Болезнь Крона – это хроническое рецидивирующее
a disease of unknown etiology characterized by granulomatous
inflammation with segmental lesions of different parts
digestive tract. В отличие от язвенного колита,
in Crohn’s disease, all layers of the intestinal wall are involved in
inflammatory process. Inflammation in most cases first
occurs in the ileum, and then moves to other departments
More about what the disease is, what the symptoms are,
and also treatment methods, we will consider in this article.
What is Crohn’s disease?
Болезнь Крона – это тяжелое хроническое воспалительное
заболевание intestine. Progression leads to defeat
deeper layers, leading to increased pain and
increase in body depletion, sometimes ending in development
serious complications that threaten the patient’s life.
Absolutely any departments of the gastrointestinal tract are involved in the inflammatory process.
from the anal orifice to the oral cavity, however the most
defeat of the colon (rectal or colon) is often noted
and / or end portion of the small (ileum) intestine.
Systemic manifestations include fever, weight loss,
damage to the musculoskeletal system (arthropathy, sacroiliitis),
eye (episcleritis, uveitis), skin (erythema nodosum, gangrenous
- The disease is chronic, with alternating acute
seizures and remissions. The first signs of illness (first attack), like
usually occur at a young age – in individuals 15 – 35 years.
- Genetic susceptibility of Crohn’s disease – if
relatives of the direct line suffer from this disease, the risk of developing
it increases 10 times.
- Women are less susceptible to similar diseases. it скорее связано
with features of nutrition and lifestyle.
- According to ICD 10 has the code K90.
Currently, the disease is considered incurable, the goal of treatment
Crohn’s disease – keeping the intestines in a long state
remission and relief of symptoms during exacerbation, as well as
prevention of complications.
So far, there is no exact answer that causes the development of the disease.
In some cases, acute Crohn’s disease may be mistaken
for inflammation of appendicitis or ulcerative colitis.
There are the following possible causes of the development of pathology:
- Hereditary predisposition. It is known that people with
Crohn’s disease often relatives suffer from chronic
inflammatory bowel disease, for example, colitis;
- In addition, an important role is played by immune disorders.
system. The fact is that autoimmune processes, accompanied by
the production of antibodies acting against their own tissues affected
areas (intestines), as well as insufficiently effective protective
function on the part of the immune system – all this serves as a serious
The background for the emergence and development of Crohn’s disease.
- The damaging effects of external factors: unhealthy food,
bad habits, poor lifestyle, infection.
Predisposing factors for the development of the disease are:
- Transferred viral infection (measles);
- food allergies;
- stress and mental strain;
- genetic predisposition.
It is noted that Crohn’s disease occurs with the same frequency in
of both sexes, and the prevalence is 50-95
people per 100 000 population.
The disease tends to spread the process to
healthy intestines. It proceeds with aggravations and incomplete remissions.
Among patients in remission, approximately 30% of patients in
Acute exacerbation and about 50% of patients
suffer exacerbation for 2 years. Gradual remission
become short and the symptoms during exacerbation
Symptoms болезни Крона
Inflammation spreads to different departments in different people.
intestines: in some (80%) only the final lesion is noted
segment of the small intestine (ileum), in others (about
20%) очаг располагается в прямой кишке (отдел толстого intestine).
it наиболее распространенные участки развития болезни Крона.
- The main local manifestations of the disease are abdominal pain,
diarrhea with blood in feces.
- Abdominal pain can be non-intense, cramping
character with a feeling of heaviness and bloating. Often the pain is localized in
right lower quadrant of the abdomen, sometimes they can not be distinguished from
those with appendicitis.
- Liquid stools mixed with blood are a constant symptom, its frequency
varies from 3 to 10 times a day. After stool abdominal pain
- In Crohn’s disease, appetite is often reduced, but even if it does not
changed, still losing weight, and often quite
Symptoms of Crohn’s disease by forms:
- Spicy The disease has a bright beginning: diarrhea (diarrhea), growing
body temperature, pain appears in the lower right abdominal segment.
These symptoms are often mistaken for appendicitis,
апоплексии яичника, что приводит к operations. Diagnostic error
found during the operation.
