Crohn's Disease

Crohn’s disease is a disease that provokes inflammation or swelling and irritation of any part in the digestive track of the human body. The parts of it that are most affected are called the ileum and the colon. Also, this disease causes severe inflammation that extends deep into the lining of the gastrointestinal track. Apart from being known as Crohn’s disease, it is classified as an Inflammatory Bowel Disease, making it very difficult to diagnose because the symptoms are similar to the rest of intestinal disorders. Furthermore, this disease has many other names, Ileitis and Enterpritis are two of these. Some of the symptoms of Crohn’s disease include abdominal pain, severe diarrhea, and even malnutrition. It is a painful and debilitating disease and it may lead to life threatening complications. Crohn’s disease is marked by abnormal responses in the body’s immune system. Normally, our immune system is composed by various cells and protein and these protect the human body from infection, however, in Crohn’s disease the immune system mistakes microbes such as bacteria found in the intestines for other invading substances and begins to attack. During the attacking process, the body sends white cells into the lining of the intestines and this way, provoking chronic inflammation. Hence, these cells harm the body and lead to ulcerations or bowel injury.
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Crohn’s disease is recognized as a disease caused by genetic mutation. It occurs through the diverse types of genes a person inherits. Also, this disease might be triggered when there is interaction of an outside agent (virus or bacteria) with the immune system may and that agent may cause damage to the intestinal wall. Moreover there have been studies made that explain exactly the genetic changes that are related to Crohn’s disease. This inflammation is related to chromosomes 5 and 10, where there is a variation in the ATG16LI, IRGM, NOD2, and IL23R genes and an increased risk to the disease takes place. All these genes mentioned provide all the instructions to formulate protein. Variations in any of these may interrupt the ability of cells in the intestine to respond to bacteria normally. Finally, an abnormal response, would lead to Crohn’s disease.

There are benefits and limitations in Crohn’s disease. The benefits include all the various types of medicines and technologies that are being used to control and to try to cure the disease. As in actual medicines, Aminosalicylates (anti-inflammatory drugs), Corticosteroids, immune modifiers, antibiotics, and biological therapies (used for patients with no response to conventional therapies) are the newest and most effective ones being used on patients with Crohn’s disease. On the other hand, there are technological advances that can also serve as prevention or treatment for Crohn’s disease. There are gene tests available, laboratory tests that include blood and stool tests, X-rays, endoscopies, and pathologies. Additionally, there is computerized tomography’s, Upper GI series and Lower GI series and if the disease gets more severe, there is surgery available. Proctocolectomy, Ileostomy, and Intestial resection surgery are the ones available and apart from these, nutritional supplementation also exists in order to cure Crohn’s disease. These supplements are especially for patients that are still developing and growing, like children. There are special high calorie liquid formulas, as well as intravenous nutrition, and finally calcium vitamin supplements.

On the other hand, Crohn’s disease has various limitations. One of the main limitations is the complications the disease might have. Intestinal blockage due to swelling, ulcers that tunnel through irritated areas, fissures in the lining of the mucus membrane of the anus, anemia, failures to grow normally in children, weakness in bones like osteoporosis, restless legs syndrome, arthritis, skin problems, inflammation on the eyes or mouth, kidney stones, gallstones, and diseases related to liver function are some of the complications this inflammatory disease might bring. Another limitation is that the disease can run through a whole family, and that there is not an exact cure but many attempts can be made in order to have it under control.
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This inflammatory bowel disease has various links with social, economical, cultural and ethical aspects. Socially, Crohn’s disease affects men and women equally. The disease may run in families and people with the disease may have biological relatives with any type of IBD’s. Also, this disease affects people from the range of 13-30, and the disease is more probable in patients who smoke. It is also known that the percentage of society with Jewish heritage have an increased risk of getting the disease, however, African American people in society have a decreased risk. There has also been research made to see if stress makes the disease worse and if pregnant women are exposed to danger with Crohn’s disease. Both studies turned out having positive results, meaning neither stress nor pregnancy are affected with this disease.
Economically, there is also an interaction with Crohn’s disease. Highly effective treatments for Crohn’s disease are highly expensive and these costs will force clinicians, patients and society to make important decisions and choices about the use and finding of these resources. Furthermore, there are analyses being made called Pharmacoeconomic analyses that are useful while patients decide if new technologies are of better value than the typical established treatments. Additionally, cost-utility models are being made to relate the increasing cost of new treatments to improvements in quality of life related to health. These analyses are composed by the collection of the valid cost and utility inputs that have become available. These cost-utility models should help decision makers in taking their personal decisions of which treatment to take to approach Crohn’s disease.
This inflammatory disease also has connections with culture and ethics. Crohn’s disease is associated more often with eastern European ancestry and less often with the rest of ethnic groups. American Jews of European descents are four to five more likely to have IBD than the rest of the population. Also, it is known that is has been a disease affecting more whites and the number of people with the disease at a given time among whites is of 149 per 100,000. However, there has been an increase of Crohn’s disease in African Americans in the past years. The rates of the disease in Hispanics and Asians are lower than the ones for whites and African Americans. Moreover, in 1996 a study was made and it said that 41.4 per 100,000 of African Americans had the disease. Additionally, an 11-year study was also made and in one state studies the rated for IBD from 1991 to 2002, doubled. All these studies are continuously being made including the number of new cases, already existing cases, and causes and differences in the disease in the diverse ethnic communities around the globe.
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Bibliography:
http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/
http://www.mayoclinic.com/health/crohns-disease/DS00104
http://www.ccfa.org/info/about/crohns
http://ghr.nlm.nih.gov/condition/crohn-disease
http://www.ncbi.nlm.nih.gov/pubmed/10597337
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