Posts Tagged ‘Gastrointestinal Tract’

Pediatric Crohns Disease

04.08.10

Delayed growth is a well-established feature of pediatric Crohns disease. Several factors have been shown to affect growth, including disease location, severity, and treatment. The recently discovered NOD2 gene has been correlated to ileal location of Crohns disease and subsequently could affect growth through the resulting phenotype or as an independent risk factor.

The aim of our study was to determine if growth retardation is affected by genotype independently of disease location or severity. Crohns disease is an inflammatory bowel disease of the gastrointestinal tract.

Approximately 500,000 Americans suffer from Crohn’s, and it is estimated that at least 150,000 of them are children under age 17.  In children, the disease usually presents between 12 and 16 years of age; however, it has been detected in children as young as 7 years old.

Both adult and pediatric Crohn’s patients may experience a number of symptoms, including diarrhea, abdominal cramps and pain, fever, rectal bleeding, loss of appetite, and weight loss. However, each individual may experience symptoms differently. If your child has been diagnosed with pediatric Crohn’s disease, talk to your child’s doctor about treatment with REMICADE.

Individual results may vary. Talk to your child’s doctor to see if REMICADE is right for your child.REMICADE is for children (ages 6-17) with moderate to severe Crohns disease who haven’t responded well to other therapies.

REMICADE has been approved for the treatment of pediatric Crohns disease, based on clinical research. Children with pediatric Crohn’s disease may have to deal with things that other children don’t — painful and sometimes embarrassing physical symptoms, eating and treatment regimens, doctor visits, and even occasional hospital stays.

Pediatric Crohn’s can have an impact of all aspects of a child’s life, including school, relationships with friends and family, and self-esteem. But by learning how to cope with the disease, they can still lead an otherwise happy, productive life. If your child has been diagnosed with pediatric Crohn’s disease, it is only natural to feel overwhelmed and scared.

Since this is a chronic illness (meaning that it doesn’t go away) that can involve painful and sometimes embarrassing symptoms, you may have questions:
• How will pediatric Crohn’s disease affect my child’s health and well-being?  Will it affect me and the rest of my family as well?
• Will this disease change my child’s appearance or interfere with normal growth?
• Will my child have to go on a special diet?
• What treatment is available for pediatric Crohn’s disease?

Crohn’s disease can have physical, social, and emotional effects on a child.  Physical symptoms of pediatric Crohn’s disease include growth problems, frequent diarrhea, abdominal pain, loss of appetite, and weight loss.

Children and teenagers may find it especially hard to deal with a chronic disease like Crohn’s and its symptoms since they are already in the process of both physical and emotional development.
Because of the physical manifestations of pediatric Crohn’s, a child may face challenges both socially and emotionally. Below are some of the social and emotional challenges a child with pediatric Crohn’s may face.

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Crohns Disease Surgery

01.17.10

Crohns disease can cause a variety of symptoms of gastrointestinal distress.

The three classic (though not specific) symptoms of inflammatory bowel disease are:
•    Persistent or recurrent diarrhea (possibly with blood, mucus, or pus)
•    Abdominal pain
•    Fever

There also may be signs and symptoms unrelated to the gastrointestinal tract. A doctor will obtain a complete medical history and perform a thorough physical examination, along with laboratory and diagnostic tests, to diagnose Crohns disease. The examination and other tests are necessary to rule out a number of transient conditions, such as viral, bacterial, or parasitic infection, that cause symptoms similar to Crohns disease.

Diarrhea
In cases of Crohns disease, patients often experience frequent loose or watery bowel movements. The stool is occasionally accompanied by thick, dark blood (not bright red smears of blood, which usually result from a bleeding hemorrhoid). There is less mucus or pus in the stool than in cases of ulcerative colitis.

