Crohn’s disease falls within the broad category of disorders called Inflammatory Bowel Disease. It is a chronic, recurrent disease characterized by inflammation of any portion of the digestive tract from the mouth to the anus. About a third of all Crohn’s disease cases involve only the small bowel. Another half of all cases involve the small bowel and colon, and the remaining 20 percent of all cases affect the colon alone. The exact cause of Crohn’s disease is not known. Crohn’s disease occurs because of an abnormal immune response in the intestinal tract. This is caused by unknown environmental factors. There is no evidence that diet is involved in causing Crohn’s disease. The disease usually occurs between the ages of 15 and 35, but it has been reported in other age groups as well. It is more common in Caucasians and Jews. While viruses and bacteria can cause colitis (inflammation of the colon), there is very little evidence that infections actually lead to Crohn’s disease. Cigarette smoking however is frequently associated with the onset and worsening of Crohn’s disease.
The treatment of Crohn’s disease focuses on relieving the symptoms of the disease. This is accomplished by prescribing medicines that reduce the inflammation in the intestinal tract. Common drugs used to treat Crohn’s disease are aminosalicylates, steroids, antibiotics, anti-TNF agents, and immunomodulators. The primary method for inducing remission in severe Crohn’s disease continues to be oral or intravenous corticosteroids such as prednisone. Steroids work by reducing inflammation throughout the body and thus long-term use is associated with many side effects like osteoporosis, diabetes, and hypertension. Results have been obtained with the use of Entocort, a corticosteroid with high topical anti-inflammatory activity. This medication, though costly, can reduce the intestinal inflammation while minimizing the side effects that would commonly be experienced with prednisone.
Other drugs often used in Crohn’s disease are Asacol, Pentasa, Azulfidine, and Colaza. These medicines are quite safe, but may require large doses. Immunomodulatory drugs such as Imuran, Azasan and Purinethol are often effective in maintaining remission of Crohn’s disease. These medications are used long-term and require monitoring to prevent adverse effects. They work by changing the way certain inflammatory cells in the intestinal lining respond to inflammatory triggers. Remicade is a powerful anti-inflammatory drug that blocks the action of a specific molecule called tumor necrosis factor (TNF), a key mediator of the inflammatory process in Crohn’s disease. It is indicated for perianal Crohn’s disease or intestinal disease not responding to the usual first-line medications. This drug is actually a synthetic antibody and is given as an intravenous infusion for both induction and maintenance of remission.
It is important to note that Crohn’s disease is a manageable condition that affects as many as one million people in the United States. If you experience symptoms associated with Crohn’s disease or ulcerative colitis, talk to a physician about your symptoms. Help is available.