Crohn's Disease (regional enteritis, Causes, Symptoms, Diagnosis

This article discusses Crohn’s disease, which is another inflammatory bowel disease. After reading the article, you will know what are the symptoms of the disease and what are its risk factors. We also tell you what the risks of malnutrition are associated with intestinal disease.

Crohn's disease

• Symptoms of Crohn's disease usually begin slowly, so it can be difficult to find.
• Smoking is a major risk factor for Crohn's disease.
• Crohn's disease can be associated with malnutrition and, in particular, a deficiency of the following vitamins: vitamin D folate, i.e. vitamin B9, vitamin B12 and vitamin B6.

What is Crohn's disease (regional enteritis)?

Crohn's disease is another inflammatory bowel disease . The disease involves an inflammatory reaction in a specific part of the gut: the end of the small intestine or the large intestine, or both .

This chronic disease may also be associated with disorders of the intestinal organs.

Prevalence of Crohn's disease

• Crohn's disease usually breaks out around the age of 20-30 .
• The disease occurs in both men and women , slightly more in women.
• In Finland, about 500-800 people get Crohn's disease every year.
• The incidence of inflammatory bowel disease has increased significantly in recent years.

What causes Crohn's disease?

The exact mechanism of Crohn's disease is unknown. The disease is thought to be caused by congenital abnormalities of the intestinal mucosa.

Predisposing factors for Crohn's disease include:

• heredity
• smoking
• effect of nutritional factors
• the impact of other environmental factors.

The incidence of Crohn's disease has increased significantly in Western countries and also especially in Finland.

What are the symptoms of Crohn's disease?

Symptoms of Crohn's disease:

• stomach ache
• diarrhea
• fever
• weight loss
• blood stools
• increased need for bowel movements
• fatigue
• nausea
• vomiting
• anal pain
• insoles
• inflammatory foci
• fistula
• extraintestinal symptoms
• arthritis
• joint pain
• lower back ailments
• sore nodules on the skin, nodule rose
• inflammation of the choroid of the eyes
• eye pain
• photosensitivity (inflammation of the iris or sclera)
• other oral or anal disorders
• other symptoms.

Symptoms may be continuous or recurrent. However, the symptoms may sometimes disappear. Symptoms of Crohn's disease usually begin gradually, which can make it difficult to find the disease. Symptoms depend on the extent and severity of the inflammation and the location.

Crohn's disease - Diet and nutrition

Crohn's disease cannot be cured or prevented with a diet, but in terms of coping and general fitness, it is worth taking care of your health with a healthy and varied diet. Good nutrition helps keep weight normal.

For an illness, no single specific food or diet is known to increase the risk of the disease or trigger symptoms. There are individual differences and certain foods may be related to a person’s gastrointestinal symptoms.

Still, diet therapy is not a substitute for drug treatment or surgery for Crohn’s disease. For detailed nutritional guidance, it is advisable to consult a competent nutritionist and doctor.

Good nutritional status also supports recovery in the active phase (acute phase).

Malnutrition in Crohn's disease

Inflammatory bowel diseases may be associated with malnutrition, which may affect, for example, endurance. Everyday fatigue can be caused by deficiencies in individual nutrients, such as low vitamin D or iron deficiency.

In inflammatory bowel diseases, the need for certain vitamins and minerals may increase. This may be due to their reduced absorption or increased consumption.

Deficiencies are more associated with Crohn’s disease than ulcerative colitis.

The absorption of certain nutrients may also be impaired if a certain part of the intestine has been removed. For example, vitamin B12 is absorbed from the rest of the small intestine, and if the rest of the small intestine, the ileum, is removed, vitamin B12 is given as an injection due to malabsorption.

Being overweight does not rule out the possibility of malnutrition.

Minerals and trace elements in Crohn's disease

Some minerals act as electrolytes in the body. They are lost in diarrhea, which affects both inflammatory bowel diseases.

In Crohn's disease, mineral deficiency can occur as a result of impaired absorption. Mineral deficiency can also occur due to their low intake.

Important minerals include calcium, phosphorus, magnesium, sodium, chloride, and potassium, as well as trace elements needed in smaller amounts such as iron, zinc, and selenium .

Vitamin deficiencies in Crohn's disease

The most common deficiencies associated with Crohn's disease are :

• Vitamin D
• folate, or vitamin B9
• Vitamin B12
• Vitamin B6 .

If you eat little vegetables, berries and fruits, you may also have a mild vitamin C deficiency.

Impaired fat absorption and lack of bile acids may impair the absorption of fat-soluble vitamins:

• Vitamin A.
• Vitamin D
• Vitamin E.
• Vitamin K .

A clean health check is a good way to find out how your body can handle and where you should direct your health to increase your daily endurance. The Putti health check includes important vitamin D and iron values, among other things. In addition, you get results on important factors that affect general health, such as cholesterol and blood sugar.

Detection of Crohn's disease

Unclassified colitis

Sometimes Crohn’s disease in the colon in the early stages of the disease cannot be distinguished from ulcerative colitis . In this case, we speak of unclassified colitis .

