During the month of May, awareness around Inflammatory Bowel
Diseases (IBDs) has been heightened and pharmaceutical company AbbVie (Pty) Ltd
is raising awareness around one particular IBD – Crohn’s disease. Supported by
the ‘Join the Fight against Autoimmune diseases’ campaign, AbbVie (Pty) Ltd
aims to raise public understanding of Crohn’s disease highlighting how
sufferers courageously cope with its debilitating symptoms every day.
“Although there are no accurate statistics, the incidence of
Crohn’s disease is about seven in every 100 000 South Africans, meaning about 3 500
new cases present each year,” says gastroenterologist at Milpark Hospital in
Johannesburg, Dr Herbert Schneider.
While the disease is more prevalent among adolescents and
young adults between the ages of 15 and 35, it can occur at any age. Men and
women are equally likely to be affected.
What is Crohn’s
Crohn’s disease is a chronic inflammatory bowel disease that
affects the small intestine and colon.
It can affect any part of the gut, from the mouth all the
way down to the anus. In the majority of cases the lower part of the small
intestine - the ileum - is affected. Patients with Crohn's disease often feel
pain and the condition can make the intestines empty frequently, resulting in
“The disease has negative psychological effects too,” says
Dr Schneider. “Because some patients have to go to the toilet often, they may
feel anxious about travelling and going out and this can result in depression
and feelings of isolation.”
People suffering from Crohn’s also experience loss of
appetite and may lose weight as a result. A feeling of low energy and fatigue
is also common. Among younger children, Crohn's may delay growth and
Because Crohn's is considered a chronic disease, Dr
Schneider says patients will likely experience periods when the disease flares
up and causes symptoms, followed by periods of remission when patients may not
notice symptoms at all.
What causes Crohn’s
Most experts agree that the immune system of people with Crohn's
disease reacts abnormally.
Gastroenterologist at Sunninghill Hospital, Dr Barry
Shmeizer in Johannesburg, says Crohn’s is an autoimmune disease that occurs
when the body's immune system mistakenly attacks and destroys healthy body
tissue, causing inflammation.
He says while diet and stress may aggravate Crohn’s disease,
they do not cause the disease on their own. Recent research suggests
hereditary, genetics, and environmental factors contribute to the development
of the disease.
“When it comes to Crohn’s disease, stress is the enemy. “If
patients find themselves under stress, such as at exam time, we often see them
presenting with flare ups of the condition.”
He adds that certain medications can also trigger a flare
Who is most at risk?
Approximately one fifth of all people with Crohn's disease
have a close relative with some type of inflammatory bowel disease. People of
Jewish descent have a higher chance of developing Crohn's disease.
“In South Africa the disease is no longer limited to certain
populations and we are seeing more of the general population developing the
disease,” says Dr Schneider.
Studies have shown that 5% to 20% of affected individuals
have a first–degree relative (parents, child, or sibling) with the disease.
Crohn’s also appears to be more common in developed
countries rather than undeveloped countries, in urban rather than rural areas,
and in northern rather than southern climates.
New treatments offer
Although Crohn’s disease is not curable, Dr Shmeizer
emphasises that it is treatable and controllable. Treatment for Crohn’s and
other IBD varieties can include the use of medication, alterations in diet and
nutrition, and sometimes surgical procedures to repair or remove affected
portions of the GI tract.
“This is a very exciting time in terms of new treatments for
Crohn’s disease,” says Dr Shmeizer. “Biologic therapies represent the latest
class of therapy used for people suffering from moderate-to-severe Crohn’s
Also known as anti-TNF agents, biologic drugs target a
chemical called Tumor necrosis factor (TNF) which causes inflammation - and destroy
Successful medical treatment allows the intestinal tissue to
heal and relieves the symptoms of fever, diarrhoea, and abdominal pain.
When treating Crohn’s disease, clinical trials have also
shown that regular, ongoing therapy with certain medications lowers the risk of
hospitalisation, and the need for surgery to a significant extent.
Dr Shmeizer points out the earlier the disease is diagnosed,
the less chance there is of complications later on.
“We’ve found that if we can intervene with medication within
two years of a patient developing Crohn’s they are likely to need fewer
surgeries or in some cases no surgery at all,” says Shmeizer.
But Shmeizer warns that Crohn’s disease is often
misdiagnosed. “The only way to diagnose Crohn’s disease is through further
investigation, involving an internal examination, blood and stool samples,
scans and laboratory tests.” Dr Shmeizer adds: “Patients are often misdiagnosed
at first – the doctor may think it is an infection or something more innocuous
such as Irritable Bowel Syndrome, which can delay treatment and cause further
damage to the gut.”
Dr Schneider says that it’s also important for patients to
know that Crohn’s disease is not the same as Ulcerative Colitis, another type
of IBD. The symptoms of these two illnesses are quite similar, but the areas
affected in the gastrointestinal tract (GI tract) are different.
Even if you think you are showing signs of Crohn’s disease
symptoms, only proper testing performed by your doctor, can render a diagnosis.
Says Dr Shmeizer: “After diagnosis, a combination of treatment
options can help patients stay in control of their disease and help them to
lead a full and rewarding life.”
know about Crohn’s disease
- Crohn’s disease is treatable and controllable
(although not curable).
- The earlier you start treatment, the better the
- Treatment for Crohn’s can include the use of
medication, alterations in diet and nutrition, and sometimes surgical
procedures to repair or remove affected portions of your GI tract
- By working with your doctor, you can control the
disease and enjoy a good quality of life.