Transcript Crohn’s 101 - Oncourse : Gateway : Home

Topics Discussed…
 What is it?
 Who gets it?
 Symptoms
 Nutrition
 Treatment
Definition…
 Crohn’s disease is a chronic disorder that causes
inflammation of the digestive or gastrointestinal
tract. Most commonly it affects the small intestine
and/or colon, but can affect any part of the GI tract
from the mouth to the anus.
 It is one of the two main classifications of
inflammatory bowel disease (IBD).
A picture of the
digestive tract, from
mouth to anus.
Picture from Crohn’s Health
Center found at:
http://www.healthcentral.co
m/chronicpain/crohns/introduction.ht
ml
A picture of the small
and large intestine
that is inflammed
with Crohn’s.
Picture from Crohn’s Health
Center found at:
http://www.healthcentral.co
m/chronicpain/crohns/introduction.ht
ml
History…
 The disease is named after Dr. Burrill B. Crohn.
 In 1932 Dr. Crohn along with Dr. Ginzburg and
Dr. Oppenheimer published a paper describing
the features of what is now known as Crohn’s
Disease.
Statistics…
 Crohn’s disease runs in families.
 20% of people with Crohn’s disease have a sibling,
parent or child with some form of IBD.
 Men and women are at equal risk
 People of European heritage are more likely to develop
the disease.
What causes it…
 Scientists believe that a combination of factors cause
people to develop Crohn’s.
 Genes a person inherits.
 The immune system.
 Environmental agent.
 Scientists believe that an outside agent (antigen)
triggers the body’s immune system to produce an
inflammation to fight off the agent. Once the defenses
are turned on they cannot turn off properly.
Diagnosis…
 A doctor utilizes a combination of factors.
 Personal history
 Physical exam
 Symptoms and overall health
 Laboratory tests, x-rays, and endoscopy will probably
be ordered. During the endoscopy the doctor may
take a biopsy as well.
 Stool samples may be asked for to determine if blood
is present.
Types (Most common)…






Persistent diarrhea (loose, watery, and frequent)
Abdominal pain and cramping
Fever and rectal bleeding at times
Loss of appetite and subsequent weight loss
Fatigue
Children with Crohn’s may suffer delayed development and
stunted growth.
 Most first appear between the ages of 15 and 30.
 All symptoms may range from mild to severe.
 Patients may also go through periods of “flae ups and
remission.
Complications…
 May cause blockage of the intestine.
 Ulcers in the affected area and surrounding tissues such as





the bladder or skin.
Development of fissures which area small cuts or tears in
the anal canal.
Abscess, a localized infection.
Fistulas may form abnormal tunnels between two
structures of the body.
Nutritional complications: deficiencies of proteins,
calories, and vitamins.
Others include: arthritis, skin problems, inflammation in
the eyes or mouth, kidney stones, gallstones, or other
diseases of the liver.
Haves…
 Good nutrition with a balanced, healthy diet is
recommended.
 Should increase the daily caloric intake.
 Eat smaller meals with more frequent intervals.
 Increase amount of fluid intake to 70 ounces per day.
 Liquid supplements may be prescribed for easier
absorption (especially vitamin b-12 and D).
 Low fiber diet is normally recommended.
Have not’s…
 There is no definite foods that need to be cut out. If
something is eaten that causes an increase in their
symptoms this food should probably be avoided in the
future. These foods are labeled as “food intolerances.”
 Foods that may cause an increase in symptoms are:
 Greasy or fried foods
 Butter, margarine, and cream sauces
 Alcohol
 High fiber foods: nuts, seeds, corn, and popcorn
 Caffeine
Medications…
 There are no cures.
 Anti-inflammatory drugs such as sulfasalazine,
mesalamine, and aminosalicylates (5-ASA).
 Immune system suppressors such as corticosteroids.
 Immune modifiers such as azathioprine and 6-MP to
help heal fistulas or maintain remission.
 Antibiotics like ampicillin and ciprofloxacin.
Medications (biologic therapies)…
 Infliximab (brand name Remicade) is an anti-tumor
necrosis factor (TNF) drug that removes the proteins that
cause the inflammation.
 Recommended to patients that do not respond to standard
therapies
 First treatment approved specifically for Crohn’s disease.
 Adalimumab (brand name Humira) designed for patients
who were intolerant to infliximab.
 Natalizumab (brand name Tysabri) inhibits types of white
blood cells that are involved in the inflammation.
 Certolizumab pegol (brand name Cimzia) is a polyethelyen
glycol which delays its excretion from the body and is
combined with an anti-TNF.
Surgery…
 Becomes necessary when medications cannot control
symptoms, to correct complications such as a
blockage, perforation, abscess, bleeding, or removal of
diseased portions of the intestine.
 This is not a cure and can reoccur in disease free
portions of the intestine.
 If entire colon is removed in a colectomy the ileum is
brought to the surface of the skin and a stoma (an
opening) is made for waste removal into a small bag.
Resources used…




































