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Crohn’s Disease aka regional enteritis

Crohn’s Disease aka regional enteritis. Overview of Presentation . General historical background information Description of the condition Management of the Disease Nutrition’s role in stabilizing the condition Conclusion Ethical dilemmas (M.D. vs Nutritional)

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Crohn’s Disease aka regional enteritis

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  1. Crohn’s Diseaseaka regional enteritis

  2. Overview of Presentation • General historical background information • Description of the condition • Management of the Disease • Nutrition’s role in stabilizing the condition • Conclusion • Ethical dilemmas (M.D. vs Nutritional) • Opinion for managing the disease • What the audience should know

  3. The naming of regional enteritis First Chief of Gastroenterology at Mount Sinai in New York. Practiced medicine until he was 90. 1932 Crohn, with two colleagues, described a series of pateintswith inflammation of the terminal ileum. Colleagues, Dr. Ginzburg and Dr. Oppenhimer, helped publish the seminal paper, “Terminal Ileitis: A new clinical entity”. Disease was known as regional ileitis upon publication. Believed the disease was caused by Mycobacterium paratuberculosis, which is responsible for a similar condition that afflicts cattle known as Johne’s disease. Unable to isolate the pathogen- undetectable under an optical microscope. Dr. Burril Bernard Crohn

  4. Inflammatory Bowel Disease

  5. Behavioral Classification Stricturing Penetrating Inflammatory

  6. Regional Tract Classification Three most common sites of intestinal involvement are: Ileititis ~30% of cases Ileocolic~50% of cases Colitis ~20% of cases Gastroduoldenal and Jejunoileitis are also common sites

  7. Crohn’s Disease Crohn's disease, also called regional enteritis, is a chronic inflammation of the intestines which is usually confined to the terminal portion of the small intestine, the ileum. Ulcerative colitis is a similar inflammation of the colon, or large intestine. These and other IBDs (inflammatory bowel disease) have been linked with an increased risk of colorectal cancer.

  8. Anorectal fistulas The lining of the intestine may ulcerate and form channels of infection, called fistulas. Fistulas tunnel from the area of ulceration, creating a hole which may continue until it reaches the surface of the organ, or the surface of nearby skin. These holes typically spread the infection that creates them, and life-threatening conditions such as peritonitis (inflammation of the lining of the abdomen) may occur.

  9. Is it Crohn’s or Ulcerative Colitis?

  10. Is it Crohn’s or Ulcerative Colitis?

  11. Symptoms Main symptoms include: • Crampy abdominal pain • Fever • Fatigue • Loss of appetite • Pain with passing stool • Diarrhea • Weight loss Other symptoms may include: • Constipation • Eye inflammation • Fistulas • Joint pain and swelling • Mouth ulcers • Rectal bleeding • Bloody stools • Skin lumps or sores • Swollen gums

  12. What’s causing Crohn’s disease? • Mycobacterium paratuberculosis • Diet and stress • Environmental stressors • Autoimmune disorder

  13. Who’s at risk for Crohn’sdisease? • Younger than 30 • Elevated risk for whites and Eastern European Jewish descent • A close relative diagnosed • Smokers • Live in an urban area • Live in a northern climate • Diet high in fat or refined foods

  14. Bio-medical Interventions • DIAGNOSIS • Colonoscopy most effective at detection (70%) • Endoscopy • Blood tests • MEDICATIONS • Anti-inflammatory drugs • Corticosteroids • Antibiotics • NUTRITION THERAPY • Vitamin B-12 • Iron • Calcium • Vitamin D

  15. Bio-medical Interventions • Surgery • Strictureplasty • Colon restructure • Colectomy • Treat symptoms • Pros • May lead to long-term remission • Cons • Disease often recurs

  16. Treatment

  17. Diet & Lifestyle Don’ts • Exclusion Diets • Food Journal • Avoid gas inducing foods: • High Fiber • Dairy • Stimulants • Spicy • High fat • Stop smoking Do’s • Drink lots of water • Multi-vitamin and mineral • Anti-inflammatory foods • Fish oil • Ginger • Raw foods • Prebiotics • Regular exercise • Stress-relief activities

  18. Vitamin D Qualitative research on 57 yr. old woman Deficient while supplimenting Tanning bed for 10 min., 3 times a week for 6 months at Boston University Med. Center Serum Vit D increase of 357% Maintained adequate levels 6 months later Hypovitaminosis D

  19. Alternative Therapy • Yoga • Tai Chi • Meditation • Biofeedback • Support Groups

  20. Ethical Dilemma – Food v. Medicine Nutrition Medicine Strong, possible quick reduction of symptoms Lots of negative side effects and adverse reacations Only potent solution to potent problems • Acute episodes often triggered by food • Poor absorption of nutrients requires intravenous feeding • No side effects from proper nutrition

  21. Conclussion • Treatment requires a multi-faceted approach • Support groups and experts necessary for proper education • Beware of snake-oil and testimonials • Get outside, get active, and gain control of your body

  22. Need to know for the test • How ulcerative colitis differs from Crohn’s disease. • Nutritional guidelines for patients with Crohn’s disease. • Most common areas affected by Crohn’s disease. • What’s the lesser known name for Crohn’s disease. • Possible causes of Crohn’s disease • High risk categories • Likelihood of contracting a IBD if family has been diagnosed.

  23. The End

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