Doctor's Notes on Crohn's Disease Anatomy
Crohn's disease is a type of inflammatory bowel disease (IBD) that involves chronic inflammation of the digestive tract. Any part of the digestive tract from the mouth to the anus can be affected by Crohn's disease, although it most commonly affects the end of the small intestine called the terminal ileum and the beginning of the large intestine called the cecum.
Complications of Crohn's disease include urinary tract infections (UTIs), vaginal infections, blockage in the intestine due to thickening of the intestinal walls, ulcers or fissures that may tunnel through the affected area into surrounding areas, fistulas, thickening of the wall due to acute inflammation that causes narrowing of the lumen of the small intestine, scar tissue resulting from the healing process that can lead to a narrowed bowel, and strictures.
What Is the Treatment for Crohn's Disease?
The treatment for Crohn’s disease usually consists of medical therapies and dietary changes to decrease symptoms and induce remission. Surgical treatments are usually only used if medical treatments are inadequate or if there is an emergency reason for surgery (such as a blockage or a perforation).
Medical therapies used to treat Crohn’s disease include:
- Oral 5-aminosalicylates (e.g., sulfasalazine, mesalamine)
- Glucocorticoids (e.g., prednisone, budesonide)
- Immunomodulators (e.g., azathioprine, 6-mercaptopurine, methotrexate)
- Biologic therapies (e.g., infliximab, adalimumab, certolizumab pegol, natalizumab, vedolizumab, ustekinumab)
Other therapies used for Crohn’s disease include:
- Cholestyramine or other bile sequestrants
- Colestipol or colesevelam
- Dietary interventions
- Avoid food triggers
- Add vitamin supplements
- Foods to eat:
- Low fiber fruits (bananas, melons, apple sauce)
- Refined grains (white rice, breads)
- Lean proteins (chicken breast, fish)
Surgery when needed often involves removal of the affected segment of bowel (resection), then when possible, the two ends of healthy bowel are joined together (anastomosis).
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.