Our digestive system is a system that starts from the mouth and continues up to the anus. Crohn’s disease, often seen in the last part of the small intestine section of this system; It is a serious disease of unknown cause, that does not heal completely, and may require surgical intervention.
From Memorial Antalya Hospital General Surgery Department, Op. Dr. Behlül Baydar gave information about Crohn’s disease and its treatment.
Dr. Behlül Baydar, who describes Crohn’s disease as “an inflammatory disease in which any part of the digestive system can be involved, but mostly the last part of the small intestine is involved; it is a chronic, unknown cause, involving the entire muscle layer of the intestinal wall”, Dr. He stated that it is mostly seen in women, on average between the ages of 30-40.
Although the cause of Crohn’s disease is unknown, it is known that genetic and environmental factors trigger its occurrence. The risk is 14-15 times higher in first-degree relatives of patients; high socioeconomic status and smoking are also important factors. Breastfeeding is protective against the development of Crohn’s disease.
The most common symptom of the disease is abdominal pain. The differences that the complaints may show are intestinal obstructions, the development of fistulas, and the aggressive course of the inflammatory disease. Weight loss, fever, growth retardation in children may be the symptoms of Crohn’s disease, either continuously or from time to time. It is observed in extraintestinal diseases in one fourth of Crohn’s patients. These occur mostly in the skin, joints, eyes, liver and biliary tract, kidney and urinary tract, vascular heart and lungs.
The diagnosis is made in the endoscopic examination performed together with the clinical history. There is no single test, sign, or sign that describes Crohn’s disease. Since there is no cure for Crohn’s disease, treatment is given for symptoms resulting from the disease. Drug therapy is given to reduce the symptoms of the disease and to prevent relapse. Special nutritional supports and recommendations can be given during periods of exacerbation of the disease.
Surgical treatment is preferred in patients who do not respond to aggressive drug therapy and develop complications, when 50-70 percent of Crohn’s patients need surgical treatment at least once during their treatment. Sometimes, surgical treatment can be preferred to prevent side effects caused by drug treatment. The presence of growth retardation in 30 percent of children with Crohn’s disease requires surgery. Other conditions that require surgery are sudden emergence of serious disease (severe inflammatory condition or toxic picture), failure of medication, obstruction in the intestine, complicated fistulas, bleeding, cancer risk.
Gastroenterology Specialist Prof. Dr. Hülya Hamzaoğlu told what should be known about Crohn’s disease.
Gastroenterology Specialist Prof. Dr. Hülya Hamzaoğlu pointed out that the most common symptoms in Crohn’s disease are abdominal pain and diarrhea, “Abdominal pain is usually felt after meals, in the area around the belly or under the belly button. “Abdominal bloating, pain, vomiting, and constipation can be seen in patients with severe intestinal constriction,” he says. Another finding is blood in the stool in patients with large intestine involvement. In the active period of Crohn’s disease, problems such as fatigue and weakness can develop, and patients’ fever can rise. Loss of appetite and involuntary weight loss are other symptoms. In anal region involvement, cracks, inflamed discharge, fistulas and abscesses can occur around the anus. Sometimes these complaints can be seen without any abdominal pain and diarrhea.
It is not known exactly what causes Crohn’s disease, but genetic and environmental factors are thought to play a role. A child with Crohn’s disease in his family has a higher risk of developing this disease than children of healthy families. Gastroenterology Specialist Prof. Dr. Hülya Hamzaoğlu drew attention to the fact that cigarette consumption takes the first place among environmental factors and says, “Quitting smoking can be as effective as drug therapy”. In addition to smoking, various substances taken with food, bacteria, bacterial toxins and viruses can play a role in the emergence of the disease. In addition, aspirin, antibiotics, some pain relievers and birth control pills can cause the disease to worsen, ”he says.
Crohn occurs in some patients with a mild picture and in some patients with a very severe picture. Gastroenterology Specialist Prof. Dr. Hülya Hamzaoğlu, stating that the treatment program is determined according to the severity of the disease and the region it is affected, gives the following information: “The first treatment step is usually medication. If there is no response to first-line medications, new treatments are introduced gradually. If a positive result is not obtained at the end of a long period of time in patients treated with medication, the surgical treatment option is considered. Surgery is only performed in very necessary situations. “
Gastroenterology Specialist Prof. Dr. Hülya Hamzaoğlu warned that problems such as loss of fluid, vitamins and minerals in the body due to reasons such as decreased appetite, impaired absorption in the intestines and diarrhea in Crohn’s disease, “Therefore, it is very important for patients to eat adequate and balanced nutrition. In addition, during the diarrhea period, it is necessary not to eat too much fiber and to reduce the fiber foods. “He should also avoid burnt fat, processed foods such as sausages, salami and sausages, and barbecued meats, as these increase the risk of colon cancer,” he says. Prof. Dr. Hülya Hamzaoğlu says that contrary to popular belief, Crohn’s patients do not need to follow a strict diet.