Anatomy and Physiology of Crohn’s Disease
Crohn’s disease (CD) is a chronic, relapsing inflammatory disease of the intestines with usually peak between 15 and 35. It is one of many Inflammatory bowl disease (IBD), and is sometimes also called Regional enteritis, Morbus Crohn’s, Terminal iletis, or Granulomatous enteritis. It primarily affects the small and large intestine, but can affect the digestive system anywhere between the mouth and the anus. It is named after the physician who examined the disease in a landmark paper written in 1932. Crohn's disease lasts for many years throughout life, and many patients require surgery at some point and even ...view middle of the document...
149 out of 100,000 whites have the disease, and African Americans have started to develop the disease more readily. However, Asians and Hispanics have a lower chance of developing the disease. Studies have also shown that people who smoke have a higher risk of developing this disease. They have found that people in developed countries who live in urban and rural areas, and live in northern climate are more likely to get the disease. The frequency of the disease also increases when people move from developed countries to undeveloped countries, and vice versa. There is also a genetic link with CD; about 3 in 20 people who have CD have a close relative who also has it.
The most common symptoms of CD are persistent diarrhea, abdominal and back pain, weight loss, mouth ulcers, nutritional deficiencies and a greater risk of developing colorectal cancer. CD is often mistaken as appendicitis at first due to the severe pain in the right side at times of flare up. Most generally feel unwell a lot of the time which can include fever and fatigue even after getting plenty of rest. Due to the fact that CD can often mistake bacteria and foods as being “invaders”, many people find that eating things that are good for you (fruit, granola, etc.) can actually cause a flare up. For most people with CD figuring out what foods to eat just becomes a trial and error process, because it is different for everyone. The disease can also affect the liver, eyes, skin (usually rash’s), and joints. Children with CD often suffer from delayed growth and sexual development.
Most medical professionals consider CD an autoimmune disease in which the immune system reacts against normal bowel bacteria and attacks the intestinal tissues. It is a heterogeneous disease, which means that it does not manifest itself in the same way in every patient. Inﬂammation of the small intestine and colon is very common for patients who have CD. This can lead to mucosal damage and further disturbance of the epithelial barrier function. The intestinal tract is a diverse microenvironment where more than 500 species of bacteria thrive. Often times in CD, most patient either lacks the good bacteria or the immune system confuses the good bacteria as an invader and tries to rid the body of it. The epithelia barrier function is a key component in the defense mechanisms required to prevent infection and inflammation. It also helps to maintain homeostasis in the intestinal tract by protecting it from pathogens. A single layer of epithelium is all that separates these microorganisms and pathogens from the underlying immune cells. The epithelial barrier consists of a dense mucous layer containing secretory IgA and antimicrobial peptides as well as dynamic junctional complexes that regulate permeability between cells.
Inflamed ulcers burrow through the bowel wall, and can tunnel into adjacent structures. If the ulcer tract reaches an adjacent empty space inside the abdomen, a collection of...