Monitoring and Treatment for Crohn’s and Colitis patients

There is currently no cure for Crohn’s and Colitis. Existing drugs can only suppress them. All drug-based treatments impact patients differently, according to the level of the disease. This vagueness complicates the treatment. It’s happened more than once that patients have had to take it on themselves to make decisions (in consultation with the doctor) that have a direct influence on their condition. Taking the correct decision requires knowledge concerning the nature of the treatment or test, and being well-informed on all the parameters that contribute to the patient’s bodily and mental state over a long period.

The patient who is forced to devote most of his strength to deal with the disease ne additional energy for tests and treatments. An understanding of the aim of the test and treatment tends to increase the motivation to undergo them. For every patient, choosing a suitable treatment is based on being well-informed about its aim, as well as on frequent monitoring of the situation.

This chapter investigates treatment methods and monitoring for both Crohn’s and Colitis, methods that include medical and self-monitoring systems, and conventional and alternative approaches to treatment. The aim of the chapter is to provide information to patients that will aid them in taking decisions concerning how they should monitor their disease and methods of treating it.

Definition

Inflammatory Bowel Disease (IBD):

An inclusive name for inflammatory diseases of the digestive system, of which the main ones are Crohn’s and Colitis.

Crohn’s disease (CD):

A chronic disease that affects the digestive system and which can appear along the entire length of the system – from the mouth to the anus. The areas most susceptible to the disease:

·         The terminal part of the small intestine – the point of connection between the small and the large intestine, also known as the Terminal Ileum.

·         The large intestine (appears in half of the cases together with impairment to the small intestine). 

Ulcerative Colitis (UC):

A chronic inflammation that appears only in the large intestine and the rectum. With Colitis the inflammation is continuous and involves only the mucus. It does not penetrate the entire intestinal wall. The reasons for the disease, and its identification and treatment, are similar for the two diseases, despite the clinical differences between them. 

Crohn’s and Colitis are diseases that have a stronger effect on the immune system which then displays uncontrolled activity, in all likelihood against the germs that are found in the bowel. The reasons for the appearance of the disease are not known. There a few theories such as a disturbance of the immune system, a bacterial or viral infection, hereditary disease, psychosomatic reasons, poisoning, damage, and so on. The reason is probably based on a combination of genetic background and environmental factors of the kind I have mentioned. Currently it is not possible exactly pinpoint the factors and therefore it is not possible to prevent the disease from appearing.

About twenty years ago, throughout the world, the disease was found mostly among Jews, but in recent years a similar percentage of non-Jews have been found to have the disease. Although the connection has not been proven in the research, it’s possible to tell from this that it has occurred along with the socio-economic improvement of these populations.

The disease is equally common to men and women, and can appear at any age. In most cases it breaks out at the end of the second decade of life (between the ages of sixteen and twenty) and is connected to a stressful period of the patient’s life (for example, army service).

An estimation of the number of patients

The frequency of Crohn’s disease is between ten and seventy patients for every 100,000 of the general population. (It more frequent among Jews of the diaspora).

Unofficial research points to an increase in the number of Crohn’s and Colitis patients globally in recent years.

Symptoms of the disease

·         Chronic diarrhea: One of the most prominent symptoms of the disease. It can appear without warning and continue for long periods. It is usually accompanied by strong odors and even bleeding.

·         Pain: Stomach pains caused by intestinal cramps are the main and most prominent and common symptoms of the disease. The pains usually begin on the lower right side of the abdomen. The pains vary from general discomfort to acute stomach pains with strong cramping of the intestines.

·         Temperature: Intense activity in the disease – especially in severe cases – includes the development of fistulae (a connection between tissues – please see the explanation later on), or ulcers – accompanied by high temperature and shivers.

·         During later stages it is possible to note other symptoms such as: Weight loss, signs of malnutrition, anemia, lack of appetite and lack of vitamins. In addition, following continuous diarrhea, damage to the anus can occur, and also injury to other systems and tissues such as joints, skin, eyes and liver.

·         Blood in stool: Characteristic of Colitis, blood mixed with feces can occur with the involvement of the large intestine. Fresh blood is a generally a sign of the involvement of the rectum.

·         A continual need to move the bowels, or tenesmus: Characteristic of Colitis, in which the patient can feel a continuous need to go to the bathroom, but without result, or with a mucous discharge only. 

The full chapter is published in the book.