Crohns Flashcards
What is Crohn’s?
Crohn’s disease is one of a group of conditions called inflammatory bowel disease, where parts of the digestive system become inflamed.
Therefore, this is an inflammatory bowel disease. While the immune system is involved, it is not thought to be an autoimmune disease. It is chronic, and can’t be cured.
It affects all ages but is usually diagnosed at the ages of 15 to 40.
What causes Crohn’s?
The cause is unclear, but some factors are thought to play a part:
• genes: the risk of developing Crohn’s is higher if a close family member has the disease.
• The immune system attacking the gut: possibly targeting bacterial antigens, causing inflammation.
• Smoking.
• A previous gut infection.
• An imbalance in the microbiome (population of gut bacteria).
How may Crohn’s be diagnosed?
To diagnose you may have a colonoscopy which is a camera up the anus to check for bowel abnormalities.
What does Crohn’s cause the inflammation of?
This causes inflammation of the digestive tract.
How may Crohn’s react in an acute flare up?
In an acute flare up the digestive tissue may become swollen, sore and ulcered.
Where can digestive tissues be found?
Digestive tissue can be found in the mouth or internal organs.
What 2 stages of health may a person with Crohn’s go through?
People with Crohn’s will have periods of good health, called remission and they may also have flare ups.
What are symptoms of Crohn’s?
Crohn’s can effect any part of the gut, but mostly effects the large intestine (colon).
• Diarrhoea
• Stomach aches and cramps, particularly in the lower right abdomen
• Blood in stool
• Tiredness
• Weight loss
Rectal bleeding
• Joint pain and swelling
• Ulcers
How can Crohn’s be treated?
Treatments include steroids, immunosuppressants, biological medications, diet, and surgery.
How do steroids treat Crohn’s?
These are tablets which give the pupil a higher dose of man-made steroids, those which the body makes naturally.
This reduces the activity of the immune system, reducing inflammation in the gut.
These can be taken orally (prednisolone), which takes 1 to 4 weeks to start working and they can be taken rectally which take a week of 2 to better symptoms.
These aren’t usually used for more than a couple months, as long term use can cause side effects.
side effects- weight gain, indigestion, insomnia, increased risk of infection , increased appetite, acne, mood swings and muscle weakness.
How do immunosuppressants treat Crohn’s?
These are used to relieve symptoms if steroids on their own aren’t effective.
These are tablets or injections that keep the immune system working as it should, by stopping it from attacking healthy cells, but it also weakens your immune system. This is a long term treatment.
A form of this is azathioprine, a tablet causing side effects like nausea, a fever, fatigue, arthralgias and bone marrow suppression. Its contraindications are acenocoumarol and adalimumab.
Another form of this is mercaptopurine, a tablet causing side effects like black stool, gum bleeding, clay coloured stool, a cough, hoarseness, a fever, nausea, and a pale complect ion. Its contraindications are acitretin, alcohol, alectanib and amsacrine.
How do biological medications treat Crohn’s?
These are for moderate to severe Crohn’s. They are given when other medications are not effective or have bad side effects.
They include monoclonal antibodies such as adalimumab that binds to and blocks TNF-(alpha) that attacks the gut.
They are produced via biological process where living organisms produce active substances made of proteins. It blocks the activity of cytokines (a protein that responds to injury and that is responsible for inflammation).
These are injected into the vein or as a drip every 2-8 weeks, and may be needed for several months to years.
Side effects include headaches, fatigue and rashes.
How does diet treat Crohn’s?
You would strip your diet of any possible allergens and slowly introduce them to see your reaction to them. Common Crohn’s diets are low FODMAP, high fibre, specific carb, gluten free and vegan.
How does surgery treat Crohn’s?
If no medications aren’t controlling their symptoms or they are having complications they may undergo surgery.
They may have a stricture plasty or bowel resection where a part of the bowel is cut out if it is unhealthy, and join the healthy parts.
They may also have a Colostomy where part of the bowels brought to the surface of the stomach with a stoma bag or an ileostomy.
Surgery can relieve symptoms and prevent them from returning for a time, but they will return eventually.
What can happen in more severe cases of crohn’s?
Inflammation can cause an obstruction of the bowel.
People with Crohn’s are at higher risk of developing bowel cancer
