Crohn's disease is a chronic inflammatory bowel disease that affects mostly young adults and children. Their cause is not very clear, although various factors regarding the development of Crohn's disease are discussed. The life expectancy in Crohn's disease is not significantly limited in individually optimized therapy.
Crohn's disease runs in spurts between which sufferers also experience times when they do not suffer from complaints of the disease. But how exactly is a thrust defined and what makes such a thrust?
An episode of Crohn's disease is characterized by the onset of various disease symptoms such as diarrhea or pain in the abdominal region. Even non-gastrointestinal symptoms, called extra-intestinal symptoms, are typical of a relapse of Crohn's disease. These include, for example, joint pain in the context of arthritis or eye complaints, for example, by an inflammation. Changes in the blood can also be detected during a spurt. There is an increased inflammatory activity to observe.
The severity of discomfort and inflammatory activity varies from patient to patient. The duration of a push also varies greatly. It can take from several days to a few weeks. If the symptoms persist for more than half a year, the disease is referred to as chronic-active. When a thrust occurs and how long it will take can not be predicted. Affected persons experience during their life time and again intervals in which they are free of complaints, and relapses, which can be very restrictive in everyday life.
A strict definition of the signs of a thrust is not possible because the disease is very individual. There are no solid signs that can predict that a boost will occur.
Affected individuals usually recognize signs of a thrust due to changes in their bowel habits such as diarrhea. Even abdominal pain, which is mainly located in the right lower abdomen, can be a sign of a push. In addition, weakness, fatigue and fatigue are possible indications of a push.
In addition to the complaints of the gastrointestinal tract, other symptoms may occur. These include joint pain and inflammation around the eyes. This includes, for example, inflammation of the middle eye skin, the so-called uveitis. Fever or a slightly elevated temperature are also typical. It can also lead to skin changes, mouth ulcers and fistulas in the anal area. Anorexia and weight loss are also possible signs of a relapse of Crohn's disease.
Many people mistakenly believe that a certain behavior would trigger a relapse of Crohn's disease. However, the onset of the disease and relapses is highly complex and not fully understood. A confirmed statement on triggers of relapses in Crohn's disease is thus not possible at the present time.
Therefore, for example, one can not safely assume that certain foods are triggers for a boost. It is only known that nicotine has a negative influence on the development of Crohn's disease. Therefore, it is very important that people who suffer from Crohn's disease do not smoke. However, nicotine is the only known preventable risk factor.
Triggering factors such as specific genetic factors or the like can not be influenced by the patient. Also psychosocial stress is to favor according to studies the occurrence of a thrust.
The duration of a push is very individual and varies greatly from sufferer to sufferer. Even a single sufferer can experience relapses during his life, which differ significantly in their severity, the severity of their symptoms and their duration.
On average, relapses of Crohn's disease last several weeks. Some relapses last only a few days, while others may last for several months. From a duration of 6 months, the course is no longer referred to as relapsing, but as chronic-active.
The duration of a push also depends on how well the patient responds to therapy in the push. Even abstaining from nicotine has an effect on the duration of the symptoms. Especially during a spell, smoking worsens the health and prevents the symptoms from improving. A fiber-free diet during the episode may help alleviate the symptoms and possibly shorten the course a little.
Experts are reluctant with specific nutritional recommendations for patients with Crohn's disease. Scientific evidence that a specific diet helps with Crohn's disease does not exist. But for many people, nutrition plays an important role.
Food allergies and intolerances should be clarified in patients with Crohn's disease, as they may be responsible for complaints of the gastrointestinal tract. Foods that are subject to intolerance or allergy should therefore be avoided. Many people have lactose intolerance, so a low-lactose diet can be beneficial.
As a general rule, Crohn's disease should be balanced and adequate, as malnutrition has a negative impact on relapses as well as overall health of the person affected.
Patients with Crohn's disease should seek advice from a nutritionally trained physician or a qualified nutritionist. General recommendations can not be easily pronounced.
Various drugs are used to treat an acute episode of Crohn's disease.
In general, steroids are used in a mild to moderately strong thrust to achieve a regression, the so-called remission, the thrust.
However, there are also cases in which a boost does not respond adequately to steroids and the symptoms do not improve. Then you access to other drugs, namely the so-called immunosuppressants. These include, for example, TNF-alpha antibodies such as adalimumab (Humira®); and azathioprine.
Why a boost does not improve in some patients on steroid therapy is not certain. Some sufferers have very high levels of inflammatory activity and severe symptoms that are poorly responsive to medication. Other patients respond very well to steroids. This can vary from thrust to thrust.
If a boost does not respond to immunosuppressive therapy, more research is needed to find the cause of the disease worsening. The cause may be, for example, an infection or a complication of Crohn's disease. Such complications include fistulas, constrictions in the intestine (stenosis) or abscesses, so encapsulated pus accumulations in the intestine. These circumstances should be clarified diagnostically. Also, a wrong or insufficient intake of the drugs by the patient are conceivable if the push does not respond properly to the therapy.
Patients with Crohn's disease often suffer from joint pain.
These joint pain caused by inflammation ( arthritis ) in the area of various joints. An autoimmune component, as it also plays a role in rheumatic joint complaints, is discussed in Crohn's disease. However, an exact cause of the joint complaints is not clear.
Different joints can be affected. Often the sacrum (sacroiliitis) is affected. Spinal complaints are also possible. However, joint pain can also be a side effect of drugs used to treat Crohn's disease. These include TNF-alpha antibodies.
The occurrence of joint involvement in Crohn's disease leads to consequences in the therapy of the thrust. The drugs sulfasalazine and methotrexate are suitable for the treatment of arthritis. In addition to physical measures, acetaminophen or, in exceptional cases, mild opioids may be used to treat pain. One should avoid taking medications such as ibuprofen or similar medication without consulting a doctor, as these can worsen the underlying condition. Professional medical advice is therefore indispensable.
Steroid therapy is at the heart of the treatment of Crohn's disease. Various glucocorticoids, including cortisone, are used to treat the thrust.
With a slight boost, glucocorticoids such as budesonide can be locally applied as a foam. For stronger episodes or the occurrence of complaints outside the gastrointestinal tract, the glucocorticoids are administered as tablets. This is called systemic therapy.
In addition to the glucocorticoids, other drugs are used in the treatment of acute episodes. Which medicines are used exactly depends on the symptoms and the individual pattern of Crohn's disease. There are different administration forms and types of glucocorticoids. Which drug is ultimately used in a person affected, is an individual treatment decision, the doctor and patients together.