Dr. Juan José Vila Costas, a leading specialist in digestive system and expert in Crohn’s disease, talks about this pathology and how it affects certain groups of people. In most cases Crohn’s disease is detected by performing a colonoscopy, although since it can affect any part of the digestive tract, it can be diagnosed by gastroscopy or even capsule endoscopy. In most cases, during colonoscopy the inflammatory involvement of the last few centimeters of the small intestine is verified and the diagnosis can be made by taking a biopsy of this involvement.
Certain radiological diagnostic techniques, such as CT or MRI, can make a presumptive diagnosis that must later be confirmed at colonoscopy.
What are the main symptoms of Crohn’s disease?
The main symptoms are fatigue, abdominal pain, fever and diarrhea with or without blood. In addition there are other manifestations that can also appear in Crohn’s disease such as the development of abscesses, perianal involvement and enterovesical fistulas (communications between the digestive tract and the bladder), enterocutaneous fistulas (communications between the digestive tract and the skin) and enterovaginal fistulas (communications between the digestive tract and the vagina).
Crohn’s disease can also cause systemic and extraintestinal symptoms. Fatigue, fever and weight loss are common systemic symptoms. Extraintestinal symptoms include arthritis of large joints, with sacroiliitis or ankylosing spondylitis; ocular manifestations such as uveitis, iritis and episcleritis; dermatological manifestations such as erythema nodosum and pyoderma gangrenosum; primary sclerosing cholangitis; secondary amyloidosis; arterial and venous thromboembolism; kidney stones; osteoporosis; vitamin B12 deficiency or pulmonary involvement.
Who is affected by this type of disease?
Between 3 and 20 new cases per 100,000 inhabitants are diagnosed each year, most of them in industrialized countries. This disease is diagnosed in most cases in young adults, between 15 and 40 years of age, and follows a chronic course, although it can be diagnosed at any age. There appears to be a predominance of involvement in women, although this may vary in different geographical areas, and the incidence is higher in Caucasians than in blacks or Hispanics.
Finally, there is a certain genetic predisposition to suffer from the disease, which is derived from the fact that between 10-25% of patients with this type of disease have at least one first-degree relative affected with Crohn’s disease or ulcerative colitis.
What type of diet should be followed and what foods are forbidden?
Although it is suspected that some elements of the diet may play a role in the development of the disease, it has not been possible to identify what these harmful elements are. Following a typical Western diet with processed, fried and sugary foods is associated with an increased risk of Crohn’s disease. In the same vein, prolonged intake of fiber, especially fruit, and a diet high in omega-3 fatty acids and low in omega-6 fatty acids, has been associated with a decreased risk of Crohn’s disease. One item that is especially prohibited in Crohn’s disease is smoking.For more information, you can consult a digestive specialist.