- Subacute. The depletion of the patient develops (decreases rapidly
weight), there is unexpressed diarrhea, any pain
The disease is also characterized by extra-intestinal manifestations, which
determined by specific immunological disorders. To such
manifestations in particular include:
- sacroiliitis – inflammation in the sacroiliac
articulation, accompanied by severe pains, concentrated
in the area of the sacrum;
- arthropathy – in this case it is about asymmetrical
lesions affecting large types of joints, which, in its
turn, leads to the appearance of pain with forced
limited mobility of the patient;
- skin rash (in particular, pyoderma gangrenosum,
- the appearance of ulcers in the oral cavity;
- drop in vision;
- gallstone disease, kidney disease;
- arthrosis, arthritis;
- inflammation in the mucous membranes of the mouth, eyes and
With a long course, formation of abscesses in the wall is possible.
intestines and fistulous passages into the abdominal cavity, to adjacent organs
(мочевой пузырь, влагалище), на поверхность кожи (в районе
anus). The acute phase of the disease is usually accompanied by
fever, general weakness.
During periods of exacerbation, the symptoms of Crohn’s disease are most
expressed. Patients complain of cramping strong enough
боли в животе, пять-шесть раз в сутки наблюдается понос,
due to digestive disorders, the patient loses a lot of weight
Crohn’s disease is dangerous not only for its unpleasant manifestations,
but also the hardest complications that can be eliminated only
surgically. These include:
- Perforation of the intestinal wall, with the addition of peritonitis
- Intestinal obstruction
- Heavy bleeding
- External and internal fistula, ulcers
- Inflammatory infiltrates and strictures (narrowing of the lumen)
- Risk of adenocarcinoma
- Мокнущие трещины и мацерации прямой guts
- Foci of abscess
Disability in Crohn’s disease can only be put in
some cases. The basis for this pathology is
The following conditions:
- complications occurred;
- disability due to pathology;
- the disease is severe, even with treatment;
- Can’t find a therapy.
Primary diagnosis consists of:
- history taking (symptoms, age, seasonality
exacerbations, family diseases, the presence of other pathologies, etc.
- visual examination of the patient (palpation of the abdominal cavity, inspection
skin and mucous membranes, probing lymph nodes,
например, на шее и т. e.);
During the diagnostic studies, the doctor should
exclude diseases that are similar in symptoms to Crohn’s disease.
So, it is necessary to differentiate diseases such as
irritable bowel, acute appendicitis, ischemic and ulcerative
The patient is directed to undergo the following examination:
- Endoscopic examination is required. it
research is necessary both for visual confirmation of the diagnosis,
and for taking a biopsy (piece of tissue) for research under
a microscope. And it is made in various parts of the digestive system.
- Colonoscopy. Allows you to get the most complete picture
состояния толстого intestine. It helps to detect the presence of ulcers
formations, foci of inflammation and bleeding. Probing thick
guts позволяет исследовать её полностью – от слепой guts до
- Ультразвуковое исследование органов брюшной полости
allows you to estimate the diameter of the intestinal loops, the presence of free
fluid in the abdominal cavity that helps in the diagnosis of complications
(перфорация стенки guts с развитием перитонита).
- Roentgenoscopy. The implementation of the techniques is carried out in conjunction with
using a contrast agent, on the basis of which there is
the ability to detect areas of constriction, granulomas and other types
новообразований в области тонкого intestine.
- Laboratory research methods. Conduct general and
biochemical analyzes of blood, urine, stool analysis, and
detailed immunological blood test.
Treatment of Crohn’s disease in adults
Main методы лечения при болезни Крона должны быть направлены
to reduce the inflammatory process, stabilization
patient and the prevention of complications. Drugs
selected individually, their effectiveness and tolerability
patient is evaluated in dynamics.
Терапия зависит прежде всего от тяжести заболевания.
Estimate it for any one indicator is impossible, it is necessary
учитывать характер поражения желудочно-кишечного tract, системные
manifestations, the presence of exhaustion and general condition.
The treatment plan includes:
- diet, right nutrition;
It is extremely important to the patient, regardless of the stage of progression
disease, to observe physical and mental peace. In many ways it is
the final result depends on the patient’s emotional background
The goal of drug therapy for Crohn’s disease is to
- relieve the symptoms (so that the disease has passed into the stage
- prevent disease outbreaks (support remission). Main
drugs used for this: Azathioprine, Methotrexate,
Infliximab and Adalimumab.
If the patient has experienced the disease at a later stage,
complex treatment is used:
- immunosuppressants (suppress the protective mechanisms of the immune
systems that attack the gut; may cause malfunctions
brain and other problems);
- There is a group of drugs that have anti-inflammatory
action designed specifically to treat Crohn’s disease
(Sulfasalazine, Mesalazine, Pentas). Drug dosage
appointed only by a doctor depending on the severity
disease, patient age and stage of the disease.
