Crohn's Dse

CROHN’S DISEASE

HOW IS CROHN’S DISEASE DIAGNOSED? (test and diagnosis)

Laboratory Blood Test  Laboratory blood tests may show elevated white cell

counts and sedimentation rates.  Other blood tests may show low red blood cell counts, low blood proteins, and low body minerals

Barium X-rays  Barium x-ray studies can be used to define the

distribution, nature, and severity of the disease.  Barium x-rays can show ulcerations, narrowing, and, sometimes, fistulae of the bowel.

Colonoscopy  Direct visualization of the rectum and the large

intestine, accomplished with a flexible viewing tubes (colonoscopes).

CT scan

 Computerized axial tomography

(CAT or CT) scanning is a computerized x-ray technique that allows imaging of the entire abdomen and pelvis.

Endoscopy  Video

capsule endoscopy, a capsule containing a miniature video camera is swallowed. The value of video capsule endoscopy is that it can identify the early, mild abnormalities of Crohn's disease.

Biopsy  The doctor takes a sample of tissue and tests it to

find out if there is Crohn’s or another disease, such as cancer.

Stool analysis  This is a test to look for blood and signs of infection in

a sample of the stool.

CROHN’S DISEASE

HOW IS CROHN’S DISEASE TREATED?

Treatment  The treatment will depend on the type of symptoms 

• • • •

and severity of the disease. Medicines usually are the treatment of choice for Crohn's disease. They can control or prevent inflammation in the intestines and help: Relieve symptoms. Promote healing of damaged tissues. Put the disease into remission and keep it from flaring up again. Postpone the need for surgery.

Medications for treating Crohn's disease includes: 2) Antiinflammatory agents such as Sulfasalizine (Azulfidine), Mesalamine (Asacol, Rowasa), Corticosteroids 3) Immuno-modulators such as Azathioprine (Imuran) and mercaptopurine (Purinethol), Infliximab (Remicade), Adalimumab (Humira), Certolizumab pegol (Cimzin), Methotrexate (Rheumatrex), Cyclosporine (Neoral, Sandimmune), Natalizumab (Tysabril) 4) Antiobiotics such as Metronidazole (Flagyl), Ciprofloxacin (Cipro) 

Cont… 4) Other Medications      

Anti-diarrheals Laxatives Pain relievers Iron supplements Vitamin B12 shots Calcium and Vitamin D supplements

CROHN’S DISEASE

SURGERY

 Surgery may be needed if there is:

• Bowel blockage (obstruction). • Abscesses or tears (fissures) in the anal area or when abnormal connections (fistulas) form between two parts of the intestine or between the intestine and other internal organs. • Holes (perforations) in the large intestine. • Cancer or precancerous tissue. • Severe disease that does not respond to other treatment. • Severe bleeding that requires ongoing blood transfusions.

Surgery choices:  Resection  Proctocolectomy and ileostomy  Strictureplasty

CROHN’S DISEASE

LIFESTYLE CHANGES

        

Dietary changes Low fiber diet Low fat diet High calorie diet High protein diet Bland diet Liquid diet and TPN (total peripheral nutrition)* Drink plenty of liquids Small meals

 Smoking cessation and exercising regularly

fin

TNF antagonists  Tumor necrosis factor (TNF) antagonists, may

be used for people who develop abnormal connections between the intestines and other organs (fistulas) or who have severe Crohn's disease that does not respond to other medicines. These medicines can be used to keep symptoms from coming back.