Crohn's Disease

By: Karlie Peters RN

Crohn’s “is a chronic inflammatory process in the gastrointestinal tract but with intermittent activation” (Crohn’s disease and IBS, 2007). Crohn’s is caused by an inflammation, which can cause “abdominal pain, severe diarrhea, and even malnutrition” (Mayo Clinic, 2009). The inflammation process can affect any aspect of the digestive system, but it is generally localized to the area of the distal parts, the ileum and colon. Crohn’s affects the deep layers of bowel tissue. “Crohn’s disease can be both painful and debilitating and sometimes may lead to life-threatening complications” (Mayo Clinic, 2009).

Signs and symptoms of Crohn’s include “diarrhea, abdominal pain and cramping, bloody stool, ulcers, reduced appetite and weight loss, fever, fatique, arthritis, eye inflammation, skin disorders, inflammation of the live or bile ducts, and even delayed growth or sexual development, in children” (Mayo Clinic, 2009).

Crohn’s disease has been linked to four components, they include “genetic predisposition to an increased intestinal permeability, an oropharyngeal bacterium that increases the mucosa; permeability of the small intestine with only a minimal inflammatory reaction, an adherent-invasive strain of Escherichia coli that penetrates the mucosa and causes an acute inflammatory reaction in the intestinal wall, and finally a secondary invasion of bacteria causing the chronic inflammatory characteristics” (Crohn’s disease and IBS, 2007).

Nurses can inform patients that the cause of Crohn’s disease is still unkown, but was previously thought of as being agitated from diet or stress. Researchers are now looking more towards a number of factors, “such as heredity and a malfunctioning immune system” (Mayo Clinic, 2009). Nurses can educate patients with the risk factors of Crohn’s disease. There are several risk factors and they include: “age, ethnicity, family history, cigarette smoking, where you live, isotretinoin (Accutane) use, and nonsteroidal anti-inflammatory drugs (NSAIDs)” (Mayo Clinic, 2009).

Teaching individuals that Crohn’s is diagnosed between in the ages of 20-30, with Caucasians having the highest risk, even those of Ashkenazi Jewish decent are even greater. Individuals whom have a close relative, like a parent or sibling, have a 1 in 5 risk. Cigarette smoking is “a determining factor for composition of the subgingival microflora” (Crohn’s disease and IBS, 2007). Lars Oble (2007) quoted that “a culture from the oral cavity of smokers showed an increased Gram-negative bacterial colonization.”

Once individuals get a general idea of the Crohn’s disease process, the individual should be identifying their own risk factors, for example, if an individual smokes, then cessation of smoking should be encouraged. Individuals should be seeking their primary physician if they are having signs and symptoms. Keeping a journal to write down all medications, a daily journal of food intake, along with personal information, such as major stresses or recent life changes, and making notes of bowel habits will help aid the physician in proper medical assistance. There are alternative medicines that include “herbal and nutritional supplements, probiotics, fish oil, and acupuncture” (Mayo Clinic, 2009). To feel in control of a disease, such as Crohn’s disease, then organizations, like Crohn’s and Colitis Foundation of America (CCFA) (888-MT-GUTPAIN) can help with providing information and accessing of support groups in the local areas.

Reference Page
Mayo Clinic. (1998-2009). Mayo Clinic. Retrieved from http://www.mayoclinic.com/ on
October, 6th 2009.
Olbe, L. (2008). Concept of Crohn's disease being conditioned by four main components,
and irritable bowel syndrome being an incomplete Crohn's disease. Scandinavian Journal of Gastroenterology, 43.

NOTE: This blog post reflects the work of Karlie Peters, RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.