Crohn's disease is a chronic inflammatory disease of the digestive tract. The disease is also called granulomatous enteritis, colitis, regional enteritis, regional ileitis, ileitis, or terminal ileitis and it causes ulcerations of the small and large intestine. The disease can affect the digestive system any-where from the mouth to the anus, but distinctively affects the terminal ileum as -well as demarcated isas of large bo-wel. The disease is named after the American physician, Burrill Bernard Crohn (1884–1983), -who described the disease in 1932.

Crohn’s Disease Symptoms

Crohns disease symptoms may include:

• Chronic diarrhea & disrupted digestion: It becomes difficult for the patients in the acute phase of the disease to eat and/or digest food.
• Painful and debilitating inflammation
• Fistulas of the colon
• Hemorrhoids
• Lipid absorption problems
• Anemia: Persistent rectal bleeding may lead to anemia.
• Bruising of the shins.
• Fever, pain and psychological damage in many cases
• Crohn's disease in children may cause delayed development and stunted gro-wth.

Crohn’s Disease Treatment

Crohns disease treatment may include medication, surgery, dietary advice and Helminthic therapy (current research).

Medication Treatment

Acute treatment: steroids is used in the initial stages. Longterm steroid therapy is discouraged because of their side effects. Corticosteroids like prednisone is traditionally used medications. The side effects of steroids may include insulin resistance and frank diabetes, hypertension (high blood pressure), glaucoma, osteoporosis, severe psychological issues etc.

Chronic treatment (Steroidsparing): The treatment may include Salicylates 5ASA derivates 5aminosalicylic acid compounds such as sulfasalazine (Azulfidine®, Salazopyrin®), mesalamine (Pentasa®, Asacol®), olsalazine, and balsalazide. Immunomodulating drugs such as azathioprine, 6mercaptopurine and methotrexate is given mainly in moderatetosevere cases. Infliximab (brand name Remicade®) is given in patients -with therapyresistant or fistulating Crohn's. Adalimumab (brand name Humira®) has been used in patients -who sho-w allergic reaction to infliximab. The drugs like thalidomide is under study trials.

Surgery

In the case of -widespread intractable Crohn's colitis, the colon and rectum (protocolectomy) is removed by the surgery ileostomy. Surgery is generally avoided, as this does not cure the disease. Crohns disease can recur at the site of the anastomosis or ileostomy.

Dietary Advice

Crohn’s patients should avoid the follo-wing foods and liquids:

• Dairy foods
• High fiber foods should be avoided during flisups.
• Hot spicy foods
• Alcohol & caffeine
• Foods containing saturated fats, found in meat and dairy products. Ho-wever some fats such as in fish oil may actually be helpful.
• Products containing corn or gluten, those made from -wheat, oats, barley, or triticale
• Foods, such as soy, eggs, peanuts, tomatoes
• Gasproducing foods such as cabbage family vegetables (broccoli, cabbage, cauliflo-wer and brussels sprouts), dried peas and lentils, onions and chives, peppers and carbonated drinks
• Foods that may irritate the intestine (particularly the cabbage family vegetables)
• Simple sugars
• Dried fruits or highsugar fruits, such as grapes, -watermelon, or pineapple
• Sorbitol (an artificial s-weetener)

Beneficial Foods:

• Fluids to keep the body hydrated and prevent constipation
• Fruits may be protective
• A high protein diet -with lean meats

Advice:

• Eat small frequent meals
• Prebiotics such as psyllium may help in the healing process.
• Probiotics may also be helpful in aiding recovery of the intestines.

Helminthic Therapy

Recent studies have come up -with a promising Crohn’s disease and ulcerative colitis treatment. Helminthic therapy is a ne-w treatment that has sho-wn impressive results in clinical trials. It argues that the absence of intestinal -worms (due primarily to higher hygiene standards) from the human intestinal tract may cause the immune system that is not evolutionary adapted to this condition, to overreact causing inflammation and other negative effects, and that reintroducing helminths through ingesting eggs of a certain species (-which is not dangerous to humans) can help do-wn regulate and normalize immune responses.

Helminthic therapy like the fecal bacterio therapy induces a characteristic TH2 -white cell response in the diseased isas -which seems to be the key in achieving and maintaining remission, and may prove to be of key significance in further research.