Pain
Patients may experience crampy, achy, or even sharp pain in the affected area. Most often, patients with Crohns disease feel pain on the lower right side of the abdomen (lower right quadrant) and just below the bellybutton. This is because the majority of cases of Crohns disease involve disease in the terminal ileum, where the small intestine meets the large intestine. The terminal ileum crosses from left to right just above the beltline, and joins the large intestine in the lower right quadrant. The type of pain associated with Crohns disease depends on what part of the GI tract is affected. Disease in the terminal ileum generally causes sharp pain, while disease in the colon causes more crampy pain, similar to that that of ulcerative colitis. Pain is sometimes relieved (temporarily) after a bowel movement.

Fever
Crohn’s is an inflammatory disease, and one of the key characteristics of the inflammatory process is fever. (The others are pain, swelling, and redness.) Some individuals with Crohns disease suffer a high fever, especially during the acute phase of a flare-up. Others run a persistent, low-grade fever. Fever may be accompanied by irritability and fatigue. Sometimes, the fever recurs each day, especially late in the day, then repeatedly breaks during sleep, causing night sweats.

Signs and Symptoms Unrelated To The GI Tract
A number of signs and symptoms that do not involve the gastrointestinal tract can occur with Crohns disease. These may occur at the same time as the intestinal symptoms, or may be experienced weeks or even months before any intestinal symptoms are noticed. If your doctor suspects inflammatory bowel disease, he or she will ask you detailed questions about whether or not these extra-intestinal symptoms have appeared:
•    Reddening and inflammation of the eye (iritis)
•    Joint pain (usually in the large joints of the knees, ankles, elbows, wrists, and shoulders), which sometimes migrates from one joint to another (migrating arthralgia)
•    Skin lesions, including tender red nodules on the shins or calves (erythema nodosum)
•    Sores inside the mouth (aphthous ulcers)

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Crohns Disease Prognosis

12.09.09

Crohn’s disease is a life-long illness. The severity of the disease can vary, and a patient can experience periods of time when the disease is not active and he or she is symptom free. However, the complications and risks of Crohn’s disease tend to increase over time. Well over 60% of all patients with Crohn’s disease will require surgery, and about half of these patients will require more than one operation over time. About 5-10% of all Crohn’s patients will die of their disease, primarily due to massive infection.

Endoscope
A medical instrument that can be passed into an area of the body (the bladder or intestine, for example) to allow examination of that area. The endoscope usually has a fiber-optic camera that allows a greatly magnified image to be shown on a television screen viewed by the operator. Many endoscopes also allow the operator to retrieve a small sample (biopsy) of the area being examined, to more closely view the tissue under a microscope.

Fistule
An abnormal channel that creates an open passageway between two structures that do not normally connect.

Gastrointestinal tract
The entire length of the digestive system, running from the stomach, through the small intestine, large intestine, and out the rectum and anus.

Immune system
The body system responsible for producing various cells and chemicals that fight infection by viruses, bacteria, fungi, and other foreign invaders. In autoimmune disease, these cells and chemicals turn against the body itself.

Inflammation
The result of the body’s attempts to fight off and wall off an area that is infected. Inflammation results in the classic signs of redness, heat, swelling, and loss of function.

Obstruction
A blockage.

Ulceration
A pitted area or break in the continuity of a surface such as skin or mucous membrane.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.)

People with Crohn’s disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohn’s disease are able to hold jobs, raise families, and function successfully at home and in society

Crohns Disease

08.20.09

It is also known as regional enteritis is a chronic, episodic, inflammatory bowel disease (IBD) that affects any part of the entire wall of the bowel or intestines. Crohns disease can affect any part of the gastrointestinal tract from mouth to anus; as a result, the symptoms of Crohns disease vary among afflicted individuals.

The disease is characterized by areas of inflammation with areas of normal lining between in a symptom known as skip lesions. The main gastrointestinal symptoms are abdominal pain, diarrhea (which may be bloody, though this may not be visible to the naked eye), constipation, vomiting, weight loss or weight gain. Crohns disease can also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, and inflammation of the eye.

