Crohn’s Disease – Part 1Jennifer ThomasKing UniversityCrohn’s Disease – Part 1Inflammatory Bowel Disease (IBD) is comprised of two separate conditions, Ulcerative Colitis and Crohn’s Disease. The focus of my paper is Crohn’s Disease which is an “idiopathic inflammatory disorder that can affect any area of the gastrointestinal tract from the mouth to the anus” (Huther & McCance, 2017, p. 921). Most commonly it affects the ileum (end of the small bowel) and the beginning of the colon (Huther & McCance, 2017, p. 921). Crohn’s Disease is a chronic autoimmune condition for which there is currently no cure. There are five types of Crohn’s Disease including: Crohn’s (granulomatous) colitis, Gastroduodenal Crohn’s Disease, Ileitis, Ileocolitis, and Jejunoileitis. The types of Crohn’s are named according to the location of the inflammation within the gastrointestinal tract. Symptom management is key to live an active lifestyle and have a good quality of life. Symptoms range from mild to severe during flares and can even be absent for a period of time during periods of remission (Crohn’s & Colitis Foundation of America, 2016, p. 8). Crohn’s disease can affect you at any age, however, it is most commonly diagnosed in individuals ranging from fifteen to thirty-five years old. It is important to understand Crohn’s Disease because so many people are affected by this disorder and many other similar inflammatory gastrointestinal conditions. We need to know and understand the early signs and symptoms of Crohn’s Disease, so we can be proactive in early diagnosis and symptom management.
Crohn’s Disease is important to me because I was diagnosed with severe Irritable Bowel Syndrome at the young age of seventeen. I have seen several specialists over the years and many have stated that it’s only a matter of time before the diagnosis of Crohn’s Disease is made. They explained to me that the area of my inflammation is most commonly seen in Crohn’s and the trend of flare ups is similar to that of Crohn’s as well. It is my hope that by compiling the following information, it will aid someone in recognizing that their symptoms may be something more serious than just some gastrointestinal discomfort. All too often we brush off our symptoms and do not get the needed tests to properly diagnose and treat our conditions.
Epidemiology of Disease
Statistics were compiled from across the United States and showed that the prevalence of Crohn’s Disease in the Midwest was 264.0 per 100,000 adults, in the Northeast 247.2 per 100,000 adults, in the West 219.3 per 100,000 adults and in the South 219.2 per 100,000 adults (Inflammatory Bowel Disease, 2015). In the United States there are more than 780,000 people living with the diagnosis of Crohn’s Disease. According to data from the Crohn’s and Colitis Foundation of America, there are around 33,000 newly diagnosed cases of Crohn’s each year. Crohn’s disease seems to be found more in urbanized and developed countries. Data shows that the trends are starting to change in other countries and the incidence in China, India, and South America are increasing (Crohn’s & Colitis Foundation of America, 2016, p. 6). Studies have shown that Caucasians are more apt to be diagnosed than other ethnicities. Most cases are diagnosed between the ages of fifteen and thirty-five with another wave of diagnosis in the later years after the age of sixty. The likelihood of getting Crohn’s Disease is equal between women and men. When women are diagnosed during their childbearing years fertility is sometimes altered during flares and it is recommended that they be in remission for at least six months before trying to conceive. If you become pregnant during a flare or have a flare while pregnant you are at increased risks for many complications including miscarriage and still birth.
There are several lifestyle and environmental factors that increase your odds of being diagnosed with Crohn’s Disease. According to the Crohn’s and Colitis Foundation of America “Most experts think there is a multifactorial explanation. This means that it takes a number of factors working in combination to bring about Crohn’s Disease” (Crohn’s & Colitis Foundation of America, 2016, p. 7). The three factors they believe contribute to your chances of a diagnosis are environmental, genetic, and an inappropriate reaction by the body’s immune system (Crohn’s & Colitis Foundation of America, 2016, p. 7).
If you are a smoker your risk of getting Crohn’s Disease doubles when compared to that of a non-smoker. Smoking cessation can help to decrease the symptoms during Crohn’s flares. Using nonsteroidal anti-inflammatory drugs can increase your chances of developing Crohn’s or if you have already been diagnosed these drugs can exacerbate the symptoms of your disease and cause a flare (Crohn’s & Colitis Foundation of America, 2014, p. 9). According to research from the CDC there is a link between the “westernization” of lifestyle such as “diet changes, smoking, differences in exposure to sunlight, pollution and industrial chemicals” and Inflammatory Bowel Diseases such as Crohn’s Disease (Centers for Disease Control and Prevention, n.d., para. 5). The CDC also suggests that “diet, oral contraceptives, perinatal and childhood infections, or atypical infections have been suggested, but not proven, to play a role in developing IBD” (Centers for Disease Control and Prevention, n.d., para. 7).
Over the years as research has progressed it is showing more and more that there is a hereditary/genetic factor in the diagnosis of Crohn’s Disease. If a person has a family member with this condition they are more likely to be diagnosed with it as well. Even though research shows this genetic link, there is currently no way to predict if you will get it or not. Genetic testing continues and will likely advance the treatment options for this chronic disease. According to data from the Crohn’s and Colitis Foundation of America in 2007 there had been eight susceptibility genes identified and because of increased research by 2012 this number had increased to 160 susceptibility genes (Crohn’s & Colitis Foundation of America, 2014, p. 18) Their research also has discovered the importance of the microbiome and the role it plays with immune system. Crohn’s disease is an inflammatory autoimmune disease so in these people when there is a trigger (bacteria, virus, or other environmental element) the immune system creates an inappropriate response that results in inflammation. This abnormal reaction occurs because the individual has the inherited gene that makes them susceptible to Crohn’s (Crohn’s ; Colitis Foundation of America, 2014, p. 5). This demonstrates how Crohn’s Disease is a multifactorial disorder.
Just as there are triggers to cause a flare of symptoms there are things you can do to try to decrease these symptoms. You can eat smaller more frequent meals, eat in a relaxed environment, avoid your trigger foods (these vary from person to person), limit food with insoluble fiber, and reduce the amount of greasy or fried foods (Crohn’s ; Colitis Foundation of America, 2013, p. 15-16). During times of flares you can also reduce symptoms by staying well hydrated with water, low-sugar sports drinks, and diluted fruit juices. You will want to avoid ice cold liquids (causes cramping) and anything caffeinated (Crohn’s & Colitis Foundation of America, 2013, p. 16). As with any condition it is best to eat a nutritious well-balanced diet as tolerated. You should also pay attention to and make note of the foods, drinks, or other environmental stressors that cause exacerbation of symptoms or a reduction in symptoms.
Centers for Disease Control and Prevention. (2018). https://www.cdc.gov/ibd/data-statistics.htmCenters for Disease Control and Prevention. (n.d.). https://www.cdc.gov/ibd/ibd-epidemiology.htmCrohn’s ; Colitis Foundation of America. (2013). Diet, nutrition, and Inflammatory Bowel Disease. Retrieved from http://www.crohnscolitisfoundation.org/assets/pdfs/diet-nutrition-2013-1.pdfCrohn’s & Colitis Foundation of America. (2014). The facts about Inflammatory Bowel Diseases. Retrieved from http://www.crohnscolitisfoundation.org/assets/pdfs/updatedibdfactbook.pdfCrohn’s ; Colitis Foundation of America. (2016). Living with Crohn’s Disease. Retrieved from http://www.crohnscolitisfoundation.org/assets/pdfs/living-with-crohns-disease.pdfHuther, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Elsevier.Inflammatory Bowel Disease. (2015). https://inflammatoryboweldisease.net/what-is-crohns-disease/statistics/