Some of these cases later turn out to be Crohn’s disease. However, differential diagnosis does not affect the drug treatment of the disease.

How is Crohn's disease treated?

Self-care for Crohn's disease

A varied diet and a healthy diet should be taken care of to keep your weight normal. A complete diet helps prevent weight loss and maintain good general condition .

However, the disease cannot be prevented or cured by diet.

The most serious nutritional problem associated with inflammatory bowel disease is malnutrition .

Prevention of Crohn's disease

Crohn's disease cannot actually be prevented, but avoiding smoking can affect the risk of developing the disease.

What are the risk factors for Crohn's disease?

General fitness and a healthy normal weight should be maintained. The disease cannot actually be prevented by lifestyles other than avoiding smoking .

Crohn's disease and smoking

Mental factors have not been found to cause Crohn's disease. However, stress increases the symptoms.

Crohn's disease (regional enteritis)

Crohn's disease (regional enteritis) is named after the American physician Burrill Bernard Crohn, who first described the disease in 1932. It is the second most common inflammatory bowel disease after ulcerative colitis (see ulcerative colitis (ulcerative colitis) ). They are also abbreviated as IBD (inflammatory bowel disease).

In Finland, Crohn's disease affects about one in 10,000 inhabitants each year and affects about 2 people in a thousand. The disease most commonly occurs between the ages of 20 and 30 but can occur in children and parents. The disease is equally common in men and women.

In Crohn's disease, an inflammatory reaction can occur throughout the gastrointestinal tract. Inflammation is not limited to the intestinal mucosa but can extend to all layers of the wall. Because of this, it can make inflammatory channels (fistulas) from one part of the gut to another or other organs and may lead to stenosis. Approximately 30% of patients have an inflammatory reaction in the small intestine, 25-30 in the colon, and 40% in both (see figure ). It may also be associated with disorders of the intestinal organs.

Causes of Crohn's disease

The disease is caused to people inherited susceptible to intestinal bacteria, nutrients, and other environmental factors, with an abnormality in the defense system causing an abnormal control reaction against the intestinal bacteria. The exact mechanism of the disease is unknown. Smoking almost doubles the risk of developing Crohn's disease.

Detection of Crohn's disease

The disease is detected by endoscopy of the colon and small intestine and microscopic examination of the specimens taken in it. The small intestine can be examined from a longer distance by capsule imaging.

The results can be refined by imaging the abdominal area with magnetic resonance imaging, and computerized imaging can be used in emergencies.

The studies are supplemented by various laboratory tests (eg pleat, CRP, blood count, fecal calprotectin).

When to see a doctor?

If you experience any of the above symptoms, you should see a doctor immediately.

Self-care for Crohn's disease

There is no specific dietary treatment for inflammatory bowel disease, and diet cannot influence the course of the disease. A nutritionally complete diet helps prevent weight loss and maintain overall fitness.

Some foods can make symptoms worse, especially during the active phase of the disease, when it may be helpful to limit their use. Often, these foods are suitable when the disease is in a quiet phase. If necessary, a nutritionist can help you find the right diet and plan a full-fledged diet.

Smoking should definitely be stopped as it increases the activity of Crohn’s disease and the likelihood of having surgery.

Treatment of Crohn's disease

Treatment does not definitively cure the disease, but suppresses symptoms and reduces harm. The choice of treatment is influenced by the location, extent, severity and nature of the disease.

Primary treatment is a drug treatment that can be implemented with several different preparations. The medicinal products used are

• corticosteroids (glucocorticoids) or cortisones
• immunosuppressive drugs (azathioprine, 6-mercaptopurine and methotrexate, and biologics).
• Biological drugs are given as injections every couple of weeks - a few months under the skin or as a drip into a vein.

Crohn's disease is characterized by remissions, or stages of recovery, in which the symptoms temporarily subside. Even during remission, drugs are used to prevent the recurrence of the disease.

The disease is not always adequately controlled with medication, requiring surgical treatment. In this case, the worst inflamed part of the intestine is removed. Other topics for surgical treatment include the development of fistulas or abscesses, intestinal obstruction, or bleeding.

Smoking cessation should also be emphasized here, as smokers are twice as likely to develop exacerbations as non-smokers.

Adequate intake of calcium and vitamin D should be ensured. Those with small bowel disease or those undergoing small bowel surgery need vitamin B 12 replacement therapy.

Patients with Crohn's disease of the colon are monitored regularly due to the risk of cancer due to inflammation.

Other support

Crohn and Colitis Association is a national interest organization that offers e.g. information, peer support, and adaptation training courses for people with inflammatory bowel disease and their relatives.

The illness must also be taken into account in the school and kindergarten with the necessary special arrangements. Special arrangements may relate to, for example, special diets, exercise classes, extra absences, or quick access to the toilet.

Prevention of Crohn's disease

Quitting smoking is worthwhile, as smoking increases the risk of illness, disease activity, and the risk of undergoing surgery.

The mechanism of the disease is not yet sufficiently known, so no other preventive measures can be recommended.