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Crohn's Disease

Crohn's Disease (CD) is a condition where the underlying problem is inflammation of the intestines. In CD, the inflammation can occur in any part of the gastrointestinal (GI) tract, between the mouth and the anus. The most common places are the last portion of the small intestine (the terminal ileum) and the first part of the large intestine (the cecum).

A second major feature of CD is that the inflammation may involve the whole wall of the intestines (transmural inflammation). The severity of the inflammation can vary from tiny ulcers to large, deep and destructive ulcers. Most of the time, the ulcers are small and heal easily with medication.

Sometimes, though, a deep ulcer forms a hole in the intestine which leads to an abdominal infection called an abscess. The abdominal abscess occurs because a hole in the intestine allows intestinal fluid to leak into the abdomen. Inflammation in CD can also cause an area of the bowel to be narrowed (strictured) and much like blocking a hose, there is back-up leading to cramping, even vomiting.

As with subtypes of IBD, CD is characterized by active periods (flares) and quiet periods (remissions). The symptoms of CD are largely related to the area of the bowel involved. As the most common area is the end of the small intestines and start of the large bowel, symptoms for most will be belly pain, fatigue, weight loss, poor height gain but without rectal bleeding.

The second most common site of involvement is the colon. People with this area involved are more likely to have pain across the lower abdomen associated with blood and mucus after having a bowel motion. There may be other organs involved outside of the gut such as the eye, the bones, the joints, the skin and the liver being among the various possibilities.

The primary treatment for CD is medical rather than surgical. The medical treatment involves medications and nutrition regimens. Exactly what is suggested by doctors will be based on a number of issues including the severity of the disease, the locations of the disease, the age of the patient and any complications that may be present. The key to successful treatment lies with eliminating the bowel inflammation. The common aim of the physician, parent and patient is to keep flares as short as possible and remission as long as possible.

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