Finally: Crohn Disease Can Occur At Any Age
Crohns disease is a chronic inflammatory disease of the entire digestive tract
, suspected to be
autoimmune in nature.The disease has been described in detail in 1932 in the United States by Dr. Burrill Bernard Crohn (1884-1983), digestive surgeon at Mount Sinai Hospital New York.
In 1993 described a mouse with a mutation in the gene for interleukin-2 and who has digestive symptoms similar to Crohns disease , making it the first animal model of disease.They are still largely unknown. Recent hypotheses suggest that there are at least 32 genetic risk factors (multiple genes potentially responsible have been identified including NOD2 (CARD15), an environmental trigger (bacteria?) And the occurrence of an uncontrolled inflammatory cascade .It is a multifactorial disease as well as ulcerative colitis or rheumatoid arthritis, other diseases relatives.
The disease can occur at any age but is found primarily in young adults . It is manifested mainly by chronic diarrhea (several weeks to several months), primarily exudative and often accompanied by abdominal pain.There is often a loss of weight (malabsorption). It is not uncommon for relapses are accompanied by a slight fever. Fatigue is a persistent symptom. It is often she who is most resented by patients.
There may be extra-intestinal manifestations, mainly osteo-articular but also hepatobiliary, ocular and skin.It uses an index of activity to determine if the disease is advanced or not is the BEST Index (CDAI for Anglo-Saxon). If this is lower than 150, the patient is considered to be in remission.
Direct visualization of lesions with colonoscopy is essential to confirm the diagnosis. Attacks are usually diffuse and discontinuous edges fuzzy. Affected areas are typically the colon and the last few centimeters of the ileum (This is known as "Crohn's ileitis). The lesions are ulcerations, aphthous or deep often. They may be in the form of real cracks in the lining.In biopsies of intestinal mucosa, the presence of an epithelioid granuloma is a strong argument in favor of the diagnosis of the disease (edema and infiltration lymphocytes and plasma cells, and large ulcers fissulaires, crypt abscesses).
Videocapsule is a small video camera that patients swallow and records images of the digestive tract. Its main advantage is the ability to visualize the small intestine that is inaccessible to endoscopy. One can also explore the small intestine using an entero (double or single balloon balloon). This is longer than an endoscope colonoscope whose progress is aided by an inflatable balloon overtube. His interest in relation to the video capsule is the possibility to intervene on the lesion and have a good precision on the location.
The absorption of a radiopaque fluid used to visualize the digestive tract. This review is useful to observe areas not visible by endoscopy (particularly the small intestine). It can detect any stenosis (narrowing), fistula, but it is avoided in severe attacks.The scanner can help diagnose, particularly if there are fistulas.
The differential diagnosis is difficult because the disease may have wrongly been labeled as a functional disorder digestive tract, also called irritable colon.
One can easily confuse ulcerative colitis (affecting only the colon) and Crohn's disease (which may affect the entire gastrointestinal tract), both forms of inflammatory bowel disease.
The diagnosis can not be worn with certainty between these two entities in the initial outbreaks, it is called indeterminate colitis. In most cases, the evolution of the disease and its clinical signs can after several months or years, eventually pinpoint the relevant disease and therefore to better tailor the treatment strategy. Sometimes, however colitis remains undetermined, the current debate is whether the cause is not a third entity of inflammatory bowel disease.Some infectious colitis may present a misleading picture.
The permanent cessation of any tobacco use is highly recommended. It seems that the reaction to tobacco to be an index for distinguishing Crohn's disease of ulcerative colitis. In the case of Crohns disease, stopping smoking causes a remission of symptoms. In the case of ulcerative colitis, smoking cessation would tend to aggravate symptoms.Crohn's disease is quite inconsistent with the consumption of tobacco, especially as it worsens, and more general fatigue brought about by the disease, symptoms and risks associated with them.
by: Barbara Herbert
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