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  • Q&A with Australian Health Practitioners

    What is crohns disease?

    Related Topics
    Crohn's Disease & Ulcerative Colitis Digestive Health
    • 2 answers
    • Crohn's & Colitis Australia
    • Dr Simon Easterbrook-Smith
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    Crohn's & Colitis Australia

    For more than 25 years, Crohn’s & Colitis Australia™ (formerly the Australian Crohn’s and Colitis Association) has been making life more liveable for more than … View Profile

    Crohn’s disease causes inflammation of the full thickness of the bowel wall and may involve any part of the digestive tract from the mouth to the anus. Ulcerative colitis is inflammation confined to the inner lining of the large bowel (colon and rectum). These diseases are commonly called inflammatory bowel disease (IBD).  IBD tends to develop between 15 and 30 years of age but can start at any age. There is a marked increase in the number of children under the age of nine years now developing Crohn’s disease. It is estimated more than 70,000 Australians have IBD.
     
    Physical effects are varied
    Everyone is different in their response to the disease. The severity of symptoms will vary from time to time and from person to person.
     
    IBD is not classed as a ‘progressive’ disease; rather flare ups can range from mild to severe and back to mild again.  Some people will experience periods of relief from symptoms in between flare-ups.
     
    There is no way to predict for how long a person will stay free from symptoms, or when the next flare up will occur. Some flare ups will settle down relatively quickly with treatment. On other occasions, it may take months for symptoms to respond to the treatment.
     
    IBD interferes with normal body functions and some of the signs and symptoms can include:

    • Pain in the abdomen
    • Weight loss
    • Diarrhoea (sometimes with blood and mucus)
    • Tiredness
    • Constipation
    • Malnutrition
    • Nausea
    • Vomiting
    • Delayed or impaired growth in children
     
    The cause is unknown
    The cause of ulcerative colitis and Crohn’s disease is unknown. Some scientists believe IBD could be due to a defect in the body’s immune system. Others feel that infection by a bacterium or virus may be important.  Stress or diet is not thought to be involved in the cause IBD. These diseases are not contagious.
     
    Various treatment options are possible
    There are a variety of tests needed to diagnose IBD. They include: blood tests, faecal (bowel motion) examination, x-rays and colonoscopy and gastroscopy procedures. The type of treatment depends on whether you have ulcerative colitis or Crohn’s disease.
    Treatment for Crohn's disease and ulcerative colitis may include:
    • Drugs to reduce the chances of a relapse once the disease is in remission.
    • Steroid (cortisone) medication.
    • Drugs to reduce the activity of the immune system.

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    Dr Simon Easterbrook-Smith

    Health Professional

    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    There is increasing evidence that differences in the kinds of bacteria which normally live in the gut (the “gut microbiome”) may be causally associated with Crohn's disease and possibly other forms of Inflammatory Bowel Disease.

    There is a popular account of the most recent paper here: http://www.sciencedaily.com/releases/2014/03/140312132617.htm . The full (technical) paper is available as a free PDF here: https://www.cell.com/cell-host-microbe/abstract/S1931-3128(14)00063-8 .

    This is at the “basic science” stage now but, with more hard work, it may lead to new therapies.

    My inclination (as a scientist, not as a clinical professional) is to avoid antibiotic therapy for Crohn's disease unless there are compelling clinical reasons for it - antibiotics could distort the gut microbiome, making things worse, not better.

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