition for a period of 6-8 weeks in patients. It is shown to reduce inflammation and larger trials are being conducted to further research the effectiveness of EEN.4

  • Therapeutic strategies show promising results. Some of these include Cell therapies using T regs, hyperbaric oxygen, and fecal microbiota transplantation.5

  • Surgical options are available but used mainly in complicated cases as a last resort. One such option is ileocolic resection which is considered a controversial surgery as it is still under investigation. Furthermore, it is highly subjective to the patient’s condition and to the nature of complexity of their disease.6
  1. Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ open. 2023 Mar 1;13(3):e 065186.
  2. Veauthier, Brian, and Jaime R Hornecker. “Crohn's Disease: Diagnosis and Management.” American family physician vol. 98,11 (2018): 661-669.
  3. Rozich, J. J., Holmer, A., & Singh, S. (2020). Effect of Lifestyle Factors on Outcomes in Patients with Inflammatory Bowel Diseases. The American journal of gastroenterology, 115(6), 832–840.
  4. Goens, D., & Micic, D. (2020). Role of Diet in the Development and Management of Crohn's Disease. Current gastroenterology reports, 22(4), 19
  5. Catalán-Serra, I., Ricanek, P., & Grimstad, T. (2023). "Out of the box" new therapeutic strategies for Crohn´s disease: moving beyond biologics. Revista espanola de enfermedades digestivas, 115(11), 614–634
  6. Meima-van Praag, E. M., Buskens, C. J., Hompes, R., & Bemelman, W. A. (2021). Surgical management of Crohn's disease: a state of the art review. International journal of colorectal disease, 36(6),1133–1145


Volume 6
2024

An Official Publication of Student Spectrum at
Islamabad Medical & Dental College

Address of Correspondence

Esha Shahzad & Eman Ammar
1st Year MBBS, Islamabad Medical and Dental College, Islamabad, Pakistan