- hormonal drugs;
- antibacterial drugs (in rare cases);
- leukotriene receptor antagonists (reduce the activity
- homeopathy (some doctors consider homeopathy
- articular syndromes can be further treated by injection
GCS joints (contraindications – gold preparations);
Drug therapy for Crohn’s disease is considered successful if
she can push the disease into remission and keep it in
without causing significant side effects.
The positive effect of surgical treatment for Crohn’s disease
usually has a temporary nature. The disease often recurs,
causing inflammation in the vicinity of the previous focus. The best tactic is
continue supportive drug therapy after
Surgical treatment is indicated for:
- развитии свищей и абсцессов (вскрытие абсцессов и их
санация, ликвидация свищей);
- the development of deep wall defects with long abundant
bleeding or intractable conservative therapy severe
течение заболевания (резекция пораженного участка
In combination with drug therapy, doctors pay a lot
attention to a special diet that is very important to reduce
mechanical, thermal and chemical irritation of the intestine.
Diet при болезни Крона не очень строгая, главное в ней — бережное
relation to the intestines.
Recommendations during meals:
- Eating should be at least 5 times a day;
- Proteins per day – up to 150 g, fats – 70-80 g, carbohydrates – 250
- Energy value – about 2100 kcal;
- Salts – no more than 8 g per day;
- Need to eat more foods containing potassium and
- Fluids – 1.7-2 liters per day;
- Cooked food should be by roasting, boiling, on
The diet of the patient should consist of such products:
- stale wheat bread;
- poultry skinless, lean grades of rabbit meat, veal,
- lean fish;
- scrambled eggs;
- vegetables pilaf;
- porridge on the water;
- dry biscuit.
Food processing must be done by means of a steam bath,
it should be boiled or stewed.
|Allowed products for Crohn’s disease||Prohibited Products|
But a diet with exacerbation of Crohn’s disease is a prophylactic
fasting, which lasts for 1-2 days. Patient allowed
only consume liquid in volumes from 1.7 to 2 liters per day.
When exacerbating the diet includes:
- liquid and pureed porridge (rice, semolina) on water, because
milk and broths are excluded.
- Convenient to use cereals for baby food, but they need
dilute with water.
- It should be borne in mind that buckwheat porridge enhances motility, therefore
during the exacerbation period is not recommended.
|For the night||
Before using any folk remedies during Crohn’s disease,
consult with a gastroenterologist.
- It should be regularly added to dietary meals seed oil
flax or pumpkin that will support the immune system and beneficially
will affect the digestive processes.
- 40 g of ground seeds of cumin insist in a thermos, 400 ml of water, with
initial temperature of 70-80⁰С. Drink 60-80 ml, before meals.
- Rosehip oil is prepared at home and drunk around the dining room
spoon according to the scheme: an hour before breakfast, 30 minutes before lunch and after 2
hours after dinner. It is necessary to take fragmented fruits (full liter
jar) and pour 1.5 liters of olive oil. Insist 2 weeks in
Due to the uncertainty of the etiology of Crohn’s disease, it is clear to warn
disease is possible. That is why all preventive
activities are reduced to the timely detection of problems and
Methods of secondary prevention:
- отказ от курения и злоупотребления alcoholными напитками;
- limiting physical and emotional stress;
- strict adherence to the recommended diet;
- observance of the optimal work and rest schedule;
- prevention of exacerbations and progression of disease symptoms
- taking medications only on prescription;
- a gastroenterologist examination at least once
Compliance with all the recommendations of a doctor, a healthy lifestyle and
proper nutrition will help reduce the aggravation.
Prediction for life
The prognosis for adults with proper treatment is good. Question,
how many live with Crohn’s disease, interests all patients, but
the initial stage does not affect life expectancy. When late
Diagnosis can be difficult.
The doctor must constantly monitor the patient’s condition and on time.
prescribe a survey aimed at identifying complications. it
helps improve forecasts.
It is worth noting that the quality and durability will be
influence several factors:
- the time of the first symptoms and the start of treatment;
- frequency of exacerbations;
- the body’s response to treatment and its susceptibility;
- level of human responsibility for their health and
recommendations of doctors.
Watch your lifestyle, eat right and avoid
stressful situations. We wish you good health, thank you for