Crohn's disease usually begins in young people and tends to involve the end of the small intestine (ileum) in inflammatory swelling. The inflammatory activity mostly involves the small bowel wall and often becomes chronic with thickening of the wall and sometimes perforation. The colon and other parts of the digestive tract are sometimes involved. Crohn's disease affects males and females equally and appears to run in some families. About 20 percent of people with Crohn's disease have a blood relative with some form of inflammatory bowel disease.
Crohn's Disease covers a spectrum of illness from early, relatively mild bowel inflammation to more destructive and even life-threatening disease. Crohn's disease usually begins in young people and tends to involve the end of the small intestine (ileum) in inflammatory swelling. The inflammatory activity is often concentrated in the small bowel wall which often thickens with scarring and inflammatory swelling. The small intestine sometimes perforates.
Sator summarized the disease process:” Crohn's disease and ulcerative colitis are idiopathic, chronic, relapsing, inflammatory conditions that are immunologically mediated. Although their exact etiologies remain uncertain, results from research in animal models, human genetics, basic science and clinical trials have provided important new insights into the pathogenesis of chronic, immune-mediated, intestinal inflammation. These studies indicate that Crohn's disease and ulcerative colitis are heterogeneous diseases characterized by various genetic abnormalities that lead to overly aggressive T-cell responses to a subset of commensal enteric bacteria. The onset and reactivation of disease are triggered by environmental factors that transiently break the mucosal barrier, stimulate immune responses or alter the balance between beneficial and pathogenic enteric bacteria. Different genetic abnormalities can lead to similar disease phenotypes; these genetic changes can be broadly characterized as causing defects in mucosal barrier function, immunoregulation or bacterial clearance. These new insights will help develop better diagnostic approaches that identify clinically important subsets of patients for whom the natural history of disease and response to treatment are predictable.” (R. Balfour Sartor Mechanisms of disease: pathogenesis of Crohn's disease and ulcerative colitis Nature Clinical Practice Gastroenterology & Hepatology (2006) 3, 390-407)
Some people with Crohn’s develop their first symptoms after a bout of "intestinal flu," "traveler’s diarrhea, after the use of antibiotics or anti-inflammatory medications such as ibuprofen. The majority of adults with Crohn’s (about 80%) are smokers; there is evidence that smoking aggravates Crohn’s and smoking cessation is essential. Exposure to "second-hand" smoke has also been linked to Crohn’s Disease. Parents and family members should obey a no-smoking rule at home if a member of the family develops Crohn’s disease.
Crohn's disease also involves whole-body problems - arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, and other diseases of the liver and biliary system. We think that this is related to the leakiness of the intestine and immune responses to the increased entry of food and microbial antigens.
There are four stages to this immune-mediated disease:
The Problem: Chronic immune-mediated inflammation of the digestive tract.
If you do not act in a timely manner and change your diet in a complete, careful manner, you may crash. If the disease mechanism intensifies, body dysfunction increases to the point that all your normal activities are suspended. The illness reaches a critical point and you crash. You are now seriously ill and/or disabled. You may end up in the emergency ward with bowel obstruction, perforation and bleeding. You may have surgery and lose digestive function and suffer further food intolerance and malnutrition. You are discouraged, possibly depressed and it is harder to take self-responsible action.
The Better Solution:
< Food Holiday
We advocate rigorous changes in life-style, diet and the conquest of addiction - no smoking and no compulsive eating. We acknowledge that self-responsible action is difficult and that heroic measures may be required to alter disease-causing conditions.
We have seen special problems with Crohn's patients. As the disease progresses, patients have increasing contact with physicians hospitals and tend to become passive and dependent. Often, food choices are poor, eating patterns are irregular, nutrition is compromised. Energy is low and many patients become depressed.
Often, physicians tell their patients to eat anything they like and institutional advice discourages self-responsible action. Diet revision is discouraged. The dogmatic advice of orthodox institutions is clearly biased but that does diminish the impact of this negative thinking on the patient.
An important task of the Crohn's patient, family, spouse and friends is to become well informed about the diet revision path we are advocating, confirm your right and ability to take self-responsible action and begin the process of constructive change. The inflamed digestive tract is injured and does not work well. You assume that your body is injured and must heal.