Crohn's disease

and it can hit, with segmental distribution (that is, a little "here and a little there, without continuity), any section from the mouth to the anus.

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Most commonly, Crohn's disease affects the terminal ileum (final portion of the small intestine) or the colon (large intestine).

The symptoms of Crohn's disease depend on the affected area and can be quite varied and different from one patient to another; among the most common, abdominal pain, diarrhea, vomiting and weight loss are reported.

Unfortunately, a cure for Crohn's disease has not yet been identified. However, there are pharmacological protocols useful for symptom control and relapse prevention, while surgery is reserved for cases complicated by intestinal obstructions, fistulas or abscesses.

For further information: Crohn's disease: Diagnosis, Complications, Course and Treatment of the intestinal mucosa.

Today, we know that the "onset of Crohn's disease can be traced to three interacting factors: a genetically determined susceptibility to the disease (it has been discovered that in patients with Crohn's disease there is a gene called NOD2 which is altered), tissue damage due to an immune reaction triggered by bacteria in the gastrointestinal tract flora, and various environmental factors.

Regarding the microflora, in healthy individuals the intestinal mucosa is in a state of controlled (physiological) inflammation; the purpose of these reactions is the formation of IgA antibodies (Immunoglobulins A), which bind to microorganisms and make their elimination easy by the immune system. In Crohn's disease, on the other hand, the inflammation is no longer controlled and causes tissue lesions.

Among the environmental factors we find the use of non-steroidal anti-inflammatory drugs (NSAIDs), which can cause recurrences, and cigarette smoking also increases the risk of developing the disease.

For further information: Symptoms of Crohn's disease

Crohn's disease is more frequently localized to the ileum (ileitis), typically affecting its final portion; rather common is the involvement of the colon (especially ascending) both alone (Crohn's disease of the colon: about 10%), and associated all "ileum (ileocolitis: about 40%); the rectum is affected in 5% of cases and even more rare is the involvement of the duodenum and stomach (1%). In a small percentage of patients, especially children and adolescents, there is also an important and extensive involvement of fasting ( central part of the small intestine), as well as the ileum. In the sections involved in Crohn's disease, inflammatory changes affect all layers of the intestinal wall, causing thickening of the intestinal wall and ulceration. Inflammation sometimes tends to spread up to to nearby lymph nodes.

For further information: Drugs to Treat Crohn's Disease

The tissue affected by the lesions caused by Crohn's disease tends to go to death (necrosis), so the mucosa can ulcerate and, under it, fistulas can form; these, in turn, can connect two intestinal loops or can even open in other organs (bladder, ureter, vagina) or even externally, especially in correspondence with surgical scars, or around the navel. Sometimes these fistulous tracts have considerable length and can also reach the gluteal region or the hip.

For further information: Herbs for Crohn's disease caused by Crohn's disease, especially if it involves large tracts of the intestine, alters the absorption mechanisms of various substances. The reabsorption of bile salts is usually compromised, which occurs above all in the terminal ileus, resulting in a loss of these substances, which normally stimulate the reabsorption of dietary fats, resulting in the appearance of steatorrhea (fats in the faeces). bile ducts bind calcium; it follows that their deficiency causes an increased risk of developing stones due to an excess of free circulating calcium. Malabsorption of some vitamins can also be established, especially B12, D and K. Crohn is widespread in very extensive tracts of the small intestine, malabsorption can be global, involving all nutritional factors.

For more information on what to eat and what not to eat in Crohn's disease see the article listed below.

For further information: Crohn's disease diet

As a rule, diarrhea occurs, due to the reduced absorption of bile salts in the ileum, the malabsorption of carbohydrates (which cause it by recalling water in the intestine), and the frequent secondary bacterial colonization that occurs in the affected portions.

Crohn's disease can create serious imbalances which, especially in subjects at greater risk of peritonitis and generalized infections, can increase the possibility of death - which manifests itself, of course, due to complications, not for the disease itself. We are talking about 5-10% of the population, of which the slice of the elderly is greater.



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; subsequently abdominal pains appear, especially in the lower right quadrant of the abdomen (right iliac fossa), where the disease is more often localized. The pain arises spontaneously, is dull, continuous and is accentuated on palpation; irregular and painful "sausage" masses. Crohn's disease is also characterized by the presence of diarrhea (3-4 discharges per day), with semi-liquid or watery stools, but without the presence of visible blood (although episodes of occult bleeding), sometimes with steatorrhea.

For further information: Symptoms of Crohn's disease

It is common for mucus to appear in the stool in people with Crohn's disease. On the other hand, it is a fairly generic clinical sign, however in very different conditions such as irritable colon, procritis, various kinds of diarrhea, ulcerative colitis, diverticulosis and diverticulitis, etc.

Crohn's disease sufferers generally show higher than normal levels of calprotectin, which assumes the role of a detectable marker without invasive operations. This is a fairly important clinical sign, since it supports the doctor in the differential diagnosis, in the evaluation of the cure and in the empirical estimation of the specific damage.