Internal Medicine

Crohn's disease attack

Introduction: what is a Crohn's disease flare-up?

Crohn's disease is one chronic inflammatory bowel diseasewhich mostly affects young adults and children. Its cause is not entirely clear, although various factors relating to the development of Crohn's disease are discussed. Life expectancy with Crohn's disease is not significantly restricted with individually optimized therapy.

Crohn's disease runs in Spurts, between which those affected also experience times when they do not suffer from symptoms of the disease. But how exactly is a thrust defined and what defines such a thrust?

A flare-up in Crohn's disease manifests itself through the appearance of various symptoms such as diarrhea or Pain in the abdominal region. Also symptoms that do not affect the gastrointestinal tract, so-called extraintestinal symptoms, are typical of a Crohn's disease flare-up. These include, for example Joint pain in the context of arthritis or Eye discomfort, for example from inflammation. Changes can also be detected in the blood during an attack. It is one increased inflammatory activity to observe.

The strength of the symptoms and the inflammatory activity varies from patient to patient. Also the Duration of an episode varies greatly. It can last from several days to a few weeks. If the symptoms persist for more than six months, the disease is called chronically active. It is impossible to predict when a flare will occur and how long it will last. Those affected experience time and again intervals during their life in which they are symptom-free, and relapses that can be very restrictive in everyday life.

Signs of a flare-up in Crohn's disease

A strict definition of the signs of a relapse is not possible, as the disease is very individual. There are no solid signs that can predict a flare-up will occur.

Those affected usually recognize signs of a flare-up Changes in their bowel habits how diarrhea. Also stomach painwhich are mainly located in the right lower abdomen, can be signs of a flare-up. There are also weakness, fatigue and Exhaustion possible clues for a thrust.

In addition to the symptoms of the gastrointestinal tract, other symptoms can occur. This includes Joint pain and Inflammation around the eyes. This includes, for example, inflammation of the middle skin of the eye, the so-called. Uveitis. fever or a slightly elevated temperature are also typical. It can continue to Skin changes, canker sores in the oral mucosa and Fistulas in the anal area come. Loss of appetite and a Weight loss are also possible signs of a Crohn's disease flare-up.

Trigger for a flare-up in Crohn's disease

Many people mistakenly believe that certain behavior causes a flare-up of Crohn's disease. The development of the disease and the relapses is highly complex and not yet fully understood. A reliable statement about the triggers of relapses in Crohn's disease is therefore not possible at this point in time.

Therefore, one cannot safely assume, for example, that certain foods are triggers for a flare-up. It is only known that nicotine has a negative influence on the development of Crohn's disease. It is therefore of great importance that people with Crohn's disease do not smoke. However, nicotine is the only known preventable risk factor.

Triggering factors such as special genetic factors or the like cannot be influenced by the patient. According to studies, psychosocial stress is also said to favor the occurrence of an episode.

Duration of an episode in Crohn's disease

The duration of a surge is very individual and varies greatly from one sick person to another. Even a single person affected can experience relapses during their life that differ significantly in their severity, the severity of their symptoms and their duration.

On average, relapses of Crohn's disease last several weeks. Some relapses only last a few Daysand others can spread over several Months extend. From a duration of 6 months the course is no longer referred to as thrust, but as chronically active.

The duration of an episode also depends on how well the patient is feeling therapy responds in thrust. Also the Refrain from nicotine has an influence on the duration of the symptoms. Smoking worsens health and prevents symptoms from improving, especially during an episode. A fiber-free diet during the episode can help alleviate the symptoms and possibly shorten the course somewhat.

Diet for a Crohn's disease flare-up

Experts are reluctant to make specific dietary recommendations for patients with Crohn's disease. There is no scientific evidence that a special diet helps with Crohn's disease. For many sufferers, however, diet plays an important role.

Food allergies and intolerances should be clarified in those affected with Crohn's disease, as they can be jointly responsible for gastrointestinal complaints. Foods that are intolerant or allergic should therefore be avoided. Many people have Lactose intoleranceso that a low-lactose diet can be beneficial.

In general, if you have Crohn's disease, you should pay attention to an adequate and balanced diet, as a Malnutrition has a negative effect on the regression of a relapse and the overall health of the person concerned.

Patients with Crohn's disease should seek medical advice from a nutritional health practitioner or a qualified nutritionist advise individually to let. It is not easy to make general recommendations.

Relapse of Crohn's disease despite medication

Complications during an attack of Crohn's disease are fistulas or an obstruction of the bowel.

Various drugs are used to treat an acute flare-up in Crohn's disease.

Read more on this topic: Medicines for Crohn's disease

As a rule, steroids are used in the event of a mild to moderately strong episode in order to achieve a regression, the so-called remission, of the episode.

However, there are also cases when a relapse does not respond adequately to steroids and symptoms do not improve. Then you turn to other drugs, namely the so-called immunosuppressants. These include, for example, TNF-alpha antibodies such as adalimumab (Humira®); and azathioprine.

It is not certain why a flare-up does not show any improvement in steroid therapy in some patients. Some sufferers have very high inflammatory activities and severe complaints that only react poorly to medication. Other patients, however, respond very well to steroids. This can vary from thrust to thrust.

If a flare-up does not respond to immunosuppressive therapy either, more research must be done to find the trigger for the worsening of the disease. The cause can be, for example, an infection or a complication of Crohn's disease. Such complications are fistulas, constrictions in the intestine (stenoses) or abscesses, i.e. encapsulated accumulations of pus in the intestine. These circumstances should be clarified diagnostically. Incorrect or inadequate use of the medication by the patient is also conceivable if the attack does not respond properly to the therapy.

Read more on the topic: Intestinal obstruction - causes, symptoms, therapy

Joint pain when developing Crohn's disease

Patients with Crohn's disease often suffer from Joint pain.

This joint pain is going through Inflammation (Arthritis) in the area of various joints. A autoimmune componentHow it also plays a role in rheumatic joint complaints is discussed in connection with Crohn's disease. However, the exact cause of the joint problems has not been established.

Different joints can be affected. Often it is Sacrum (Sacroiliitis) affected. Complaints of Spine are also possible. However, joint problems can also be considered Side effect of medication that are used to treat Crohn's disease. This includes TNF-alpha antibodies.

The occurrence of joint involvement in Crohn's disease has consequences in the therapy of the relapse. The drugs Sulfasalazine and Methotrexate are suitable for the treatment of arthritis. To Pain management can in addition to physical measures Paracetamol or in exceptional cases light opioids are used. You should avoid taking medication such as ibuprofen or the like on your own without consulting a doctor, as these can worsen the underlying disease. Professional medical advice is therefore essential.

Cortisone therapy for an episode of Crohn's disease

The Steroid therapy represents the central core of the therapy of an episode in Crohn's disease. There are various glucocorticoids, to whose group also the Cortisone counts, used to handle the thrust.

With a slight flare-up, glucocorticoids such as Budesonide as foam local be applied. The glucocorticoids are administered as tablets in the event of severe attacks or symptoms outside of the gastrointestinal tract. This is known as systemic therapy.

Read more on the topic: cortisone supplements

In addition to the glucocorticoids, other drugs are used to treat an acute episode. Exactly which drugs are used depends on the symptoms and the individual pattern of Crohn's disease. There are different dosage forms and types of glucocorticoids. Which medication is ultimately used in a person affected is an individual therapy decision that the doctor and patient make together.