Crohn’s disease

Crohn’s disease is a condition named after a doctor, who first described this and it is an inflammatory condition, particularly prevalent in certain sections of the community and has in some circumstances a genetic predisposition.It is an inflammatory reaction set up by the body’s immune system which causes inflammation in the bowel.It may involve all parts of the bowel, including the oesophagus, stomach, small bowel and colon and often will present with symptoms such as abdominal discomfort, diarrhoea, anaemia and growth issues.Patients often have mouth ulcers, and they may have problems at the bottom end as well.

Diagnosis is helped by a faeces test, called calprotectin, and also blood tests, including full blood count, ESR and CRP.If clinical suspicion dictates then the best way to make the diagnosis is by ileo-colonoscopy and upper GI endoscopy.Other tests such as wireless capsule endoscopy and abdominal MRI scan can be helpful and if the diagnosis is confirmed and the disease is widespread or confined to the small bowel and terminal ileum it is usually treated with nutritional therapy but if not then other anti-inflammatory medications such as Prednisolone and Azathioprine, which is particularly good for the colon, may be used and monitored.Nowadays, if the disease is more severe, injectable forms of anti-inflammatory medicines such as Infliximab and Adalimumab can be useful as a back up or occasionally as a first line treatment.It is not particularly common now for children to have surgery for inflammatory bowel disease, especially if Crohn’s disease, but it can be needed if medicines are not effective.Further information can be gathered at www.cicra.org.

Full assessment by Dr Thomson would occur prior to endoscopy and then the disease and its course and management would be discussed in depth and regular follow up would then ensue.

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