Crohn’s disease is a chronic and long-term condition which causes inflammation of the lining of the digestive system. The inflammation can affect any part of the digestive system from the mouth to back passage, or all of it. Most commonly, the inflammation usually affects the last section of the small intestine (ileum) or the largest intestine (colon).
Crohn’s is a largely uncommon condition and there are currently at least 115,000 people diagnosed and living with the disease in the United Kingdom. Crohn’s is a disease that can affect people of any ages, including young children. However, it is most likely that a case will develop between the ages of 16 and 30 years old. Still, a large number of cases develop between 60 and 80 years of age.
The disease is affects slightly more women than it does men, but in children it is boys that are more affected than girls. Furthermore, the condition is most common in white people and less common in black or Asian people. However, it is most prevalent amongst Jewish people of European origin and descent.
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What are the symptoms of Crohn’s disease?
Symptoms of Crohn’s disease can include:
- Abdominal pain
- Reoccurring diarrhoea
- Unintended weight loss
- Fatigue (extreme, usually unexplained tiredness)
- Blood and/or mucus in your stools
Less common symptoms
- High temperature, with a fever of 38C (100F) or above
- Feeling sick (nausea) or being sick (vomiting)
- Joint pain and swelling (arthritis)
- Mouth ulcers
- Areas of red, swollen and painful skin – typically on the legs
- Inflammation and irritation of the eyes (uveitis)
- Itchy skin
- Problems swallowing
As someone with Crohn’s, you may experience all or only one of the above listed symptoms. Some people experience the symptoms more severely than others.
Sufferers of Crohn’s disease can be fortunate enough to go for long periods (weeks or months) of time without any symptoms at all, or very mild symptoms at that. This is known as ‘Remission’. People with Crohn’s face ‘flare-ups’ in which their symptoms return and cause a lot of problems for their physical wellbeing and their lifestyle can be disrupted.
Children with Crohn’s disease may find that they grow at a slower rate than their peers, and than expected. This is because the inflammation can prevent the body from absorbing the nutrients from food.
What causes Crohn’s disease?
The exact cause of Crohn’s disease is still unknown. Nevertheless, research has suggested there could be a variety of factors which may be responsible. These include:
- The immune system (the body’s defence against illness and infection) – If you have a problem with your immune system, it may explain the inflammation.
- Genetics – certain genes your inherit from your parents can increase your chances of developing Crohn’s disease.
- Environmental factors – interestingly, Crohn’s disease is most common in westernised countries such as the UK, and is the least common in poorer parts of the world such as Africa. This leads experts to believe that environment has a part to play in Crohn’s disease. This is none as the hygiene hypothesis.
- Smoking- Those who smoke with Crohn’s disease experience more severe symptoms than non-smokers who also have Crohn’s.
- Previous infection – having had a previous infection may trigger abnormal responses in the immune system and make symptoms worse.
Treating Crohn’s disease
At present, there is no cure for Crohn’s. The aim for treatment then, because of the lack of cure, is to stop the inflammatory process, relieve symptoms to hopefully maintain ‘remission’ and ultimately avoid surgery wherever it is possible.
A steroid medication called ‘corticosteroids’ is often offered as the first treatment to reduce symptoms. Some examples of corticosteroids used for treatment of Crohn’s disease include hydrocortisone injections or prednisolone tablets. While these medications are effective in reducing symptoms of Crohn’s, but can have some undesirable side effects, including the following:
- Swelling of the face
- Weight gain
- Weakening and thinning of the bones (osteoporosis and osteopenia)
- Increased vulnerability to infections
Due to these side effects being undesirable, your dosage will be gradually reduced once the symptoms start to show improvement.
It may be preferable, where possible to choose a milder form of steroid medication called budesonide. This medication has fewer side effects but is ultimately less effective.
Failing any progress with the steroid medication, a medication to supress the immune system (immunosuppressant) and a medication to reduce inflammation may be considered to prescribe. These medications are not suitable for everyone, therefore a blood test is required to ensure you are suited to the medication. Common side effects of immunosuppressants include:
- Nausea and vomiting
- Liver problems
- Increased vulnerability to infection
- Felling tired and weak, with breathlessness which is caused by anaemia.
During the process of taking this medication, you will have regular blood tests to check for any serious side effects. The medication is also considered safe during pregnancy and breastfeeding, so women can continue to use this throughout these events in her life. It is important to still talk to your GP before planning a family or become pregnant while taking and relying on this medication.
In some cases, surgery may be necessary. The surgery will be performed to remove the inflamed area of the intestine.
Once in remission, further medication is offered to maintain the remission status and continue relieving symptoms.
In children, the treatment provided is also hoped to promote healthy growth and development, as this can be affected by Crohn’s disease. Where there are concerns about the development of a young person, a special liquid diet may be recommended as a first treatment. This diet is known as a polymeric or elemental diet – it aims to reduce inflammation by allowing the digestive system to recover from solid foods while still ensuring all the nutrients one needs are being absorbed to promote healthy growth.
It is possible to get access to the private health to help you diagnose and manage symptoms of Crohn’s disease. At MediCompare, we work with the main healthcare insurers in the UK and can help you compare health insurance and find the right level of cover and treatment for you or your loved one.