Crohn's disease (Leśniowskiego): causes, symptoms, treatment of Crohn's disease

Leśniowski's disease attacks the intestines, stomach, esophagus and even the mouth and penetrates deep into the digestive tract wall. It manifests itself with diarrhea, abdominal pain, blood and mucus appear in the stools. Leśniowski's disease is a chronic and recurrent disease - symptoms worsen and weaken. What is life like with Crohn's disease and how is it treated?

Crohn's disease is classified as a chronic inflammatory bowel disease. It is most often diagnosed in young, female people between 15 and 30 years of age, although the symptoms of the disease may also appear later, in the range of 60-80 years. Crohn's disease also occurs in children.

Up to 4,000 people have Crohn's disease in Ireland. It mainly affects young people under 35 years of age. According to the 2018 "Study of patients with inflammatory bowel disease (IBD)", 25% of respondents with Crohn's disease are under 25 years of age, and 61% are between 26 and 40 years old. 65% of the sick are women.

The younger the age of onset, the more aggressive the course of the disease, which limits everyday functioning. How to live when you have to deal with abdominal pain, accompanying diarrhea (usually without blood), occurring in 70-90% of patients, or fever?

The consequence of disease activity is iron deficiency anemia, malnutrition, and sometimes exhaustion of the body, and the need for multiple operations, in many cases resulting in the creation of a stoma. Patients do not find understanding in society, they are stigmatized and excluded from everyday, normal functioning. And yet they want to study, work, enter into relationships, start a family and participate in social life. Only 46% of people with Crohn's disease work full-time.

A characteristic feature of Crohn's disease is that the inflammation affects only selected parts of the digestive system, leaving others without signs of disease. Inflammation, caused by Crohn's disease, most often, in 40-50% of patients, is located in the ileum (this is the final segment of the small intestine). In 30-40 percent of patients, the inflammation affects both the small intestine and the large intestine, and in 20 percent only the large intestine. In addition, it is rare, although it is rare, that inflammation travels up the digestive system and affects the stomach, esophagus and even the mouth.

Crohn's disease - causes

The causes of Crohn's disease are not fully understood, although specialists indicate several factors that may affect its occurrence. It is also possible that a combination of several of them is necessary to develop the disease. The causes of Crohn's disease include:

• genetic conditions - the disease is more common in people whose close relatives suffer from enteritis
• a sudden decrease in immunity, caused e.g. by a viral or bacterial infection
• smoking
• use of contraceptive hormonal pills
• the use of non-steroidal anti-inflammatory drugs

Crohn's disease - symptoms

In Crohn's disease, the symptoms depend on where the inflammation is taking place and how severe it is.

If your symptoms are getting worse, especially if you have diarrhea, you notice blood or mucus in your stools, or if your stools are black, you need medical attention. Also, if your belly is bloated, you experience severe pain and symptoms are accompanied by a fever above 38 degrees C.

Most often, patients complain of:

• abdominal pain (usually on the right side, at hip level, which is often mistaken for appendicitis)
• flatulence
• weight loss
• weakness and feverish conditions
• perianal abscesses
• anal fissures

Moreover, in the course of the disease, fistulas between the intestine and the skin or the urinary bladder or vagina develop in women.

Inflammation can also occur in other parts of the body - such as:

• skin complications (erythema nodosum)
• arthritis
• iritis
• pericarditis
• myocarditis
• vasculitis, thromboembolic changes

According to the 2018 Study of Patients with Inflammatory Bowel Disease (IBD), many patients also have comorbidities as a result of immune system disorders or medications, especially glucocorticoids and immunosuppressants.

A survey conducted in 2018 among patients with inflammatory bowel diseases showed that they are often accompanied by, among others:

• peptic ulcer disease / reflux in 18% of patients
• hypothyroidism or hyperthyroidism in 13%
• chronic kidney disease in 8%
• 8% of asthma or COPD
• arterial hypertension in 7%

Crohn's disease: diagnosis

The diagnosis is made on the basis of an interview with the patient, after a series of tests, including:

• blood tests - ESR and CRP
• endoscopic examinations - gastroscopy and / or colonoscopy, during which a biopsy of the intestine is performed, and the taken sample is assessed
• abdominal x-ray with contrast
• abdominal tomography
• abdominal ultrasound
• magnetic resonance imaging

Crohn's disease: treatment

Since Crohn's disease is an incurable disease, the aim of the therapeutic process is to prevent further relapses and progression of the disease, which may involve subsequent sections of the gastrointestinal tract, lead to a full-walled inflammatory infiltrate and the development of intestinal and parenteral complications.

As a result of numerous complications arising from improper treatment, patients have to face the necessity of, among others, parenteral or enteral nutrition (through a tube inserted into the stomach through the nose) and a significant disability in everyday functioning, they are also exposed to a greater risk of disease, for example: for colon cancer and many other diseases.

According to a study by Swedish scientists, Leśniowski's disease is associated with more than a twofold increase in mortality compared to healthy people, especially when it begins before the age of 18.

In acute conditions, antibiotics are used, although they do not cure the disease themselves, but only single symptoms. In addition, anti-inflammatory drugs, immunosuppressants that reduce immunity and biological drugs are also used - effective, but unfortunately expensive.

There are also many natural methods that you can use alone to relieve symptoms on a daily basis - such as a proper diet and dietary supplements.

• increase the population of beneficial bacteria in the digestive tract - take probiotics that help them grow, probiotics help maintain the right conditions for good bacteria to live
• choose foods with a mild taste and semi-fluid texture - for example, boiled carrots, white rice, stewed apples, if you already suffer from diarrhea and stomach ache, eating spicy foods and spicy spices will only make matters worse
• eat less fat - fried foods, fatty meat and other fatty foods can cause intestinal cramps, resulting in more diarrhea
• eat less fiber when your disease gets worse - foods high in fiber are very good for your digestive tract, but if you have Crohn's disease, fiber can cause painful gas
• patients with this disease often do not digest lactose, the sugar that is an ingredient of dairy products, so when you have gas and distension, avoid milk and milk products for a few days, if the symptoms improve - you can assume that you suffer from lactose intolerance
• take supplements that contain a multivitamin and mineral salts - this treatment will help fill the losses caused by prolonged diarrhea

Worth knowing

In the past, people suffering from Crohn's disease were advised to eat ... onion skins. Contemporary researches confirm this method. Onion skins contain quercetin, a natural antihistamine that helps block or alleviate allergic reactions to certain foods common with this disease. When you are cooking the soup - add the whole onion to the water without peeling it. The quercetin will boil off and find it in the soup. If you don't like onions - you can buy quercetin capsules (available at the pharmacy without a prescription).