Books:
Banks, P. A., Present, D. H., & Steiner-Grossman, P. (1983). The Crohn's disease and ulcerative colitis fact book. New York: Scribner.
Sklar, J. (2007). Crohn's disease and ulcerative colitis: An essential guide for the newly diagnosed. First year series. New York: Marlowe and Co.
Warner, A. S., & Barto, A. (2007). 100 questions & answers about Crohn's disease and ulcerative colitis: A Lahey Clinic guide. Sudbury, Mass: Jones and Bartlett.
Movies:
Films for the Humanities (Firm). (2000). Inflammatory bowel disease Coping with Crohn's and colitis. Princeton, N.J.: Films for the Humanities & Sciences.
Golder, J., DiGregorio, R., Yip, M., & Verdi-Rose, C. (2008). True guts Struggle & triumph over Crohn's disease and ulcerative colitis. Sherborn, Mass: Aquarius Health Care Media.
Lerner, E., Lerner, A. C., Douglas, P., & Miles, V. (1998). Coping with Crohn's & Colitis. Cutting edge medical report, 1125. Boca Raton, Fla: Information Television Network.
E Books:
European Crohn's and Colitis Organisation. (2007). Journal of Crohn's and Colitis. Supplements. New York, N. Y.: Elsevier Science. http://www.sciencedirect.com/science/journal/18739954.
Zonderman, J., & Vender, R. (2000). Understanding Crohn disease and ulcerative colitis. Understanding health and sickness series. Jackson, Miss: University Press of Mississippi.
Websites:
Crohn’s & Colitis Foundation of America at http://www.ccfa.org/
National Digestive Diseases Information Clearinghouse at http://digestive.niddk.nih.gov/
Living With Crohn’s Disease at https://www.livingwithcrohnsdisease.com/livingwithcrohnsdisease/crohns_disease/inside_crohns.html
HealingWell.com at http://www.healingwell.com/ibd/
Article: Care and Feeding on a Crohn’s Diet http://www.healingwell.com/library/ibd/gray1.asp
Crohn’s Health Center at http://www.healthcentral.com/chronic-pain/crohns/?ap=1003
Teens with Crohn’s Disease at http://pages.prodigy.net/mattgreen/
Crohns-Disease-info.com at http://www.crohns-disease-info.com/
I Hate IBD (Inflammatory Bowel Disease) at http://www.ihateibd.com/
Crohn’s Online at http://www.crohnsonline.com/
Crohn’s Disease Info Center at http://www.shafran.net/crohn/
Websites that link to others:
Patientcommunity.com at http://www.patientcommunity.com/
Crohn’s Disease at http://www.crohns-support.net/
Crohn’s Disease Ulcerative Colitis Inflammatory Bowel Disease at http://qurlyjoe.bu.edu/cduchome.html
Graphic Organizer:
http://www.gliffy.com/publish/1599536/
To embed into a blog use:
<img src="http://www.gliffy.com/pubdoc/1599536/M.jpg"/>