What is Crohn’s disease?

  Crohn’s disease is an inflammatory disease of the intestine of unknown origin that can occur anywhere in the gastrointestinal tract, but is more prevalent in the terminal ileum and right hemicolectum. The disease and chronic nonspecific ulcerative colitis are collectively referred to as inflammatory bowel disease (IBD). The clinical manifestations of the disease are abdominal pain, diarrhea, and intestinal obstruction, accompanied by fever, nutritional disorders, and other extraintestinal manifestations. The course of the disease is prolonged, recurrent and not easily curable. The disease is also known as limited enteritis, limited ileitis, segmental enteritis and granulomatous enteritis.  There is no cure, and many patients develop complications that require surgery, and the recurrence rate after surgery is high. The recurrence rate of the disease is related to the extent of the lesion, the strength of the disease invasion, the prolongation of the disease, and the increase in age, with a consequent increase in mortality.  The etiology of the disease is unknown and may be related to infection, genetics, humoral immunity and cellular immunity. Crohn’s disease is a proliferative lesion that penetrates all layers of the intestinal wall, invading the mesentery and local lymph nodes, and is confined to the small intestine (mainly the terminal ileum) and the colon, or both, often the ileum and the right hemicolectum. The lesions are segmental in distribution, with clear boundaries between normal intestinal segments, and are characterized by a skip area. The pathological changes are divided into acute inflammatory phase, ulcer formation phase, stricture phase, and fistula formation phase (perforation phase). The acute phase is characterized by edema and inflammation of the intestinal wall; the chronic phase is characterized by thickening and stiffening of the intestinal wall and a tubular shape of the affected intestine with dilatation of the upper part of the intestine.  There is no specific treatment for this disease. In the absence of complications, supportive therapy and symptomatic treatment are important to relieve the symptoms. Bed rest and a high nutrition, low residue diet are recommended during the active phase. In severe cases, temporary fasting, correction of water, electrolyte and acid-base balance disorders, and enteral or parenteral nutrition support are recommended. For anemia, vitamin B12, folic acid or blood transfusion may be used. For hypoproteinemia, albumin or plasma can be transfused. Drugs such as salicylic acid azo-sulfapyridine, adrenocorticosteroids or 6-mercaptopurine are effective in controlling symptoms during the active phase. Antispasmodic, analgesic, antidiarrheal and control of secondary infections also help in symptom relief. Supplementation of multivitamins and minerals can promote the synthesis of enzymes and proteins in the body, and also have a protective effect on cell membranes.