Crohn disease (also called Crohn's disease) is an inflammatory bowel disease. It is a chronic condition that may recur at various times over a lifetime. It usually involves the small intestine, most often the lower part called the ileum. However, inflammation may also affect the entire digestive tract, including the mouth, esophagus, stomach, duodenum, appendix, or anus. Crohn disease is also called ileitis or enteritis.
There are many theories regarding Crohn disease, but none has yet been proven. One theory suggests that some agent, perhaps a virus or bacteria, affects the body's immune system and triggers an inflammatory reaction in the intestinal wall.
Although there is a lot of evidence that patients with this disease have abnormalities of the immune system, it is not known whether the immune problems are a cause or a result of the disease.
Physicians believe that there is little proof that Crohn disease is caused by emotional distress or by an unhappy childhood. Commonly Affected Populations
Twenty percent of all cases of Crohn disease affect children. Crohn disease is seen in children as young as seven years old. Males and females are affected equally.
It appears to run in some families, with about 20 percent of people with Crohn disease having a blood relative with some form of inflammatory bowel disease. In those who have a family history, it is very likely that Crohn disease will begin in the teens and twenties.
The following are the most common symptoms of Crohn disease. However, each individual may experience symptoms differently. Symptoms may include:
Some people have long periods of remission when they are free of symptoms, sometimes for years. There is no way to predict when a remission may occur or when symptoms will return.
The symptoms of Crohn disease may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.
People who have experienced chronic abdominal pain, diarrhea, fever, weight loss, and anemia may be examined for signs of Crohn disease. In addition to a complete medical history and physical examination, diagnostic procedures for Crohn disease may include:
At this time there is no cure for Crohn disease; however, several methods are helpful in controlling it. The usual goals of treatment are to:
Specific treatment will be determined by your child's physician based on the following:
Treatment may include:
Abdominal cramps and diarrhea may be helped by medications, which often lessen the inflammation in the colon. More serious cases may require steroid drugs, antibiotics or drugs that affect the body's immune system.
No special diet has been proven effective for preventing or treating Crohn disease. Some symptoms are made worse by milk, alcohol, hot spices or fiber, but this may not be true for everyone. Large doses of vitamins are ineffective and may even cause harmful side effects.
Children lose weight because of inadequate calorie intake, which can be due to several factors:
A small number of patients, who temporarily need extra nutrition, may need periods of feeding by vein (intravenously).
Crohn disease may be helped by surgery, but it cannot be cured by surgery. The inflammation tends to return to the areas of the intestine next to the area that has been removed. Surgery may help to either relieve chronic symptoms of active disease that does not respond to medical therapy or to correct complications, such as intestinal blockage, perforation, abscess, or bleeding.
Types of surgery include:
Different types of ostomy are performed depending on how much and what part of the intestines are removed, and may include:
The intestines help to digest and absorb foods. Malabsorption occurs when food is not digested well, and nutrients are not absorbed into the body. This can lead to poor growth and development. Children with short bowel syndrome (SBS) can have a reduced ability to absorb nutrients from the foods they eat. Malabsorption occurs because part of the intestines have been removed or are not functioning properly.
Common symptoms of malabsorption include the following:
Because diarrhea is the primary symptom of short bowel syndrome, the goal of the diet plan is to help control and/or reduce diarrhea and malabsorption. Guidelines that may help control diarrhea include the following:
Children with short bowel syndrome often need total parenteral nutrition (TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein, fat, vitamins, and minerals that are given through an IV into the veins. Many people call it intravenous feedings. TPN provides the nutrients your child needs when he/she can not eat or absorb the nutrients from foods. The TPN solution is usually infused continuously over several hours of the day.
Crohn's disease is a chronic condition that may recur at various times over a lifetime. Children may experience physical, emotional, social, and family problems as a result of the disease, increasing the importance of proper management and treatment of the condition.
The following chart summarizes some of the problems children may face:
|Emotional Responses||Social Problems||Effects on the Family|