What are the complications of Crohn’s disease?

Intestinal blockage can occur in people with Crohn’s disease. Blockage occurs because the intestinal wall thickens or swells from inflammation and scar tissue. Ulcers can also cause tunnels to form through the inflamed areas of the intestine or even the healthy parts. These tunnels are called fistulas. Sometimes pockets of infection, called abscesses, can form in and around the fistulas. Fistulas can be treated with medicine, but sometimes surgery is needed.

People with Crohn’s disease often don’t get the nutrients they need. If you have Crohn’s disease, you may not get enough protein, vitamins, or calories in your diet. If you aren’t getting nutrients, it may be because you

-have an upset stomach that keeps you from eating enough-may be losing protein in the intestine-may not be able to absorb nutrients from your food

Other problems that some people with Crohn’s disease suffer from are arthritis, skin problems, swelling in the eyes or mouth, kidney stones, and gallstones.

Vitamin D might fight Crohn's disease

Vitamin D, touted as the "sunshine cure," might also prevent and fight Crohn's disease, suggests a new study by Montreal researchers.

The discovery has yet to be confirmed by clinical trials, but it raises hopes for the estimated 170,000 Canadians with either Crohn's disease or ulcerative colitis.

Canada has one of the highest reported rates in the world for Crohn's disease, a chronic inflammatory bowel disorder that usually affects the lower small intestine.
"Our data suggests for the first time that Vitamin D deficiency can contribute to Crohn's disease," said John White, an endocrinologist at the Research Institute of the McGill University Health Centre.

White noted that people who live in northern climates -- which receive less sunshine that is essential for the fabrication of Vitamin D by the human body -- are especially vulnerable to Crohn's disease.

White and his colleagues treated cancer cells in the lab with Vitamin D, and then carried out a micro-array or genetic analysis of those cells. They found that Vitamin D switched on two genes that are important in preventing or fighting Crohn's disease.

"It's reasonable to think that Vitamin D deficiency can contribute to the frequency of the disease," White said. "Siblings of patients with Crohn's disease that haven't yet developed the disease might be well advised to make sure they're Vitamin D sufficient."

As for whether taking Vitamin D could be an effective treatment for Crohn's, White was cautious, saying that would have to be demonstrated in a clinical trial.

The White study was published in the Journal of Biological Chemistry.

This article is a reprint of http://www.vancouversun.com/news/thewest/Vitamain+might+fight+Crohn+disease+says+study/2494382/story.html

The time or date displayed reflects when an article was added to Google News Feb.23 2010

What is the treatment for ulcerative colitis?

Colitis treatment depends on the severity of the disease. Each person experiences ulcerative colitis differently, so treatment is adjusted for each individual.

Hospitalization

Occasionally, symptoms are severe enough that a person must be hospitalized. For example, a person may have severe bleeding or severe diarrhea that causes dehydration. In such cases the doctor will try to stop diarrhea and loss of blood, fluids, and mineral salts. The patient may need a special diet, feeding through a vein, medications, or sometimes surgery.

Surgery

About 25 to 40 percent of ulcerative colitis patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer. Sometimes the doctor will recommend removing the colon if medical treatment fails or if the side effects of corticosteroids or other drugs threaten the patient's health.

Surgery to remove the colon and rectum, known as proctocolectomy, is followed by one of the following:

Ileostomy, in which the surgeon creates a small opening in the abdomen, called a stoma, and attaches the end of the small intestine, called the ileum, to it. Waste will travel through the small intestine and exit the body through the stoma. The stoma is about the size of a quarter and is usually located in the lower right part of the abdomen near the beltline. A pouch is worn over the opening to collect waste, and the patient empties the pouch as needed.

Ileoanal anastomosis, or pull-through operation, which allows the patient to have normal bowel movements because it preserves part of the anus. In this operation, the surgeon removes the colon and the inside of the rectum, leaving the outer muscles of the rectum. The surgeon then attaches the ileum to the inside of the rectum and the anus, creating a pouch. Waste is stored in the pouch and passes through the anus in the usual manner. Bowel movements may be more frequent and watery than before the procedure. Inflammation of the pouch (pouchitis) is a possible complication.

Not every operation is appropriate for every person. Which surgery to have depends on the severity of the disease and the patient's needs, expectations, and lifestyle. People faced with this decision should get as much information as possible by talking to their doctors, to nurses who work with colon surgery patients (enterostomal therapists), and to other colon surgery patients. Patient advocacy organizations can direct people to support groups and other information resources.