Crohn’s Disease is a chronic inflammation of the digestive track.

The digestive track covers the following:
•    Mouth
•    Esophagus
•    Stomach
•    Small Intestine
•    Large Intestine
•    Rectum
•    Anus

Crohn’s can affect any of those areas, but most commonly attacks the ileum or the lower small intestine. The swelling of the affected area will cause pain and diarrhea.

Statistics
Crohn’s can be found in both men and women. It may run in families, 20% of people diagnosed with the disease have a blood relative with some form of inflammatory bowel disease. It is usually diagnosed between the ages of 20 to 30, although people of all ages can suffer from Crohn’s. People of Jewish heritage have a greater risk of developing the disease while people of African American heritage have less of a risk.

Prevalance of Crohn’s disease: 500,000 Americans

Prevalance Rate: approx 1 in 544 or 0.18% or 500,000 people in

Hospitalization statistics for Crohn’s disease: The following are statistics from various sources about hospitalizations and Crohn’s disease:
•    0.17% (21,634) of hospital consultant episodes were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    82% of hospital consultant episodes for crohn’s disease required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    42% of hospital consultant episodes for crohn’s disease were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    58% of hospital consultant episodes for crohn’s disease were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    35% of hospital consultant episodes for crohn’s disease required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    9.6 days was the mean length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    6 days was the median length of stay in hospitals for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    39 was the mean age of patients hospitalised for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    78% of hospital consultant episodes for crohn’s disease occurred in 15-59 year olds in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    5% of hospital consultant episodes for crohn’s disease occurred in people over 75 in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    36% of hospital consultant episodes for crohn’s disease were single day episodes in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
•    0.18% (93,538) of hospital bed days were for crohn’s disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)

Treatment for Crohn’s disease depends on its location and severity, the presence of complications and the patient’s response to medications. The goal of treatment is to reduce the inflammation that triggers symptoms. Treatment relieves symptoms and results in long-term remission.

Treatment for Crohn’s disease usually involves medication and/or surgery.Drug therapies must be custom-designed for each patient. Finding which medications best alleviate the symptoms may take time. When a patient with Crohn’s disease undergoes surgery, it is important that the health care team (including the surgeon, anesthesiologist, and the primary treating physician) know which medications the patient is taking. Many patients with mild to moderate disease are treated with medications containing mesalamine.

These medications differ based on what parts of the bowel are treated. The use of mesalamine to treat Crohn’s disease, either to achieve or maintain remission, is sometimes controversial because not all studies have consistently shown that mesalamine is effective for Crohn’s disease. Mesalamine is usually well-tolerated and has no serious side effects. Patients may experience nausea, headache and diarrhea.

Some patients who have severe active disease or do not respond to mesalamine therapy may need corticosteroids such as prednisone to control inflammation and induce remission. These drugs are effective but have significant side effects, such as increased susceptibility to infection, mood swings, anxiety, depression, elevated blood pressure, glaucoma, cataracts and osteoporosis.

Physicians may use different strategies to administer these drugs in order to reduce side effects. Budesonide is a corticosteroid that is rapidly broken down by the liver, resulting in a much lower frequency of side effects. These medications are gradually reduced once remission is achieved — and mesalamine or a drug that suppresses the immune system is used to maintain remission.Antibiotics such as metronidazole are sometimes used to treat Crohn’s disease.

They are particularly helpful in patients with fistulas and are often combined with other medications. The use of metronidazole to treat active Crohn’s disease or to delay the recurrence of Crohn’s for the first two to three years after an ileum resection surgery is often controversial because not all studies have consistently shown that metronidazole and other antibiotics are effective in these patient groups.

Metronidazole can be effective in managing perineal Crohn’s disease (involving the pelvic area). Many patients require surgery because medical therapy does not control their symptoms or because complications such as blockage, abscess, perforation or bleeding into the intestines have developed

Inflammatory bowel disease, or IBD, describes two similar yet distinct conditions called Crohn’s disease and ulcerative colitis. These diseases affect the digestive system and cause the intestinal tissue to become inflamed, form sores and bleed easily. Symptoms include abdominal pain, cramping, fatigue and diarrhea.Crohn’s disease can affect any part of the gastrointestinal tract, from the mouth to the anus. Patches of inflammation occur, with healthy tissue between the diseased areas.

The inflammation can extend through every layer of affected bowel tissue. Crohn’s disease can not be cured by drugs or surgery, although either or both can help relieve symptoms.Ulcerative colitis affects only the inner layer of the colon, or large bowel. It always starts in the rectum and may extend as a continuous inflammation from there into the rest of the colon. Usually ulcerative colitis can be controlled with medication. The disease can be completely eliminated by surgically removing the colon, but afterward, waste material may have to be stored and expelled through an external appliance.

While ulcerative colitis causes inflammation only in the colon (colitis) and/or the rectum (proctitis), Crohn’s disease may cause inflammation in the colon, rectum, small intestine (jejunum and ileum), and, occasionally, even the stomach, mouth, and esophagus.The patterns of inflammation in Crohn’s disease are different from ulcerative colitis. Except in the most severe cases, the inflammation of ulcerative colitis tends to involve the superficial layers of the inner lining of the bowel. The inflammation also tends to be diffuse and uniform. (All of the lining in the affected segment of the intestine is inflamed.) Unlike ulcerative colitis, the inflammation of Crohn’s disease is concentrated in some areas more than others and involves layers of the bowel that are deeper than the superficial inner layers. Therefore, the affected segment(s) of bowel in Crohn’s disease often is studded with deeper ulcers with normal lining between these ulcers.

The most common disease that mimics the symptoms of Crohn’s disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms. It is important to differentiate these diseases, since the course of the diseases and treatments may be different. In some cases, however, it may not be possible to tell the difference, in which case the disease is classified as indeterminate colitis.

Currently there is no cure for Crohn’s disease and remission may not be possible or prolonged if achieved; in cases where remission is possible, relapse can be prevented and symptoms controlled with medication, lifestyle changes and in some cases, surgery. Adequately controlled, Crohn’s disease may not significantly restrict daily living. Treatment for Crohn’s disease is only when symptoms are active and involve first treating the acute problem, then maintaining remission.