Crohn's disease, Enteritis regionalis, Enterocolitis regionalis, Ileitis terminalis, Crohn's disease
Crohn's disease is a chronic disease that can be associated with inflammation throughout the digestive tract.
Abdominal pain and diarrhea are common symptoms. The end section of the small intestine, the so-called “terminal ileum”, is most frequently inflamed. This is why the disease used to be called “ileitis terminalis”. Although chronic inflammatory bowel disease cannot be cured, the vast majority of cases can be controlled with the right treatment.
Crohn’s disease is a chronic inflammatory bowel disease that often progresses in episodes and frequently recurs. This means that periods without symptoms alternate with periods of illness. The disease is chronic – and therefore usually a lifelong companion. However, it can usually be treated well so that normal everyday life is possible.
Crohn’s disease owes its name to the US gastroenterologist Burrill Bernhard Crohn, who first described it. It has many other names, for example Crohn’s disease, enteritis regionalis, enterocolitis regionalis, ileitis terminalis or Crohn’s disease.
The inflammation can affect the entire digestive tract, from the mouth to the anus. However, they most frequently occur at the point where the small intestine joins the large intestine. This last area of the small intestine is called the “terminal ileum”. In addition, the inflammation can affect not only the uppermost layer of the mucous membrane, but all layers of the intestinal wall.
A further characteristic of Crohn’s disease is that the inflammation does not spread continuously throughout the intestine, but rather the inflammatory foci develop at several, non-contiguous points in the intestine. In between are healthy intestinal sections. Doctors refer to this pattern of infestation as segmental, discontinuous infestation.
The situation is different with the very similar bowel disease ulcerative colitis:
Among other forms of intestinal inflammation, doctors summarize both clinical pictures under the term chronic inflammatory bowel disease (IBD).
Chronic inflammatory bowel disease (IBD) is one of the most common diseases in Switzerland: Around one in 350 people suffer from it. This means that more than 25,000 people are affected by IBD. Men and women fall ill about equally often.
In principle, Crohn’s disease can affect people of all ages. The intestinal disease usually first appears in adolescents and young adults, between the ages of 15 and 34.
The causes of Crohn’s disease are still largely unknown. Researchers do not yet know exactly what triggers ulcerative colitis either. However, there is probably not “one” cause, but several factors must interact in the development. However, one thing is clear: Crohn’s disease is not an infectious disease and is therefore not contagious to others.
Doctors are aware of a number of risk factors associated with Crohn’s disease.
Researchers have also identified several other risk factors for Crohn’s disease. These include, for example, smoking or treatment with antibiotics during adolescence.
Psychological factors do not appear to play a role as causes of Crohn’s disease. However, emotional stress or conflicts can influence the course of chronic inflammatory bowel disease. They can either trigger new relapses or exacerbate existing ones.
Crohn’s disease can cause a wide variety of symptoms, which primarily affect the gastrointestinal tract. However, the symptoms can also occur outside the bowel and extend to other areas of the body. However, not every patient develops all symptoms to the same extent. The chronic inflammatory bowel disease ulcerative colitis also causes similar symptoms. These symptoms are common in Crohn’s disease:
They affect a wide variety of organs:
At the USZ, patients with Crohn’s disease are cared for by a highly specialized, interdisciplinary team of gastroenterologists and surgeons. We discuss complex cases in a joint consultation, in which individual treatment plans are determined and the indications for complex operations are carefully examined.
When diagnosing Crohn’s disease, we always start with your medical history. The following questions, for example, are interesting for him to gain initial clues:
This is followed by a physical examination during which we palpate the abdomen. For example, the size and position of organs can be determined.
We also use imaging examinations and various laboratory tests to diagnose Crohn’s disease.
If only the large intestine is inflamed, even experienced doctors cannot always easily distinguish between Crohn’s disease and ulcerative colitis. Sometimes only the course of the disease reveals which of the two chronic inflammatory bowel diseases is actually involved. Sometimes it is not possible to make a clear distinction between the two forms over a longer period of time, which is then referred to as IBDu (IBD unclassified)
The causes of Crohn’s disease are still largely unclear. There is therefore no way to prevent chronic intestinal inflammation (primary prevention). If you have Crohn’s disease, it is important to prevent a return of the disease in the form of new flare-ups – so-called secondary prevention. Giving up smoking seems to have a positive effect here.
Early detection plays a role in Crohn’s disease because those affected have an increased risk of bowel cancer. And in general: Crohn’s disease that is detected early can also be treated better. This reduces the risk of health consequences and complications.
Crohn’s disease is one of the chronic diseases that accompany you throughout your life. There is currently no cure for Crohn’s disease. But the bowel disease can be treated well, so that a normal everyday life with a good quality of life is often possible. Crohn’s disease progresses in episodes: phases of the disease alternate with periods without symptoms.
However, you can positively influence the course of the disease to a certain extent: seek psychological support or learn a relaxation technique such as Jacobson’s progressive muscle relaxation or autogenic training.
The course of Crohn’s disease varies greatly from person to person. It is therefore not possible to make any general statements about the forecast. Most people are able to cope with their everyday lives and do their jobs. Life expectancy is also hardly limited. However, it should be noted that the risk of bowel cancer is higher in people with Crohn’s disease than in people without the disease.
Crohn’s disease can lead to various complications – either from the disease itself or from the various treatments.
The exchange with people who are affected by the same disease can be a great support in coping with the disease. Advice on finding a suitable self-help group is available from Selbsthilfe Zürich. Self-Help Zurich and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.
Other possible complications, although these occur less frequently:
There are several treatment options for Crohn’s disease, which we often use in combination. This increases their effectiveness and impact. The aim of treatment is always to alleviate symptoms, reduce the number of relapses, extend the time between relapses and prevent complications.