(Brief Summary, more details on following pages)
CD is a disorder of the gastro-intestinal (GI) tract. It can affect any portion of the GI tract — from the lips to the anus. Most often, it affects the region where the small intestine changes into the large intestine.Patches of inflammation appear, extending through every layer of affected bowel tissue
Common Symptoms :
Fatigue,
Loss of appetite,
Abdominal cramps,
Diarrhea and weight loss.
Nausea
Pain
Joint Problems
Bleeding
Fistulas
Periods of “flare-ups” alternate with “remissions” that can last anywhere from weeks to years. Most people will “relapse” and have multiple attacks. The severity of IBD symptoms will also vary from one person to another. Some people have mild symptoms and can be treated with a combination of drugs and nutritional therapy, while others experience debilitating symptoms and need to take potent drugs, visit hospital frequently, and/or have surgery.
In addition, some patients may experience nausea, vomiting or bloating. Others may develop abscesses or draining skin openings in the area around the anus, so-called “perianal disease”. Unexplained fevers, pain or swelling of the joints and anemia can also occur. Children with Crohn’s disease may grow more slowly than their peers, and puberty may start late, but most will eventually catch up.
The symptoms and possible complications will vary, depending on the part of the intestinal tract that is inflamed. Because of this, it is very important for you to know which part of your intestine is affected by the disease
What CD do you Have
Gastroduodenal Crohn’s Disease – Affects the stomach and duodenum (the first part of the small intestine).
Symptoms/Complications: Pain in the upper middle part of the abdomen may occur infrequently; significant weight loss; loss of appetite; nausea. Vomiting may indicate that strictures (narrowed segments of bowel) are obstructed. Typically identified as “ulcer disease” and usually diagnosed only after ulcer treatments fail.
Jejunoileitis — Patchy areas of inflammation in the jejunum (upper half of the small intestine).
Symptoms/Complications: Abominal pain and cramps after meals (pain can range from mild to intense, depending on disease severity). Fistulas (abnormal channels between two loops of intestine, or between the intestine and other organs) may form. Diarrhea and malabsorption may lead to weight loss and malnutrition.
Ileitis — Affects the ileum (the lower part of the small intestine).
Symptoms/Complications: Diarrhea; cramping or pain in the right lower part or middle of the abdomen, often after meals (intensity varies according to disease severity); iron and/or vitamin B-12 deficiency; obstruction; fistulas; inflammatory mass or abscess in the right lower quadrant of the abdomen.
Ileocolitis – The most common form of Crohn’s, affecting the ileum and colon.
Symptoms/Complications: Same as ileitis; significant weight loss also is common.
Crohn’s (Granulomatous) Colitis – Affects the colon only.
Symptoms/Complications: Diarrhea; rectal bleeding; disease around the anus (e.g., abscess, fistulas, ulcers). Some extraintestinal complications (e.g., skin lesions, joint pains) are more common in this type of IBD.
The genetics of inflammatory bowel disease
(In brief)
| Bonen DK, Cho JH.
The Martin Boyer Laboratories, Gastroenterology Section, Department of Medicine, University of Chicago Hospitals, Chicago, Illinois.
The inflammatory bowel diseases (IBD) comprise complex genetic disorders, with multiple contributing genes.
Linkage studies have implicated several genomic regions as likely containing IBD susceptibility genes, with some observed uniquely in Crohn’s disease (CD) or ulcerative colitis (UC), and others common to both disorders.
The best replicated linkage region, IBD1, on chromosome 16q contains the CD susceptibility gene, NOD2/CARD15. NOD2/CARD15 is expressed in peripheral blood monocytes and is structurally related to the plant R proteins, which mediate host resistance to microbial pathogens.
Three major coding region polymorphisms within NOD2/CARD15 have been highly associated with CD among patients of European descent. Having one copy of the risk alleles confers a 2-4-fold risk for developing CD, whereas double-dose carriage increases the risk 20-40-fold.
All 3 major CD variants exhibit a deficit in NF-kappaB activation in response to bacterial components. Carriage of NOD2/CARD15 risk alleles is associated with ileal location, earlier disease onset, and stricturing phenotype.
Other IBD genomic regions include IBD2 on chromosome 12q (observed more in UC), and IBD3, containing the major histocompatibility complex region. A short genomic region has been associated with CD on chromosome 5q, but the precise contributing gene is as yet unidentified.
The characterization of additional IBD susceptibility genes could potentially lead to the identification of novel therapeutic agents for IBD, make possible a molecular reclassification of disease, and increase understanding of the contribution of environmental factors (notably, tobacco and the intestinal microbial milieu) to intestinal inflammation.
PMID: 12557156 [PubMed - in process] |
Last Modified – April 2005
