Crohn’s Disease: Diagnosis Difficult, Treatment Worse?

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ORLANDO, Fla. (Ivanhoe Newswire) — Crohn’s disease is a chronic inflammatory bowel disease of the digestive, or, GI tract. It causes inflammation, which can lead to abdominal pain, severe diarrhea, weight loss and fatigue. It is often misdiagnosed for ulcerative colitis, or, IBS. Discover fact from fiction when it comes to diagnosing Crohn’s disease.

Crohn’s can attack anywhere in the GI tract. Symptoms can also affect the eyes, skin and joints.

David Suskind, MD, Director of Clinical Gastroenterology at the Seattle Children’s Hospital said, “There are a lot of other symptoms that can be associated with Crohn’s as well including joint pain, current oral ulcers, skin tags.”

With such a wide possible area Crohn’s can affect, it’s difficult for doctors to diagnose it correctly. In a recent survey of people with inflammatory bowel disease, one in ten Crohn’s patients said they were misdiagnosed with ulcerative colitis.

Also, there’s not just one test to diagnose the condition. Patients are likely to go through multiple tests and procedures, such as blood tests, fecal tests, x-rays, even a colonoscopy to get a definitive diagnosis. There is also no known cause for Crohn’s.

To get a quick and clear diagnosis, rule out any other health problems that can have similar issues, gather information about your family history to see if any blood relative may have had the condition and have doctors determine which part of the GI tract is affected. The earlier the diagnosis, the quicker you can start treatment to relieve symptoms.

There is no cure for Crohn’s disease. There are medications to relieve symptoms and maintain remission. Surgery is also another option, but the relief may be temporary.

Contributors to this news report include: Milvionne Chery, Producer; Roque Correa, Editor. 

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CROHN’S DISEASE: DIAGNOSIS DIFFICULT, TREATMENT WORSE?
REPORT #2490

BACKGROUND: Crohn’s disease is a type of inflammatory bowel disease (IBD) in which an abnormal immune system response causes chronic inflammation in the digestive tract. Crohn’s is often confused with ulcerative colitis, a similar IBD that only affects the large intestine. According to the Crohn’s & Colitis Foundation of America, about 1.4 million Americans have Crohn’s disease or ulcerative colitis, and of those about 700,000 have Crohn’s. Anyone can develop Crohn’s or ulcerative colitis. However, IBDs are usually diagnosed in young adults between the ages of 15 and 30. Boys develop IBDs at a slightly higher rate than girls. With Crohn’s disease, the immune system mistakenly attacks healthy bacteria in the GI tract. Chronic inflammation causes thickening of the intestinal wall, which triggers the symptoms. The exact reason this occurs is not clear, but there is a hereditary factor. Research shows between 5 and 20 percent of people who have an IBD, have a relative with this disease. The risk is even higher of being diagnosed with Crohn’s when both parents are affected.

(Source: https://www.healthline.com/health/crohns-disease/facts-statistics-infographic#2)

LIVING WITH CROHN’S: People with Crohn’s disease can experience periods of severe symptoms followed by periods of remission that can last for weeks or years. The symptoms of Crohn’s disease depend on where the disease occurs in the bowel and its severity. Some general symptoms include chronic diarrhea (often bloody and containing mucus), weight loss, fever, abdominal pain and tenderness, or feeling of a mass or fullness in the abdomen. A variety of treatment options may be able to lessen the severity and frequency of the symptoms. Changes to diet and lifestyle may help reduce the recurrence of symptoms and lessen their severity. Food doesn’t cause Crohn’s disease, but it can trigger disease flares. Once you have a definitive diagnosis, your doctor will likely suggest that you make an appointment with a registered dietitian who will guide you through the process of understanding how food affects the symptoms. More than four classes of medication are used to treat Crohn’s disease. However, if less invasive treatments and lifestyle changes don’t alter or improve the symptoms, surgery may be necessary. During surgery, your doctor will remove damaged portions of your digestive tract and reconnect the healthy sections.

(Source: https://www.webmd.com/ibd-crohns-disease/crohns-disease/digestive-diseases-crohns-disease#1 and https://www.healthline.com/health/crohns-disease#treatment)

CURRENT RESEARCH: Patients with moderate to severe Crohn’s disease showed significant improvement on a drug called ustekinumab, according to results published in the New England Journal of Medicine. Ustekinumab is a drug already used in the treatment of psoriasis and psoriatic arthritis. It blocks certain proteins which are known to play a role in the inflammatory response. In the study, researchers tested the drug in two trials of more than 1,300 patients with untreated Crohn’s. “The inflammatory bowel disease (IBD) program within the Digestive Health Center is actively engaged in clinical trials involving new therapies for Crohn’s disease and ulcerative colitis, with over a dozen protocols testing different mechanisms of action in a broad range of IBD patients,” said Stephen Hanauer, MD, the Clifford Joseph Barborka Professor of Medicine in the Division of Gastroenterology and Hepatology at Northwestern. This drug was approved by the FDA for moderately to severely active Crohn’s disease in September of 2017.

(Source: http://news.feinberg.northwestern.edu/2017/01/testing-a-new-treatment-for-crohns-disease/)

* For More Information, Contact:

David Suskind, MD

David.suskind@seattlechildrens.org