Department of Pathological Anatomy and Forensic Medicine

  Topic :- Crohn’s Disease

 

What is Crohn’s Disease?

Crohn’s disease is a type of inflammatory bowel disease that affects the intestines.

The intestine become irritated and swollen causing pain, diarrhea, and ulcers.

What are the symptoms? Belly pain Diarrhea Mouth sores Weight loss Blood in stool Ulcers Inflammation in

the liver Arthritis

Loss of appetite Bowel blockage Fever Tears in the anus Delayed growth Vomiting Nausea Bowels can thicken

with scar tissue

What causes the disease?

Heredity/Genetics Viruses or bacteria that can trigger an abnormal

immune reaction Could be due to an initial immune deficiency

Pathology Gross appearance

Transmural, predominantly submucosal inflammation characterized by a thickened colonic wall

Cobblestone appearance on endoscopy The bowel wall may be entirely encased by creeping fat of the

mesentery, and strictures may develop in the small and large intestine The mucosa may demonstrate long, deep linear ulcers that appear like

“railroad tracks” or “bear claws.” Normal mucosa may intervene between areas of inflammation, causing

“skip areas” characteristic of the disease Histologic

transmural inflammation, submucosal edema, lymphoid aggregation, and ultimately fibrosis

Pathognomonic: the noncaseating granuloma, a localized, well-formed aggregate of epithelioid histocytes surrounded by lymphocytes and giant cells; found in 50% of resected specimens

Crohn’s Disease affects:

What are the risk factors?

People of all ages are affected by this disease The same number of men are affected as women The age for diagnoses is between 20 – 30 years old Caucasian are more likely to be affected than any other

ethnic group. Environmental factors can play a role- people who live in

urban or industrial areas Smokers

Crohn’s Disease is a systemic condition causing extraintestinal manifestations effecting 25% More common joint pain skin rash oral ulcers gall stones liver disease eye problems growth retardation in children

Other less common anemia blood clots kidney stones nerve damage lung disease pancreatitis pericarditis menstrual irregularities severe gingivitis osteoporosis

Diagnosis Rule out infectious causes Differentiate from UC by extra-colonic

involvement (e.g. oral, anal) Characteristic radiographic findings:

skip lesions, contour defects, longitudinal and transverse ulcers, a cobblestone-like mucosal pattern, strictures, thickening of the haustral margin, and irregular nodular defects

What is the treatment ? Mild to moderate treatment usually is treated with an antibiotic Some of the newer antibiotics come in capsules but are in lower

dosage. Moderate to severe treatment is treated with a steroid or even surgery. The steroids can be taken as a suppository, by injection, foam, and

orally. The form is determined by the severity or location of the condition.

Other Medication:Anti-diarrheaLaxativesPain relieversStrong Iron Supplements for intestinal bleedingSpecial Diets

Effects of Treatment can cause: Susceptibility to infection Weight gain (particularly increased fatty tissue on the face and upper trunk and back) Rash Loss/Excess hair growth High blood pressure (hypertension) Accelerated osteoporosis Cataracts and glaucoma Diabetes Wasting of the muscles Menstrual irregularities Upper gastrointestinal ulcers Numbness Skin disorders / Acne

Coping with Crohn’s Disease Avoiding stress by: exercising, relaxation and breathing techniques. Limit the amount of dairy products Low fat food Eating high fiber food – passes through the intestines easily than fatty

foods Eating smaller meals Drinking plenty of fluids Having a dietitian Take multivitamins

Resources Yahoo Healthhttp://health.yahoo.com/digestive-overview/crohn-s-disease-topic-overview/healthwise--uf6004.html

Health Centralhttp://www.healthcentral.com/ibd/irritable-bowel-syndrome-000103_1-145.html

National Digestive Disease Information Clearinghouse

http://digestive.niddk.nih.gov/ddiseases/pubs/crohns_ez/index.htm

Mayo Clinichttp://mayoclinic.com/health/crohns-disease/DS00104