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Crohn’s Disease is one of the inflammatory bowel diseases (IBD). This means that there is inflammation affecting the tissues of the digestive tract. It can affect any section of the digestive system from the mouth to the anus.
Crohns can affect any part of the gastrointestinal tract, including the mouth, small intestine as well as the large intestine. It can cause various symptoms, including diarrhoea, pain and weight loss.
Nutrition and growth may be adversely affected due to the disease.
The main symptoms are:
Various therapeutic options are available, including medical, surgical and nutritional options.
Management aims to control the inflammatory process, resolve symptoms and prevent complications.
In children and adolescents, ensuring normal growth and development are critical.
Medically, Crohns is considered a life-long condition without a cure. It tends to have periods of exacerbation and remission, which means that there are typically episodes of no symptoms, interrupted by the reappearance of symptoms.
Dysbiosis (alteration of the normal, healthy, gut microbial composition) has been linked to IBD, and has been found to be more common in Crohns, with lower microbial diversity (a marker of a healthy gut bacterial composition).
Specific bacteria associated with producing butyrate (a marker of healthy gut microbiome), such as Faecalibacterium prausnitzii are decreased and Escherichia coli – associated with production of endotoxins and histamine – is increased in Crohns’
In patients known to have IBD, a genetic component is suspected to increase their susceptibility to specific gut microbes. These can trigger arthritis. Hence a Crohn’s patient who has diarrhoea and arthritis may have either a “reactive arthritis” caused by a gut infection, or it could be a flare of the IBD associated with arthritis.
Faecal Microbial Transplant (FMT), which is also known as stool transplant or bacteriotherapy, is a procedure in which faecal matter, or stool, is collected from a healthy person and administered into the intestines of another person. Interestingly, transfering donor faeces by way of “yellow soup” to a recipient with gut diseases dates back to the 4th century in China!
In FMT, the donor stool is given either by mouth (though a tube into the intestine, or in “Crapsules”) or via the rectum (enema) or during colonoscopy.
Preliminary studies suggest that FMT may be an effective therapy in Crohn’s disease, but so far, this is not widely available as a treatment.
Almost all children with Crohn’s have a history of weight loss or lower-than expected weight gain. This is typically due to decreased intake, due to the anorexic effects the disease process, plus pain and feeling full after a small amount of food.
Other contributory factors include malabsorption or increased energy requirement. Children often exhibit poor growth and delayed onset of puberty. This can mean that a child might not reach their full height potential.
A nutritional approach to the management of Crohn’s Disease has been supported by recent research, with the benefit of controlling inflammation, reducing symptoms and optimising growth. A great advantage is the minimal side-effects and permitting avoidance of other therapies that may adversely impact on children with regards to growth, development and socialisation.
House of Health Ltd