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Crohn's Disease

Crohn's disease:  This inflammatory disorder can affect any part of the GI tract (usually the terminal ileum), extending through all layers of the intestinal wall.  Crohn's disease may also involve regional llymph nodes and the mesentery.

The cause of Crohn's disease is not known, possible causes are; allergies, immune disorders, lymphatic obstruction, genetic factors and infections.



Symptoms:  Varies according to location and the extent of inflammation .

Acute:

Right lower quadrant pain

Cramping

Tenderness

Flatulence

Nausea

Fever

Bleeding (usuallly mild but can be massive)



Chronic:

Diarrhea (approx. 4 - 6 stools a day)

Right lower quadrant pain

Steatorrhea ( excess fat in feces)

Marked weight loss

Possible clubbing of fingers

Possible weakness

Lack of ambition

Inability to cope with everyday stress



Treatment:

Drug therapy may include:

Anti-inflammatory corticosteroids

Immunosuppressant agents such as  azathioprine

Antibacterial agents such as sulfasalazine

Opium tincture and diphenoxylate may help combat diarrhea (but are contraindicated in patients with significant intestinal obstruction)

Effective treatment requires important changes in life-style-- Physical rest, restricted fiber diet (no fruit or vegetables), and elimination of dairy products for lactose intolerance.

Surgery may be necessary to correct bowel perforation, massive hemorrhage, fistulas, or acute intestinal obstruction.

Patients with extensive disease of the large intestine and rectum may require colectomy with ileostomy

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