Causes Crohn’s disease

The cause of Crohn’s disease has not yet been clearly clarified.Several factors are discussed: The occurring improvement under Corticoiden (Cortison) speaks for an immunological, i.e. from the defense system of the body outgoing, genesis, as one finds it with all illnesses from the rheumatic form circle. Corticoids suppress the body’s own defense system (immunosuppression). In some patients an improvement can also be observed when certain foods are avoided. Possibly allergies play a role here.

Family disposition
Genetic causes
Infectious causes or
Immunological causes.

Complaints/symptoms

The symptoms of Crohn’s disease depend on the different stages and manifestations. They are determined by the location, extent and activity of the inflammatory process. The effects on neighbouring organs may also play a role.

The disease progresses intermittently and manifests itself mainly through abdominal pain, flatulence and diarrhea, which can rarely be bloody. Nausea, vomiting and fever also occur frequently. As a consequence, weight loss, especially during a relapse, is usually associated with a strong feeling of illness, fatigue and possibly a greatly reduced general condition.

In terms of symptoms, Crohn’s disease often cannot be clearly distinguished from ulcerative colitis. Appendicitis can also be confused with appendicitis. In addition to the symptoms directly related to the bowel, there are also so-called extraintestinal manifestations – i.e. symptoms independent of the digestive tract.

This is why some patients experience joint inflammation and pain at an early stage, mainly in the large joints of the arms and legs, the spinal joints and the sacroiliac-iliac joint. Often these symptoms persist even during the periods when the patient is not suffering from relapses, but then more frequently in the small joints of fingers and toes. Inflammations of the cornea or iris of the eye (these manifest themselves as redness and pain), of the mouth (in the form of painful aphtae).

On the skin, rashes such as erythema nodosum or pyoderma gangraenosum may occur, gallstones may form and liver changes may occur. In Crohn’s disease, pain occurs mainly during relapses, but in about one-fifth of patients, pain also occurs in the relapse-free period. The most common form of pain is abdominal pain in the right lower abdomen.

The type of pain varies from patient to patient. In addition, there is pain due to inflammation outside the intestine (see above). Painkillers can help, but they should only be taken in consultation with the treating physician, as some common and freely available painkillers can trigger or aggravate relapses (e.g. ibuprofen)!

Diarrhea is the most common symptom of Crohn’s disease. Similar to pain, it can occur both during and outside of an episode. The high fluid and nutrient loss can weaken the affected person within a very short time, which is why it is essential to ensure a sufficient fluid intake.

Due to the loss of nutrients, food should continue to be consumed. Easily digestible foods with little fat and low fiber are recommended. If the diarrhea persists, the stool should be thickened with so-called anti-diarrhoeal agents (e.g. loperamide) in consultation with the treating physician.

In addition, swelling substances such as psyllium husks are available, which have a “water-absorbing” effect in the intestine and thus thicken the stool. Less frequently than diarrhea, constipation can also occur. Here too, the consistency of the stool should be adjusted by the diet (high-fiber diet, plenty of fluids); laxatives or swelling agents can be used as prescribed by a doctor.

The disease manifests itself on the skin primarily through inflammation of the subcutaneous fatty tissue, especially on the knee, lower leg and ankle. These lead to the formation of several, reddish to greenish and extremely painful nodules (so-called erythema nodosum). More rarely, extremely painful, extensive ulcerations with subsequent death of the affected skin may occur (Pyoderma gangraenosum).

These require rapid professional treatment in order to keep tissue damage to a minimum. Crohn’s disease manifests itself in children through the same symptoms as in adults, i.e. primarily through abdominal pain, diarrhea and weight loss. Often only some of these symptoms are found.In addition, the chronic inflammation in children leads to growth retardation or even complete growth retardation, which may be the only symptom of the disease.

Early diagnosis and treatment is therefore very important in children to ensure normal growth. Those affected have an increased risk of developing depression. This is partly due to the fact that symptoms such as severe diarrhea or constant pain make it difficult to participate in social life and lead to loneliness.

Also, because of the reduced general condition, less sport is done and patients generally feel less desire to be socially or physically active and therefore tend to withdraw more often. Depression or anxiety in turn has an unfavorable effect on the course of the disease and can cause new relapses – a vicious circle from which those affected should break out with professional help if necessary. Blood in the stool, usually either mixed with the stool or “lying on top”, is less common in Crohn’s disease than in ulcerative colitis.

The blood suggests an active inflammatory process in the bowel, which damages the mucous membrane or even deeper layers of the bowel wall. If there is blood in the stool, a physician should always be consulted, also in order to exclude other serious illnesses that are revealed by blood in the stool. or blood in the stool – these are the causes!

Decisive are above all ultrasound (sonography) and colonoscopy (colo-ileoscopy). Ultrasound can detect thickening of the intestinal wall, intestinal dilatation before possible narrowing, as well as fistulas. During a colonoscopy, the so-called cobblestone relief of the intestinal mucosa is noticeable.

Complications such as fistulas (explanation see below), ulcers (mucous membrane ulcers) or stenoses (constrictions due to scarring) can also be visualized. The laboratory values give the following results in the context of the signs of inflammation: Since the intestinal function is disturbed in Crohn’s disease, vital vitamins and trace elements can be poorly absorbed. The following constellations would be conceivable: To exclude a pathogen-induced intestinal inflammation, stool samples are also examined for germs.

In some cases, an MRI is also performed using the Sellink technique. This is an MRI of the abdomen with a contrast medium, which can make inflammatory changes in the intestinal mucosa visible.

BSG – acceleration (blood sedimentation rate increased)
Increase of CRP (C- reactive protein; inflammation parameter: the higher the value, the stronger the inflammation; however, it does not indicate the type of inflammation)
As well as an increased number of leukocytes and thrombocytes (white blood cells and platelets).
Vitamin- B12 reduced
Calcium reduced
Magnesium lowered
Iron humiliated
Vitamin A and D reduced