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Specialty scores for Crohn Disease
Crohn’s disease is an inflammatory bowel disease (IBD) which is characterized by inflammation of the inner lining, often involving deeper involvement, of different areas of the digestive tract from the mouth to the anus.
The incidence of Crohn’s disease has been determined in the United States and Norway to be between six to seven cases per 100,000 people. Different colitis foundations estimate the incidence to be between 28 nearly 200 cases per 100,000 people.
Crohn’s disease is more common in the northern countries and the incidence increases in patients located even further north of those countries.
Most commonly, Crohn’s disease begins in patients in their teens and 20s, and in those between 50 and 70 years of age. Female children are more severely affected than their male counterparts, although slightly more women are affected than men.
First degree relatives of patients with Crohn’s disease are three to 20 times more likely to develop the condition. In twin studies it was found that if one sibling has the condition, then the other one has a 55% chance of developing Crohn’s disease.
The exact cause of Crohn’s disease is not clearly understood at this stage. Currently, certain risk factors have been associated with the development of this condition.
These include bacterial or viral infections which may trigger an immune response that results in the immune system attacking the normal cells of the gut, or patients may have a genetic predisposition (with a strong family history) to developing the condition.
Other risk factors include smoking cigarettes, using non-steroidal anti-inflammatory medications and living in northern climates.
Signs and symptoms of Crohn’s disease can vary from mild to severe, and these issues usually have a gradual onset.
The issues experienced by patients when the condition is active includes increased abdominal cramping, diarrhea which may or may not be bloody, mouth sores, decreased appetite, weight loss and perianal pathology such as a fistula.
Patients with severe Crohn’s disease may also present with inflammation of the skin, joints and eyes, as well as inflammation of the bile ducts and liver, and even delayed sexual development and growth in children.
Crohn’s disease is suspected on the patient’s medical and family history. There is no one test that confirms the diagnosis of the condition, but rather a combination of investigations that help to do so.
Investigations that are performed include a combination of endoscopes (gastroscopy and colonoscopy), radiological testing (through CT scans and MRIs), possible capsule endoscopy (where a camera pill is swallowed) and biopsies of suspect areas.
There is no cure for Crohn’s disease but treatment options are available to help manage the condition.
These include medications such as the anti-inflammatories that include sulfasalazine and corticosteroids; immune system suppressants such as azathioprine; biologicals such as infliximab; cyclosporine to manage and treat fistulas; and methotrexate if the mentioned medications aren’t effective.
Patients who experience complications such as abscesses and infected fistulas can be prescribed antibiotics such as metronidazole and ciplofloxacin.
Symptomatic medication can also be prescribed such as methylcellulose to manage diarrhea; acetaminophen and ibuprofen for abdominal pain; iron supplementation for anemia; vitamin B12 injections for a deficiency caused by decreased absorption of this vitamin due to damage of the gut; and vitamin B and calcium supplementation to prevent osteoporosis which can be caused by the steroids used to treat Crohn’s disease, or due to the condition itself.
Diet and lifestyle changes will help to reduce the symptoms caused by the condition.
If all these options fail, then surgical removal of the affected bowel may be warranted.