Crohn’s Disease: support for patients tackling a debilitating condition
During the month of May, awareness around Inflammatory Bowel Diseases (IBDs) has been heightened and pharmaceutical company AbbVie (Pty) Ltd is raising awareness around one particular IBD – Crohn’s disease. Supported by the ‘Join the Fight against Autoimmune diseases’ campaign, AbbVie (Pty) Ltd aims to raise public understanding of Crohn’s disease highlighting how sufferers courageously cope with its debilitating symptoms every day.
“Although there are no accurate statistics, the incidence of Crohn’s disease is about 7 in every 100 000 South Africans, meaning about 3 500 new cases present each year,” says gastroenterologist at Milpark Hospital in Johannesburg, Dr Herbert Schneider.
While the disease is more prevalent among adolescents and young adults between the ages of 15 and 35, it can occur at any age. Men and women are equally likely to be affected1.
What is Crohn’s Disease?
Crohn’s disease is a chronic inflammatory bowel disease that affects the small intestine and colon2.
It can affect any part of the gut, from the mouth all the way down to the anus. In the majority of cases the lower part of the small intestine – the ileum – is affected. Patients with Crohn’s disease often feel pain and the condition can make the intestines empty frequently, resulting in diarrhoea3.
“The disease has negative psychological effects too,” says Dr Schneider. “Because some patients have to go to the toilet often, they may feel anxious about travelling and going out and this can result in depression and feelings of isolation4.”
People suffering from Crohn’s also experience loss of appetite and may lose weight as a result. A feeling of low energy and fatigue is also common. Among younger children, Crohn’s may delay growth and development1.
Because Crohn’s is considered a chronic disease, Dr Schneider says patients will likely experience periods when the disease flares up and causes symptoms, followed by periods of remission when patients may not notice symptoms at all 1,4.
What causes Crohn’s disease?
Most experts agree that the immune system of people with Crohn’s disease reacts abnormally3.
Gastroenterologist at Sunninghill Hospital, Dr Barry Shmeizer in Johannesburg, says Crohn’s is an autoimmune disease that occurs when the body’s immune system mistakenly attacks and destroys healthy body tissue, causing inflammation.
He says while diet and stress may aggravate Crohn’s disease, they do not cause the disease on their own. Recent research suggests hereditary, genetics, and environmental factors contribute to the development of the disease1.
“When it comes to Crohn’s disease, stress is the enemy. “If patients find themselves under stress, such as at exam time, we often see them presenting with flare ups of the condition5.”
He adds that certain medications can also trigger a flare up.
Who is most at risk?
Approximately one fifth of all people with Crohn’s disease have a close relative with some type of inflammatory bowel disease. People of Jewish descent have a higher chance of developing Crohn’s disease3.
“In South Africa the disease is no longer limited to certain populations and we are seeing more of the general population developing the disease4,” says Dr Schneider.
Studies have shown that 5% to 20% of affected individuals have a first–degree relative (parents, child, or sibling) with the disease1.
Crohn’s also appears to be more common in developed countries rather than undeveloped countries, in urban rather than rural areas, and in northern rather than southern climates1.
New treatments offer hope
Although Crohn’s disease is not curable, Dr Shmeizer emphasises that it is treatable and controllable5. Treatment for Crohn’s and other IBD varieties can include the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of the GI tract6.
“This is a very exciting time in terms of new treatments for Crohn’s disease,” says Dr Shmeizer. “Biologic therapies represent the latest class of therapy used for people suffering from moderate-to-severe Crohn’s disease5.”
Also known as anti-TNF agents, biologic drugs target a chemical called Tumor necrosis factor (TNF) which causes inflammation – and destroy it7.
Successful medical treatment allows the intestinal tissue to heal and relieves the symptoms of fever, diarrhoea, and abdominal pain6.
