Crohn's disease
Crohn's disease is a chronic disorder that causes inflammation of the gastrointestinal (GI) tract, most commonly at the end of the small intestine (the ileum) and beginning of the large intestine (the colon).
People with Crohn's disease may suffer all of their lives, experiencing an ongoing cycle of "flare-up" and remission. Together with ulcerative colitis, Crohn's disease belongs to the group of illnesses called inflammatory bowel disease (IBD).
An estimated 900,000 people suffer from Crohn’s disease in UCB’s top 7 markets (France, Germany, Italy, Japan, Spain, UK and US)
Who is affected?
The onset of Crohn's disease usually occurs in young people between the ages of 15 and 35. The disease tends to run in families, with studies showing that 20 to 25 percent of patients with Crohn's disease have a close relative with either Crohn's disease or ulcerative colitis.
Did you know?
The north-south divide: A higher incidence of Crohn’s disease is reported in Northern Europe and North America compared to Southern Europe and Asia.
What are the symptoms of Crohn’s disease?
The most common symptoms reported by Crohn's patients include:
- Diarrhoea
- Fever
- Nausea
- Abdominal pain
- Severe weight loss.
These debilitating symptoms may be accompanied by depression as Crohn's disease can have a significant impact on the quality of a patient's life.
Complications associated with Crohn’s disease
A number of complications of Crohn’s disease can further impact the lives of people living with the disease:
- Obstructions: the most common complication of Crohn’s disease is blockage of the intestine due to inflammation and formation of scar tissue. The result is thickening of the bowel wall and a significantly narrowed intestinal passage. If medication does not alleviate the obstruction, surgery may be required
- Fissures: severe bouts of diarrhoea and inflammation can lead to small tears or cracks, known as fissures, developing in the intestine, particularly the colon
- Fistulas: deep ulcers within the GI tract can turn into small channels, called fistulas, which create connections to different parts of the intestine. They can also occur between a part of the intestine and the skin, or an organ such as the bladder or vagina. These fistulas become channels of infection from one area to another and require drainage through a surgically inserted tube
- Malnutrition: another common complication in Crohn’s disease is nutritional deficiency, particularly in patients where the disease has been extensive and of long duration resulting in a continued inadequate diet and poor absorption of nutrients.
Diagnosis
There is no single test which can diagnose Crohn’s disease. However, diagnosis is usually by a combination of tests and examinations including endoscopy, biopsy, stool-testing and physical examination.
Treatment goals
The main goal of medicinal therapy is two-fold:
- To relieve symptoms by allowing intestinal tissue to heal brining about a clinical response and remission
- To decrease the frequency of disease flare-ups thereby maintaining response and hopefully leading to remission.
Treatment options
There are several groups of drugs used to treat Crohn’s disease including: aminosalicylates (5-ASA) – anti-inflammatory drugs, corticosteroids, immunomodulators, antibiotics and biological therapies.
What is the role of surgery?
Two thirds to three quarters of patients with Crohn’s disease will require surgery at some point during their lives. Surgery can be required for different reasons but is usually indicated when medication is unable to control the disease symptoms.
One indication is the presence of an intestinal obstruction. In this case, the diseased bowel segment is removed, known as a resection, and the two healthy ends joined together in a procedure called anastomosis. Surgery cannot be considered a cure for Crohn’s disease as frequently the disease recurs at the site of anastomosis.
