Crohn's disease: what is it?

Crohn's disease can rightly be considered one of the most terrible and difficult in the treatment of diseases of the gastrointestinal tract . It is characterized by a chronic course, accompanied by an atypical inflammatory process with segmentation, formation of deep ulcers and lesions of all layers of the gastric mucosa.Crohn's disease can affect absolutely any part of the gastric tract. intestinal tract, but most often the small intestine and large intestine are affected. Despite the fact that this disease is quite rare, everyone should know about its manifestation in order to see a doctor in time for treatment.

The first mention of Crohn's disease came in 1932, when an American gastroenterologist, along with his colleagues, described 14 cases of the disease at a time. Finding similarities between them not only in the symptoms observed, but also in the course and nature of development, Crohn gave his name to the disease and began to seek possible treatment.

However, in order to find a cure for a disease, you need to know the reason why it occurs. Until today, scientists have not agreed on the main reason for the development of Crohn's disease, and they propose three main factors that could be the cause of the development of the disease.

  • Genetic factor: most often the disease is transmitted to parents by blood, twins and siblings. To date, there are 34 known genetic variants that cause symptoms;
  • Infectious factor: it was detected only in rats, in humans, doctors also suggest the possibility of an infectious effect, for example, pseudotuberculous bacteria;
  • Immune factor: Crohn's disease can be autoimmune in nature, as the analysis shows a significant increase in the number of T lymphocytes.

The disease is more common in whites, especially in close communities, where consanguineous marriages often take place, and the disease gene is selected.

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Symptoms of Crohn's disease

The diagnosis of the disease is complicated by the fact that many symptoms are similar to those of colitis, especially ulcerative colitis. The specialist will be able to distinguish one disease from another at an early stage of development, and the longer the disease progresses, the more distinct its symptoms become.

Cases of localization of the disease in all parts of the gastrointestinal tract have been described, but most often it develops in the terminal part of the intestine closer to the large intestine. It is in Crohn's disease that there is a clear segmentation of the affected parts of the intestine and the healthy parts, but the entire mucous membrane is covered with ulcers and abscesses.

Everything can be complicated by the appearance of fistulas in the intestinal walls, through which communication with other internal organs, or the peritoneum, is possible. This threatens a possible infection of other organs and a significant complication of the general picture of the disease. As a result of inflammatory processes, the intestinal mucosa passes into scar tissue, loses the ability to absorb nutrients from food intake and peristalsis, and stenosis of the intestinal lumen occurs.

Crohn's disease is also characterized by damage to the lymph nodes, which explains the significant increase in the blood picture in the number of T lymphocytes and eosinophils, which try to suppress the disease on their own in the early stages.

Local symptoms

  • Pain in the abdomen due to mucosal damage and constant irritation of nerve endings. Recurrent pain, similar to appendicitis;
  • Diarrhea associated with the inability of the intestine to absorb nutrients from food and water. The development of disintegration processes is possible;
  • Bleeding resulting from the development of perforated ulcers and fistulas;
  • Secondary symptoms: perforation of the intestinal wall, toxic dilation, abscess and infiltration, intestinal obstruction

General symptoms at the time of diagnosis serve as confirmation and are more indirect than direct indicators of Crohn's disease. They include the characteristic symptoms of many other diseases, often unrelated to the intestines and inflammatory processes, but in combination with local symptoms, they will help give a precise answer, Crohn's disease in humans or something else.

Common Symptoms of Crohn's Disease:

  • fever,
  • general weakness
  • rapid and sudden weight loss without alteration of appetite,
  • increase in body temperature (characterizes the inflammatory process),
  • osteoporosis (impaired absorption of calcium),
  • multi-hypovitaminosis (impaired absorption of vitamins),
  • osteomalacia,
  • dehydration of the body,
  • deterioration of general condition,
  • lethargy, weakness.

Classification of Crohn's disease by location

Due to the fact that Crohn's disease can be localized in different parts of the intestine, experts have proposed a classification of the disease to make it easier to distinguish one form from another.

  • Ileocolitis is a predominant lesion of the ileum and colon;
  • Gastro-duodenal form - predominant lesion of the stomach and duodenum;
  • Ileitis - selective lesion of the ileum without affecting other parts of the gastrointestinal tract;
  • Ejunoileitis is a predominant lesion of the small intestine and ileum;
  • Crohn's disease of the colon is a selective lesion of the large intestine without affecting other parts of the gastrointestinal tract.

In addition to this classification, there are two more, which are also successfully used by doctors around the world: according to Bocus, which offers seven variants of the disease, and the classification according to Fedorov and Levitan, which offers three variants of disease.

Blood picture

From the blood side, normochromic and normocytic anemia, leukocytosis, a significant decrease in hemoglobin against the background of an increase in ESR and C-reactive protein are observed. The main fact that Crohn's disease can be monitored is a change in the amount of calprotectin, which very rarely remains normal with such a diagnosis.

After careful analysis of the blood test result, specialists may decide to analyze the feces for indirect evidence of the disease, or to proceed with a colonoscopy immediately. Sowing is carried out if a septic lesion is suspected, a colonoscopy is always performed.

Colonoscopy and endoscopy

An examination of the large intestine (colonoscopy) is mandatory, however, specialists at the GMS Clinic, as well as specialists around the world, perform a thorough examination of the large intestine and terminal ileum for the detection of ulcers, segmentation or fistulas.

At this point, a biopsy is taken - taking samples for a thorough histological study, since it is this step that allows you to confirm or deny the diagnosis. Most often, a video recording of the study is also made, which allows you to review the colonoscopy, but not to involve the patient in the procedure.

Then an x-ray and x-ray examination of the intestines are carried out: in the first case, it is possible to detect swelling of the intestinal walls, in the second, contrast is used to identify asymmetric parts of the intestine and irregularities in the walls. If necessary, ultrasound, computed tomography and determination of antibody resistance to ASCA are performed - all of this can confirm the diagnosis if it has not yet been made.

 

The disease should begin with an explanatory conversation with the patient. The specialist should not only reassure the patient, but also tell him what is the period of exacerbation and remission of the disease, how they differ from each other and how dangerous they are. After that, you need to proceed to the appointment of a comprehensive treatment of the disease. The first thing that a patient with Crohn's disease is prescribed upon diagnosis is a different diet for the acute form and for remission.

Click here for the recommended diet

The diet during the exacerbation of the disease is characterized by a special mild mechanical and chemical diet, the inclusion of a large amount of proteins and vitamins in the diet, the complete exclusion of milk and non-digestible food components from the diet. 

Since these diets have a significantly reduced calorie content, it is possible to eat protein and protein shakes, which completely eliminates the presence of lactose and difficult-to-digest vegetable fibers. The diet includes a set of vitamins, which to a lesser extent enter the body.

Crohn's disease surgery

In the event that drug treatment not only does not give results, but does not bring at least temporary relief, specialists decide on a planned or urgent operation.

The operation consists of a resection (removal) of a segment of the intestine, followed by rehabilitation measures. Simply put, doctors remove the part of the intestine affected by the disease, suture the tissues, and prescribe special diets and procedures to quickly restore the body.

Preventive measures

It is very important, according to experts, to monitor your health. And we're not even talking about symptoms as important as food indigestibility, constant bleeding or abdominal pain. Already in the early stages, the disease begins to affect the systemic functions of the body, causing dehydration, multivitaminosis, leading to dryness and dullness of the skin, hair loss and general deterioration of the condition of the body.

Choose a healthy diet. We don't encourage you to eat raw foods, but don't forget about natural foods, fresh produce, and fruits.

Click here for the recommended diet

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