45 - Crohn's Disease (w/ Shehzad Sheikh!)
45. Crohn's Disease (w/ Shehzad Sheikh!)
People who have years of experience with Crohn’s disease under their belt know it’s no joke. What is the digestive tract? What happens when your immune system picks on it unfairly? What is the current course of treatment for these disorders? Let’s learn to be scientifically conversational.
General Learning Concepts
1) What is Crohn’s Disease?
a. What is the digestive (gastrointestinal, GI) tract? The digestive system is made of up the GI tract and the liver, pancreas, and gallbladder. The GI is made up of the mouth, esophagus, stomach, small intestine (duodenum, jejunum, ileum), large intestine (appendix, cecum, colon, rectum), and anus.
b. What is inflammation? Very generally speaking, inflammation is the body’s immune system’s response to an irritant. The irritant might be a germ, but it could also be a foreign object, such as a splinter in your finger.
c. What is Crohn’s Disease? Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract; it is a part of a group of diseases called inflammatory bowel diseases (IBD). IBD affects an estimated 3 million Americans. Men and women are equally likely to be affected by Crohn's disease. [2]
i. Effects: Anywhere from diarrhea, cramping, weight loss, abscesses, vomiting, nausea, rectal bleeding, loss of appetite, and abdominal pain.
d. What is Ulcerative Colitis? Ulcerative colitis is a chronic disease of the large intestine (colon and rectum), in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers. Only affects the inner-most lining of the large intestine.
2) What causes Crohn’s Disease?
a. Exact cause: This seems to be unknown; factors seem to stress or aggravate Crohn’s, but not necessarily cause it. IBD is the result of immune system complications, where the immune system attacks its own host.
b. Genetics: The inheritance pattern of Crohn disease is unclear because many genetic and environmental factors are likely to be involved. However, Crohn disease tends to cluster in families; about 15 percent of affected people have a first-degree relative (such as a parent or sibling) with the disorder.
c. Differences in Crohn’s: The GI tract is rather extensive; this means that different parts of the GI tract can be affected from the disease.
3) Development for treatments of Crohn’s disease:
4) Fun Tidbits
a. IBD is not the same thing as irritable bowel syndrome (IBS): IBD should not be confused with irritable bowel syndrome or IBS. Although people with IBS may experience some similar symptoms to IBD, IBD and IBS are very different. Irritable bowel syndrome is not caused by inflammation and the tissues of the bowel are not damaged the way they are in IBD. Treatment is also different.
b. Length of the GI tract: About 30 feet in length in adults. Mouth mechanically breaks down food, passes food through the esophagus and other muscles into the stomach. Further liquification happens in the stomach, and slowly releases the contents into the small intestine. Further digestion, and absorption by fingerlike villi (VILL-ee), is done in the small intestine. Secretions from the liver, pancreas, and gallbladder help digest further. Remaining material moves in the large intestine, which absorbs liquids and electrolytes, and allows for bacterial communities to break down undigested material. Final solid waste is lost as feces through the rectum / anus.
5) Solicited Questions
a. What should I do if I think I have a GI disorder?
b. Why have I heard that smoking influences Crohn’s? Environmental and lifestyle factors likely have a large impact on Crohn disease risk. Studies have found that cigarette smoking doubles the likelihood of developing this disease, and it may also play a role in periodic flare-ups of signs and symptoms. Crohn disease is more prevalent in urbanized societies, suggesting that factors related to increased industrialization and sanitation also play a role. Additionally, certain aspects of a person's diet, including sugar, fats, and fiber, have been proposed to influence Crohn disease risk. Many of the potential lifestyle and environmental risk factors are probably related, directly or indirectly, to abnormal inflammation. However, the exact relationship between these factors and Crohn disease risk remains unclear.