Lupus and Crohn's Disease
CROHN'S DISEASE is an inflammatory bowel disease (in some ways, similar to irritable bowel syndrome and ulcerative colitis). It is also called ileitis or enteritis. It causes inflammation in the small intestine which extends deep into the lining of the intestine and causes pain. It also makes the intensines empty frequently causing diarrhea.
The most popular theory for the cause of Crohn's disease is that the body's immune system reacts to a virus or a bacterium by causing ongoing inflammation in the intestine. Most people with Crohn's disease have an immune system disease (like LUPUS). Doctors do not know if Crohn's causes the disease or if the disease causes Crohn's.
The symptoms are abdominal pain, diarrhea, rectal bleeding, wheight loss and fever. Bleeding may be serious and persistent, leading to anemia. The disease is diagnosed with blood tests for anemia and white blood cell count, stool sample test to detect bleeding or infection, upper gastrointestinal (GI) series and or a colonoscopy.
Complications of the disease are a thickening of the intestinal wall with swelling and scar tissue which narrows the passage. It can cause sores or ulcers that tunnel through the affected area into surrounding tissues and can become infected. Protein and vitamin deficiencies can also occur as well as arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones or other diseases of the liver and biliary system.
TREATEMENT: this can depend upon the location of the disease and its severity. Many people can have long periods of remission, sometimes for years, where they are free of symptoms. Most people are first treated with drugs containing mesalamine (such as Sulfasalazine) to help control the inflammation. If you cannot tolerate Sulfa drugs, doctors may prescribe 5-ASA agents (Asacol, Dipentum or Pentasa). Doctors may also prescribe corticosteroids and immunosuppressive drugs (Methotrexate and Cyclosporine). Antibiotics are used to treat bacterial overgrowth in the small intestines and antidarrheal agents for the diarrhea and crampy abdominal pain.
The U.S. Food and Drug Administration has approved Infliximab (brand name: Remicade) for moderate to severe Crohn's disease which does not respond to standard treatments. This is an anti-tumor necrosis factor (TNF) substance which removes TNF from the bloodstream before it reaches the intestines, thereby preventing inflammation.
DIET: No special diet has been proven effective for treating the disease. However, some people find their symptoms are made worse by milk, alcohol, hot spices or fiber!!
Here is a list of treatments being considered for Crohn's:
1. Anti-TNF (as explained above)
2. Interleukin 10 - a cytokine that suppresses inflammation
3. Antibiotics - for bacterial infections
4. Budesonide - a corticosteroid that causes fewer side effects
5. Methotrexate and Cyclosporine - immunosuppresive drugs
6. Natalizumab - an experimental drug that reduces the symptoms
7. Zinc - removes free radicals which may contribute to inflammation.