Crohn's Disease | Treatment | Expert Homeopathy

Crohn's Disease

Definition [what is crohn's disase?]
It is characterized by a localized area of nonspecific chronic granulomatous inflammation of small, or more rarely, of large intestine. 50% of crohn's disease patients have ileocolitis...


Causation
Unknown by familial, genetic, infective and immunologic factors may play part, and mainly young people are affected...


Pathology
The disease mainly involves the terminal ileum, which becomes engorged and edematous in all layers, narrowing the lumen. The mucosa becomes ulcerated and fissure. Microscopically, grades of inflammation with giant cell and granuloma may be seen. [Focal granulomas in 50%] [Diagnostic].

The spectrum of signs and symptoms can but due to :
  • Intestinal obstruction
  • Fistula formation
  • Anal fissures, fistulas
  • Extraintestinal disease
  • Malabsorption

Symptoms
  • Onset is gradual
  • Low-grade fever, loss of weight, weakness and malaise may be the first complaint
  • Gradually anorexia increases
  • Localized pain in the lower right quadrant or around the umbilicus, often colicky
  • Diarrhea following pain is frequent, stools may contain blood
  • Gradual loss of weight

Signs
  • The patient is emaciated in later stages
  • Tenderness in right iliac fossa
  • Fixed mass in right iliac fossa may be palpable
  • Multiple fistulas are seen opening on to the surface of the abdomen, in the perianal region or other organs e.g, faces or air in urine
  • Clubbing of fingers
  • Erythema nodosum
  • Asymmetrical arthritis
  • Episcleritis or uveitis may also occur

Investigations
Barium meal follow-through shows alteration of mucosal pattern. Evidence of narrowing of lumen, string sign or areas of dilatation above the lesion with difficulty in filling the bowel - segments of the gut may be involved with normal tissue lying between, showing the so-called skip lesions.

Stool examination: Formed or loose, may contain frank blood

Pus cells and R.B. Cs

Evidence of malabsorption in some cases

Blood examination: E.S.R raised

Creative protein level may be raised

Anemia

Leukocytosis

Colonoscopy: In cases where colon is also involved

Biopsy may also be taken


Complications
  • Abscess formation
  • Malabsorption syndrome
  • Fistula in ANO
  • Obstruction due to stricture
  • Erythema nodosum
  • Gall stones and renal stones
  • Carcinoma colon, hemorrhage

Treatment
Mental and physical rest
Surgical treatment if necessary or for complications
Vitamin B12 and vitamin D supplementation
Diarrhea, colic and abdominal pain must be controlled. A low roughage diet may cause the diarrhea and colic. Hypo-albuminemia should be treated with a high-protein diet.
Differential diagnosis:
Ulcerative colitis
Intestinal neoplasms
Segmental colitis.


Homeopathic medicines[Expert Homeopathy]
Argentum Nitricum: Diarrhea, worse at night, watery, slimy, always after drinking or eating soup, immediate discharge from the bowels, as though the fluid were rolling through without stopping. Soreness and burning in the region of the sigmoid flexure; emaciation, desire for sugar.

Aresenicum Album: Worse about midnight, burning pain in the abdomen, discharge burning, cadaverous smelling, excoriating the anus, thin lumpy, great thirst, restlessness, exhaustion and emaciation, old look on the face, very cross and despondent.

Baptisia: Stools dark, offensive, exhausting, pain in the liver and region of gall bladder, sweat and urine extremely fetid, little or no thirst, gone feeling at pit of stomach, frequent fainting.

Bryonia alba: Pain in the bowels after eating or drinking, the slightest motion brings on a discharge which looks like dirty water, showing on standing a whitish, finely granulated sediment of undigested food at the bottom of the vessel.

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