The disease was independently described in 1904 by Polish surgeon Antoni Lesniowski and in 1932 by American gastroenterologist Burrill Bernard Crohn, for whom the disease was named. Crohn, along with two colleagues, described a series of patients with inflammation of the terminal ileum, the area most commonly affected by the illness.

Crohns disease affects between 400,000 and 600,000 people in North America. Prevalence estimates for Northern Europe have ranged from 27–48 per 100,000. Crohns disease tends to present initially in the teens and twenties, with another peak incidence in the fifties to seventies, although the disease can occur at any age. Although the cause of Crohns disease is not known, it is believed to be an autoimmune disease that is genetically linked. The highest relative risk occurs in siblings, affecting males and females equally. Smokers are three times more likely to get Crohns disease.

Unlike the other major types of IBD, there is no known drug based or surgical cure for Crohns disease. Treatment options are restricted to controlling symptoms, putting and keeping the disease in remission and preventing relapse. Crohns disease is a chronic inflammatory disease of the intestines. It primarily causes ulcerations (breaks in the lining) of the small and large intestines, but can affect the digestive system anywhere from the mouth to the anus. It is named after the physician who described the disease in 1932.

It also is called granulomatous enteritis or colitis, regional enteritis, ileitis, or terminal ileitis. Crohns disease tends to be more common in relatives of patients with Crohns disease. It also is more common among relatives of patients with ulcerative colitis. Crohns disease is related closely to another chronic inflammatory condition that involves only the colon called ulcerative colitis.

Together, Crohns disease and ulcerative colitis are frequently referred to as inflammatory bowel disease (IBD). Ulcerative colitis and Crohns disease have no medical cure.

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Crohns Disease Prognosis

08.05.09

Crohns disease is a life-long illness. The severity of the disease can vary, and a patient can experience periods of time when the disease is not active and he or she is symptom free. However, the complications and risks of Crohns disease tend to increase over time. Well over 60% of all patients with Crohns disease will require surgery, and about half of these patients will require more than one operation over time. About 5-10% of all Crohn’s patients will die of their disease, primarily due to massive infection.

Endoscope
A medical instrument that can be passed into an area of the body (the bladder or intestine, for example) to allow examination of that area. The endoscope usually has a fiber-optic camera that allows a greatly magnified image to be shown on a television screen viewed by the operator. Many endoscopes also allow the operator to retrieve a small sample (biopsy) of the area being examined, to more closely view the tissue under a microscope.

Fistule
An abnormal channel that creates an open passageway between two structures that do not normally connect.

Gastrointestinal tract
The entire length of the digestive system, running from the stomach, through the small intestine, large intestine, and out the rectum and anus.

Immune system
The body system responsible for producing various cells and chemicals that fight infection by viruses, bacteria, fungi, and other foreign invaders. In autoimmune disease, these cells and chemicals turn against the body itself.

Inflammation
The result of the body’s attempts to fight off and wall off an area that is infected. Inflammation results in the classic signs of redness, heat, swelling, and loss of function.

Obstruction
A blockage.

Ulceration
A pitted area or break in the continuity of a surface such as skin or mucous membrane.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.)

People with Crohns disease may feel well and be free of symptoms for substantial spans of time when their disease is not active. Despite the need to take medication for long periods of time and occasional hospitalizations, most people with Crohns disease are able to hold jobs, raise families, and function successfully at home and in society.

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Colitis and Crohns

06.07.09

Inflammatory bowel disease, or IBD, describes two similar yet distinct conditions called Crohns 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.Crohns 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. Crohns 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), Crohns 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 Crohns 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 Crohns 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 Crohns disease often is studded with deeper ulcers with normal lining between these ulcers.

The most common disease that mimics the symptoms of Crohns 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 Crohns 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, Crohns disease may not significantly restrict daily living. Treatment for Crohns disease is only when symptoms are active and involve first treating the acute problem, then maintaining remission.

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