When treating Crohn’s disease, clinical trials have also shown that regular, ongoing therapy with certain medications lowers the risk of hospitalisation, and the need for surgery to a significant extent.2
Early, accurate diagnosis critical
Dr Shmeizer points out the earlier the disease is diagnosed, the less chance there is of complications later on5.
“We’ve found that if we can intervene with medication within two years of a patient developing Crohn’s they are likely to need fewer surgeries or in some cases no surgery at all5,” says Shmeizer.
But Shmeizer warns that Crohn’s disease is often misdiagnosed. “The only way to diagnose Crohn’s disease is through further investigation, involving an internal examination, blood and stool samples, scans and laboratory tests.” Dr Shmeizer adds: “Patients are often misdiagnosed at first – the doctor may think it is an infection or something more innocuous such as Irritable Bowel Syndrome, which can delay treatment and cause further damage to the gut5.”
Dr Schneider says that it’s also important for patients to know that Crohn’s disease is not the same as Ulcerative Colitis, another type of IBD. The symptoms of these two illnesses are quite similar, but the areas affected in the gastrointestinal tract (GI tract) are different1,4.
Even if you think you are showing signs of Crohn’s disease symptoms, only proper testing performed by your doctor, can render a diagnosis1.
Says Dr Shmeizer: “After diagnosis, a combination of treatment options can help patients stay in control of their disease and help them to lead a full and rewarding life.”
Learn more
To learn more about the issues affecting people with Crohn’s disease, visit the Crohn’s and Colitis Foundation of America website at www.ccfa.org.
The ‘Join the Fight against Autoimmune diseases’ campaign is a global initiative by AbbVie (Pty) Ltd that seeks to help raise awareness of autoimmune diseases and to unite and support sufferers. For more information about the campaign and how you can get involved contact Dean Krawitz on: 011 326 3428 or 083 768 1433 or visit our Facebook page:http://www.facebook.com/#!/JoinTheFightAgainstAutoimmuneDiseases.
5 important things to know about Crohn’s disease:
- There are five different types of Crohn’s depending on which part of the gastrointestinal tract is affected8.
- Crohn’s disease is treatable and controllable (although not curable)5.
- The earlier you start treatment, the better the likely outcome5.
- Treatment for Crohn’s can include the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of your GI tract6.
- By working with your doctor, you can control the disease and enjoy a good quality of life5.
Please note: this information and advice is intended for educational purposes only and is not a substitute for professional medical advice. You should always consult your healthcare provider to determine the appropriateness of the information for your own situation or if you have any questions regarding a medical condition or treatment plan.
References:
1. Crohn’s and Colitis Foundation of America. What are Crohn’s and Colitis? Available on: http://www.ccfa.org/what-are-crohns-and-colitis/. Last accessed 19-04-2013.
2. Feagan BG, Panaccione R, Sandborn WJ, D’ Haens GR, Schreiber S, Rutgeerts PJ, et al. Effects of Adalimumab Therapy on Incidence of Hospitalization and Surgery in Crohn’s Disease: Results From the CHARM Study. Gastroenterol 2008; 135: 1493-1499.
3. Medical News Today. What Is Crohn’s Disease? What Causes Crohn’s Disease? 28 May 2009. Available on:http://www.medicalnewstoday.com/articles/151620.php. Last accessed 19-04-2013.
4. Schneider, H. Information supplied in response to interview 18-04-2013.
5. Shmeizer, B. Information supplied in response to interview 18-04-2013.
6. Crohn’s and Colitis Foundation of America. Crohn’s Treatment Options. Available on: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohns-treatment-options.html. Last accessed 19-04-2013.
7. Crohn’s and Colitis Foundation of America. Crohn’s Disease Medication Options. Available on: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohns-medication.html. Last accessed 19-04-2013.
8. Crohn’s and Colitis Foundation of America. Types of Crohn’s Disease and Associated Symptoms. Available on: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/types-of-crohns-disease.html. Last accessed 19-04-2013.
