Crohn's Disease (Regional Enteritis): An inflammatory disease of the small intestine, regional enteritis is often considered an affliction of early middle age; but in half it's victims it starts even earlier, between the ages of 20 and 30.
It is usually non-specific , not related to any specific bacterial infection. It may attack one or many areas of the small intestine; particularly the lower end or ileum, sometimes extending to the upper part of the large bowel or colon. The inflammation appears to begin in the lymph vessels under the mucous membrane of the intestine, but soon involves all the layers of the intestinal wall with swelling, dilatation of the blood vessels and infiltration by many white blood cells, followed by many white blood followed by the development of fibrous scar tissue as the body tries to heal the lesion. These areas of inflamed intestine frequently become permanently thickened, hardened and inelastic, and the condition may later be complicated by the development shallow ulcerations in the inner lining of the intestine, the formation of abscesses due to secondary bacterial infection, or the appearance of fistulas, scarred tunnel-like openings through the tissue which may extend from one part of the intestine to another or may even open into the abdomen. Often as much as one to two feet of the lower end of the intestine is involved, and is not uncommon for multiple areas to be involved all at once.
The affliction may appear quite suddenly in an acute form or may become a chronic disease with frequent recurrences and progressively severe symptoms.
There is no single known cause that accounts for the incidence of regional enteritis, but many authorities consider it to be an excellent example of a disease in which very real physical change and damage to body tissue are closely related to physical and emotional tension, continuous worry, pressure or conflict. many Gastroenterologists regard regional enteritis as primarily a physical affliction which is merely aggravated to some degree by emotional factors; but many psychiatrists take the extreme opposite view.
In most cases symptoms include the development of cramping pain and colic I the mid-abdomen, accompanied by a change of bowel habits from the normal pattern of defecation once or twice a day to the passage of small. loose, bowel movements from three to six or seven times a day. When the disorder is acute there is often fever, sometimes quite high, with steadily increasing abdominal pain which may be felt primarily in the right lower quadrant of the abdomen and can often be confused with the acute pain of appendicitis.
In a more chronic form the pain may not be so severe, or may wax and wane, with a loss of appetite, a persisting mild fever and, presently, weight loss of some degree. In the chronic form partial obstruction may also occur periodically with milder episodes of cramping pain and vomiting which then proceed to subside, only to recur again. In many cases the onset is so gradual that the patient seeing a doctor is unable to pinpoint any specific acute episode.
Occasionally during an acute attack or an acute recurrence of chronic condition, symptoms of intestinal obstruction develop, with a sharp increase in abdominal pain and distention, followed by vomiting.
Usually the disease does not seem to bear any relationship to eating habits, and acid indigestion or peptic ulcer symptoms are absent unless a peptic ulcer is also present independently.
The doctor may suspect the diagnosis from a patient's history, but in most cases diagnosis can be established by X-ray where some barium sulfate suspension is ingested for an Upper GI series of X-rays is allowed to pass through the small intestine with hourly X-ray films checking it's progress. Diagnosis may also be made by exploratory surgery when a patient with a sudden attack comes to surgery, because the doctor cannot rule out appendicitis and cannot wait long enough for a GI Series or risk precipitation of further problems if it would be appendicitis.
Occasionally, when diarrhea is present, tincture paregoric or other anti-diarrheal medicines, except bulking agents, may be of help. Some doctors use antibiotics, even in the absence of evidence of bacterial infection, but others consider the risk of further irritation of the intestine by the drug to outweigh any possible benefits. In acute cases or acute exacerbations of chronic cases the cortisone-like hormones have also proven helpful. Any treatment program may well have to be continued for a long period of time, sometimes as much as 6 months or more.
Surgery for removal of the infected area of bowel is not always the best treatment for this condition, unless a life-threatening complication such as intestinal obstruction, perforating fistula or massive bleeding intervenes. Surgery may actually "increase" the rate of occurrence.
This can be a thoroughly disabling disease. Treatment of acute recurrences, combining medications and diet may at least render this condition tolerable, but the best overall approach to treatment when the disease is chronically disabling is with a carefully programmed diet and medication regimen. Emotional stress in your life should also be attended to.
"Maybe my doctor was right that I do have it because my last colonoscopy did reveal narrowing and hardening of my intestines, but I wouldn't accept that from him since he said there was nothing he could do for me!"
I also forgot to tell you I was put on a "Bland Diet" and so was my niece.
Hope this helps....I also have lots of other medical books. JEAN
Quote of the day: Don't walk in front of me, I may not follow. Don't walk behind me, I may not lead. "Walk beside me and be my friend."
>----- Original Message -----
From: KCarter706@aol.com
To: Multiple recipients of list ADHESIONS
Sent: Sunday, July 01, 2001 8:16 AM
Subject: Re: Karen- Crohns Disease
Jean,
The nuclear scan is for my Thyroid, that needs to get done in July.They are testing everything. I can't eat, nauseated, diarrhea, vomiting, loss of weight, almost 15 pounds now. Depression has set in, What exactly is Chron's. I have found very little information on it. I would appreciate more. I have been out of the loop for so long I need some much needed help. I I have only been able to eat soft foods for almost two weeks now. It's horrible.
Thanks Jean for the help, Love Karen
Karen Carter