Crohn's Disease

Crohn's Disease is an intestinal disorder characterized by inflammation of the digestive tract. Crohn's disease is characterized by ulceration of the intestines and affects the GI tract. The exact cause for Crohn's disease is unknown thought it is suspected to be due to bacterial infection. Crohn’s disease is an inflammatory bowel disease that differs from ulcerative colitis in that the inflammation and ulceration is noticed in all the layers of the intestines. It is noticed that people of Jewish descent are at increased risk for developing Crohn's disease. The symptoms are similar to irritable bowel syndrome.

20% cases of Crohn's disease are hereditary in nature. Symptoms of Crohn's disease are rectal bleeding and diarrhea. There is abdominal pain and weight loss. Nutritional deficiencies are noticed with patients suffering from Crohn's disease caused due to poor absorption. There may be arthritis, skin problems or gallstones.

Blood tests are done to check for presence of certain antibodies that may help diagnose Crohn's disease. A colonoscopy can aid the doctor in examining the lining of the intestines and checking the extent of inflammation. A small sample may also be taken for biopsy. CT scans and small bowel x-rays can help in identifying the areas of inflammation within the intestines. Anti-inflammatory drugs are prescribed to control inflammation. Corticosteroids such as Prednisone are used in treating Crohn's disease. Antibiotics are used to treat bacterial overgrowth in the small intestine. Surgery is often resorted to in most cases of Crohn's disease. A part of the intestine is removed or any blockage is removed. But Crohn's disease is likely to resurface after some years of surgery.

Intestinal Obstruction

A complete or partial blockage of the bowel thereby preventing intestinal content to move through is termed as intestinal obstruction. The bowel comprises the large intestine and the small intestine. When there is a block in either of them, the condition shows up. Intestinal content like fluids, food and gas do not pass through completely or partially due to this condition.

Intestinal obstruction is also known as paralytic ileus, bowel obstruction or colonic ileus. The blockage or obstruction may cause pain that is intermittent. If left untreated, intestinal obstruction may lead to death of those parts of the intestine that are blocked leading to further complications. However if treated on time, intestinal obstruction can be treated effectively.

What causes intestinal obstruction?

Common causes for intestinal obstruction:

• Inflammatory bowel diseases such as Crohn's disease
  
  
• Tumors in the small intestine
  
  
• Intestinal adhesions, bands of fibrous tissue in the abdominal cavity that are formed after the pelvic or abdomen surgery.
  
  
• Intussusception
  
  
• Volvulus i.e. twisted intestine.

Mechanical causes for intestinal obstruction arise from

• Hernia
  
• Tumor, Colon cancer
  
• Stricture, narrowing of the colon caused by inflammation or scarring.
  
• Diverticulitis
  
• Impacted stool, noticed in people who get constipated for long periods.
  
• Post surgery scar tissues or adhesions.
  
• Gallstones in a few cases
  
• Inflammatory bowel diseases such as Crohn's disease.

Paralytic ileus or pseudo-obstruction is a major cause of intestinal obstruction in children and infants. Conditions that cause paralytic ileus include:

• Complications from an abdominal surgery or pelvic surgery.
  
• Kidney or lung disease
  
• Bacteria or virus that cause intestinal infections
  
• Decreased blood supply to the intestine
  
• Abdominal infections like appendicitis
  
• Chemical, mineral or electrolyte imbalance
  
• Substance abuse like use of narcotics
  
• Muscle and nerve disorders like Parkinson's.

Symptoms include abdominal pain and cramping, distention and bloating. There is reduced appetite and vomiting. An obstruction in the intestines can lead to either constipation, diarrhea or flatulence. After physical examination, Xray or CT scan of the abdomen might be suggested as also . In some cases, an enema or stent is required to open up a partial blockage. Nasogastric tube (tube from nose to stomach) is passed so as to relieve abdominal swelling and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.

Ulcerative Colitis

Ulcerative colitis is an condition of inflammation or ulcers in the lining of the large intestine, rectum and colon. Rarely is the small intestine affected by ulcerative colitis. Ulcerative colitis is also referred to as proctitis. While this condition can affect anyone, it is noticed more often in the US, England, Eastern Europe and persons of Jewish ancestry. Ulcerative colitis is a chronic condition that is often noticed to run in families. The symptoms of Ulcerative colitis are similar to Crohn's disease. But this disease tends to affect the small intestine or the mouth, esophagus, appendix or duodenum. Ulcerative colitis and Crohn's disease are both inflammatory bowel diseases. Typical symptoms of Ulcerative colitis include fatigue, nausea and severe abdominal cramps. Rectal bleeding and diarrhea are noticed with persons suffering from Ulcerative colitis, though the intensity depends on the inflammation. There is loss of appetite and weight loss. The symptoms may tend to recur at regular intervals or when eating highly seasoned food or raw fruits and vegetables. Other conditions such as hepatitis, osteoporosis, anemia and arthritis are sometimes triggered by Ulcerative colitis.

Ulcerative colitis has been traced to abnormal disorder of the immune system of the intestine. Consequently the immune system triggers off an inflammation of the intestinal tissues. Often a diet high in fat and refined foods may be responsible for ulcerative colitis. Symptoms of ulcerative colitis tend to come in spurts, with periods of acute illness followed by periods of remission. If left untreated, persons suffering from ulcerative colitis carry significant risk of carcinoma. Treatment for ulcerative colitis is based on the seriousness of the condition. While medication can help in most cases, surgery is resorted to for severe inflammation and life-threatening condition. Medications cannot cure ulcerative colitis but they can help in maintaining periods of remission. The patient can enjoy a better quality of life. Anti-inflammatory and immunomodulators are prescribed for patients of ulcerative colitis to reduce inflammation.