Crohn's disease

Reviewed by Dr Paul Klenerman, consultant physician

Diet
Normally, there are no restrictions but, as with other intestinal diseases, a low-fat diet may reduce the person's diarrhoea.

What are the complications of Crohn's disease?

Bleeding and iron deficiency.

Ileus (reduced bowel mobility), or obstruction (partial or complete blockage of the intestine).

Perforation of the inflamed intestines or formation of fistulas.

Inflammation of the liver, joints and eyes, and skin rash.

Problems with digestion of food, either due to extensive scarring in the intestine, or because the intestine has become too short after a number of operations.

Prognosis
The above symptoms notwithstanding, most patients lead normal lives.

How is Crohn's disease treated?

The treatment depends on the severity and extent of the disease, as well as the effect of the disease on the patient.

Medication can in many cases control the inflammation, keep the symptoms down, and reduce the probability of relapse.

Surgical removal of the affected areas is sometimes necessary, but the disease can recur elsewhere.

Severe attacks require treatment in hospital.

Which medicines may be used?

Aminosalicylates and corticosteroids are the backbone of treatment for acute attacks.

Aminosalicylate or corticosteroid enemas or suppositories are introduced into the rectum to reduce inflammation in acute mild to moderate disease affecting the rectum or lower part of the intestine.

Disease that is more widespread in the intestine, or is unresponsive to rectal treatment, requires oral treatment to reduce the inflammation in the intestinal wall. Mild disease is treated with aminosalicylate tablets. More moderate disease requires corticosteroid tablets.

Severe attacks require admission to hospital and treatment with intravenous corticosteroids.

Immunosuppressants, such as azathioprine or ciclosporin, are sometimes used for very severe symptoms that have not responded sufficiently to intravenous corticosteroids. (This is an unlicensed indication for these medicines.)

Infliximab is used for very severe disease that is not improved by treatment with corticosteroids or immunosuppressants.

Antibiotics are used if there is an additional bacterial infection.

Vitamin supplements are used in cases where blood samples have shown a lack of one or more vitamins.

Medicines to treat diarrhoea can be used if this is a major problem.

Nutritional support may be required during active phases, for example with 'elemental' diets that consist of very easily digested food products.

<<Go To Page 1

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use



© Copyright 1998 - 2004 NetDoctor.co.uk - All rights reserved