Crohn's disease, also known as Crohn's disease, is a chronic inflammation of the gastrointestinal tract. Like ulcerative colitis, it is one of the chronic inflammatory bowel diseases.
Here you will find further information as well as qualified Crohn's disease specialists and centers.
Crohn's disease is a chronic inflammation of the gastrointestinal tract and, like ulcerative colitis, is a chronic inflammatory bowel disease. It is also known as Crohn's enteritis regionalis, enteritis terminalis, ileitis terminalis or scarring enteritis. The disease usually progresses in episodes and is not contagious.
The entire gastrointestinal tract, i.e. from the mouth to the anus, can be affected by Crohn's disease. However, the disease usually manifests itself in the area of the lowest section of the small intestine, at the transition to the large intestine.
This is where
In contrast, ulcerative colitis only occurs in the large intestine and only affects the surface of the intestinal mucosa. In Crohn's disease, deeper layers of the intestinal wall can also be affected by the inflammation.
A distinction is made, for example, depending on the affected section:
Crohn's disease in figures
Crohn's disease is one of the most common chronic inflammatory bowel diseases:
The causes of Crohn's disease are not exactly known. However, due to the familial clustering, it is assumed that there is a hereditary predisposition. If a close relative already has Crohn's disease, the other family members have a tenfold increased risk.
In addition, disorders of the immune system are discussed, which lead to pathological interactions with the intestinal wall and thus to inflammation.
Environmental factors also appear to play a role in the development of Crohn's disease. For example, smokers and people from industrialized nations have a higher risk.
Althoughpsychological factors (e.g. psychological strain, stress) have no influence on the development of Crohn's disease, they do have an impact on its progression. Diet, on the other hand, is not responsible for either the onset or the flare-ups.
Crohn's disease is typically characterized by
This is usually accompanied by a lack of appetite and weight loss. The symptoms are similar to those of ulcerative colitis.
The exact symptoms depend, among other things, on which part of the digestive system is affected by the inflammation. Some sufferers only experience mild symptoms, while others experience severe symptoms.
In addition, the symptoms can be unspecific, especially at the beginning of the disease. In children, Crohn's disease can also manifest itself in slower growth and a later onset of sexual maturity.
As inflammation can also occur outside the intestine, so-called extraintestinal manifestations can also occur. These include
Crohn's disease has a chronic and intermittent course, in which the disease activity increases and decreases again. Depending on the severity of the inflammation, an acute attack of Crohn's disease is therefore classified as mild, moderate or severe.
Crohn's disease can affect only a single section or several areas of the digestive tract at the same time. The following sections are most frequently affected:
Although Crohn's disease is a long-term illness, the life expectancy of patients is hardly affected. The majority of patients can lead a largely normal life.
The following video shows the findings of a colonoscopy (colonoscopy):
Depending on the extent and duration of the disease, complications can occur. However, this is rarely the case. The occurrence of a complication can often be an indication for Crohn's disease surgery.
The most important complications of Crohn's disease occur in the intestinal area:
The most important complications of Crohn's disease outside the intestine are
The diagnosis usually begins with questioning the patient(medical history) about
This is followed by physical and other examinations.
During the physical examination, the abdomen is palpated. The doctor will look for pressure pain in the lower right abdomen and indurations. The anus is examined for fistulas and fissures.
Blood test: Certain changes can be detected in the blood count. Often there is
In addition to a visual assessment of the bowel, acolonoscopy allows tissue samples to be taken from the mucous membrane to confirm the diagnosis.
An ultrasound examination (sonography) can be used to check whether the intestinal wall is thickened.
Gastroscopy and other imaging procedures such as magnetic resonance imaging(MRI) may also be necessary.
As the causes for the development of Crohn's disease are not known, the disease cannot be cured. Therefore, the treatment of Crohn's disease primarily aims to
Depending on the severity and course of the disease, various options are available for the treatment of Crohn's disease:
Crohn's disease surgery is an important treatment option for Crohn's disease patients, as the following figures show:
The most important reasons for Crohn's disease surgery are
A Crohn's disease operation at the right time can prevent complaints and complications.
During surgery, as little small bowel as possible is removed, as recurrence can occur despite resection (removal).
Two types of Crohn's disease surgery can be distinguished:
Surgery cannot cure the disease. Even after Crohn's disease surgery, there is a risk of relapse (recurrence). The pros and cons of surgery for Crohn's disease must therefore be clarified on an individual basis.
In principle, however, the following indications for Crohn's disease surgery exist:
In the following cases, Crohn's disease surgery should be postponed for as long as possible:
If Crohn's disease surgery is planned, the following in particular are carried out in advance
The diagnostics should answer the following questions before surgery for Crohn's disease:
The most common procedures for Crohn's disease surgery are
Crohn's disease surgery is only performed on the affected section of bowel. Radical Crohn's disease operations, i.e. removal of large sections of bowel, have proven to be disadvantageous and are therefore avoided. Surgery is only performed on an inflamed area if it is causing symptoms.
Occasionally, scars or adhesions can cause constrictions (stenoses) in the bowel. This prevents the intestinal contents from being transported. It is then necessary to remove the affected section of bowel.
Crohn's disease surgery for stenosis consists of the sparing removal of the narrowed segment of bowel. In the case of short narrowings (strictures), plastic dilation is sometimes sufficient without having to remove the intestinal tissue itself. By restoring the unrestricted passage of stool (stricturoplasty), the inflammation heals and the patient is free of symptoms.
Fistulas from the bowel to the bladder (enterovesical fistulas) and fistulas that end blindly in the posterior abdominal cavity can be dangerous. This can affect other organs (e.g. the urogenital tract) or lead to dangerous accumulations of pus in the body (abscesses). The fistula usually heals quickly after removal of the diseased bowel sections.
An abscess can either be punctured or the fluid can be drained via a drainage tube.
Fortunately, real emergencies are rare in Crohn's surgery. The figures are just under 5 percent of all surgical procedures.
Emergency indications are
In all these situations, immediate action must always be taken and the results are somewhat worse than with planned Crohn's disease operations. However, emergency operations should be the exception in good medical care for Crohn's patients!
A specialist in visceral surgery or a specialist in general surgery is responsible for surgery for Crohn's disease.
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