A bad bout of intestinal infection either from a flu or food poisoning with its associated upset stomach, gas and diarrhea is enough to knock most of us off of our feet and leave us feeling under the weather for at least a few days while we recover. People with Crohn’s Disease (CD) unfortunately experience these sorts of symptoms on an ongoing basis with the effect being a significant reduction in the quality of life.
Crohn’s disease is one of several conditions grouped under the umbrella title of Inflammatory Bowel Disease (IBD). It is an autoimmune condition in which the body’s immune system attacks the digestive system anywhere from the mouth to the stomach, to the intestines, to the anus. Besides the previously mentioned symptoms, those suffering from the condition can also experience pain in their stomach area and blood in their feces. In many cases, they will also experience weight loss from a digestive system that cannot effectively absorb nutrients.
As with other autoimmune disorders, those with the condition will experience flare-ups and periods of lower disease activity. In the worst cases, those with the condition may have to endure more than 20 trips to the bathroom in a given day. If that does not affect your life, its hard to say what would!
Crohn’s Disease affects approximately 60 to 120 thousand people in the UK, as many as 500 thousand in the US, and 10 thousand in Australia. The average age at which someone will show symptoms of the disease is between 15 and 30, but the disease occurs in people of all ages.
Though it is definitely affected by genetic factors, it is not a directly inherited disease. If someone you are related to has the condition, your risk of also developing Crohn’s is only about 5%. The disease is thought to be the result of a combination of genetic and environmental factors, however, no exact relations have been identified except for a tie to higher occurrence of the disease in those living in western industrialized countries.
Diagnosis of the disease is difficult and typically involves a number of tests because no one test can be conclusive on its own. Blood tests, fecal tests, and x-rays of the intestines are common methods for diagnosis. Additionally, diagnosis is also possible using endoscopy or visual inspection with a camera attached to a thin tube inserted into the anus. A more advanced approach that is becoming more common is the use of pill with an onboard camera that is able to capture images as the pill moves down though the digestive system. Together these tests and techniques usually allow the doctor to diagnose the condition.
Unfortunately, the number of people affected by Crohn’s Disease is increasing. In a study completed on approximately 10% of the French population, the overall rate of increase in occurrence of the disease was roughly 21% between 1988 and 2005. For those 10 to 20 years of age, however, the rate of increase was a very significant 49%. The reasons for the increase are not known.
Little is known about the controllable factors affecting the risk of developing the disease. However, smoking is a known contributor that increases the risks of developing Crohn’s Disease by a factor of 3 to 4 times. Additionally, researchers at the University of Liverpool have also implicated bacteria in cow’s milk as a possible cause. However, the finding has been controversial and is not yet proven. Other research from Cornell University also suggests that E. coli bacteria in the intestine may cause the disease, but how it might cause the condition was not identified.
Related research completed at the Research Institute of the McGill University Health Centre has found a single gene that controls how the body detects bacteria in the stomach. Their findings suggest that in some people this gene may cause the detection of bacteria to be too weak with the result being that the bacteria are able to repeatedly enter the walls of the intestine before being detected. This means that the walls of the intestine are constantly inflamed and fighting infection.
With more than 30 genes now associated with the disease based on the latest research from the University of Oxford, Crohn’s is a condition with a complex set of causes. Some of the genes involved in the disease are also associated with diabetes, rheumatoid arthritis, psoriasis, and even asthma. Based on their research, the scientists at Oxford suspect that hundreds of genes may be involved in disease with different “bad” genes each slightly increasing the possibility of developing the disease.
While such research does not yet point to a cure in any predictable time frame, the understanding of the disease that science is attaining offers the chance for many possible future treatment options. In addition, working to decipher the relationship amongst all of these autoimmune diseases means that research focused on other conditions may also benefit research into Crohn’s Disease.
Another future blog entry will look at some of the latest treatments available for those with more severe forms of the disease.