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Crohns Disease
Shane Dokey
Madonna University
Senior Seminar Research Paper

Abstract
In this paper I will be discussing the disease of the excretory system called
Crohns Disease. I will be describing the causes of the disease, the symptoms
that come along with the disease, treatment options, and how enteral
feeding can help in remission of this disease.

Crohns disease named after Dr. Burrill B. Crohn also known as regional
enteritis is disease of the excretory system that causes inflammation of the
gastrointestinal (GI) tract and is a chronic, relapsing-remitting condition
distinguished by skip lesions, and transmural inflammation meaning the
inflammation goes through all of the layers of the intestinal wall2. Crohns
disease can happen anywhere in the GI tract, which is mouth to anus but
mainly occurs in the cecum portion of the large intestine and the ileum
portion of the small intestine1. Crohns disease falls under the category of
inflammatory bowel disease (IBD). There are other similar IBDs such as
ulcerative colitis and microscopic colitis.
South America, Eastern Europe, and Asia have lower commonness of
IBDs making this a disease of developed societies. With that being said it is
increasing throughout the world, nonetheless the disease is generally more
common in industrialized countries .To get more specific Crohns mainly
affects people between the ages of twenty and twenty-nine, having a family
member who has it, most often a sibling or parent, or one who smokes. It can
affect anyone at any age3. In the Subodh text it states that people of Jewish
descent are three to six time more likely to have it than other people4.
The suspected causes of Crohns disease can be related back to
autoimmune reaction, genes, and environment. Scientists believe that when
bacteria and viruses enter the body it attacks the body uses an auto immune
response, white blood cell attack harmless bacteria and viruses causing an

inflammatory response in the GI tract3. According to the University of

Maryland Medical center about a quarter of people who have Crohns disease
have a close relative that has Crohns disease. The environment has some
correlation with Crohns disease, people with high fat diets, smokers, and
living in an industrialized country all factor in with this disease.
With many varying signs and symptoms of Crohns disease here is a
list of the most common: diarrhea (with or without blood), abdominal pain
and bloating, fatigue, poor appetite weight loss fever nausea and vomiting,
floating stools (caused by poor digestion of fat), anemia (low iron levels). 4
Crohns disease can be diagnosed by a physical exam by a physician
that would show skin rash, swollen joints, mass or tenderness in the
abdomen or ulcers in the mouth. An array of other test such as barium
enema or upper GI series, Colonoscopy or sigmoidoscopy, CT scan of the
abdomen, capsule endoscopy, MRI of the abdomen, enteroscopy, and stool
culture.

The main issue with having Crohns disease is that it causes blockages
of the GI tract from the build of scar tissue from chronic inflammation. With
these intestinal blockages occurring it is becomes very troublesome to get
the daily nutritional values that are needed to stay healthy. When fully
blocked it stops the flow of food causing nausea, vomiting, and abdominal
cramps. This can lead to an iron deficiency in the blood (anemia) making the
person drowsy and tired. Another thing that Crohns disease does is it

creates ulcers in the GI tract which can cause tunnels called fistulas (mostly
seen around the rectum and anus), then abscesses (pockets of infection)
occur3. Most of these fistulas can be treated with medications but some do
require surgery to be removed.
Since there is no known cure for Crohns treatment is all that can
happen. With that being said the type of treatment depends on where the
disease is located in the GI tract, what problems have already occurred, and
past treatments. The objective of treatment is to relieve symptoms for as
long as possible so the person is not unconfutable or in pain. The treatment
may include medicines such as anti-inflammation medicines, immune system
suppressors, biological therapies, antibiotics, and anti-diarrheal medicines
and fluid replacement. Surgeries such as intestinal resection, ileostomy, and
proctocolectomy do not cure the disease but subsidizes symptoms for a
while. Most people require more than one surgery3. Managing stress,
exercising, and a strict diet can also help the treatment of Crohns disease.
When looking at a diet for people with Crohns disease it is said that
high calorie liquid diets are beneficial. Enteral nutrition (tube feedings into
the GI tract) use liquid formulas make it easier to get all the proper nutrition
for the patient. With loss of appetite patients it is plus because they do not
have to physically eat the food. It administered through a tube which allows
them to get the necessary nutrition without eating. Studies show that only
five percent of patients who came out after surgery that went on nutrition

therapy for twelve months relapse compared to thirty five percent of patients
who after surgery were put on a non-restrictive diet. As talked about earlier
most people require surgery more than once it can be significantly lowered if
given the right nutrition therapy, in this case enteral. The understanding of
how enteral feedings help with remission of Crohns disease is not fully
understood yet but is it thought to help by regulating the immune system
and the imbalances in flora and lessening the exposure of key mucosa to
antigens. Continuing on enteral feedings help suppress the immune systems
effects on the GI tract, by promoting mucosal healing, modifying intestinal
microbiota, and supporting bowel rest. In turn leads to a better nutritional
status2. This article clearly showed an increased serum albumin levels,
weight gains, and linear growth recovery shortly after starting nutritional
therapy. With this article showing both adult and children studies showed
that enteral feedings effected children greater in a positive way than it did
with adults. But it did help improve adults overall health but not as
significantly as it did to children.
Crohns disease is a nasty disease that cannot be cured. Also it can
troublesome if not managed correctly. If managed correctly it can be put in
remission and the nutritional status of a person with it can be very positive.
Although this paper suggests the use of the enteral nutritional therapy to
help with that process, meeting with a medical professional would still be the
best way to go because each case is different in itself. The suggestion made

trying enteral nutrition along with all the other treatments discussed is
definitely a plausible way to help in the fight against Crohns.

Works Cited
U.S. National Library of Medicine. Crohn disease
https://www.nlm.nih.gov/medlineplus/ency/article/000249.htm
Published N/A Last updated: Jan 22,2015
Accessed Nov 1 2015
Moftah H. Alhagamhmad , Andrew S. Day, Daniel A. Lemberg , Steven T.
Leach. An update of the role of nutritional therapy in the management of
Crohns disease. J Gastroenterol (2012) 47:872882 DOI 10.1007/s00535012-0617-9
National Institute of Diabetes and Digestive and Kidney Diseases Crohns
Disease

http://www.niddk.nih.gov/health-information/health-topics/digestivediseases/crohns-disease/Pages/ez.aspx#treat
Published December 2011 last updated: July 10, 2013
Accessed Nov 1, 2015.

University of Maryland Medical Center (UMMC) Crohn Disease

https://umm.edu/health/medical/altmed/condition/crohns-disease
Published: N/A Last Updated March 22, 2015
Accessed Nov 1, 2015