Diet and Health FAQ

Tagged As: What Is Crohns

Question:
I'm new here and I have a question. My 16 year old son is in the process of being diagnosed with Crohn's, after two years of battling with excruciating pain, missed school, anemia, all kinds of wacky blood work, every test under the sun, and baffling doctors.  Now his GI is expecting to find Crohn's in his colonoscopy results.  The pictures showed inflammation and ulcerations (doc's words) but he needs to get the biopsy results back to confirm the diagnosis.  What exactly does the pathology show that will lead to a confirmation of this diagnosis? Certain cells exclusive to Crohn's? I can't seem to find information about this.

Answer:
The pathology will be able to detect granuloma (a mass of inflamed granulation tissue, usually associated with ulcerated infections http://dictionary.reference.com/search?q=granuloma) in the middle layer of the intestinal wall. Crohn's starts off in the middle layer or submucosa of the intestine. On endoscopy the mucosa can look normal, but the disease is busy bubbling away in the submucosa. This is the reason why biopsies that include the submucosa are required for a diagnosis. This initial disease activity might not necessarily be accompanied by major symptoms. However, after a certain period of time the disease affects the entire wall of the intestine http://education.yahoo.com/reference/gray/248.html;_ylt=AhKlQ6lg.KCff... causing significant damage and mild, moderate or severe Crohn's symptoms. I was not diagnosed for many years and most Crohn's sufferers report the same. Ulcerative colitis patients tend to be diagnosed faster because the disease is present only in the upper mucosa and confined to the colon, which makes it easier to investigate. There also seem to be several sub-types of Crohn's, e.g. stenosing Crohn's, constipating Crohn's, Crohn's colitis, Crohn's ileitis, Crohn's of the upper gastrointestinal tract, etc., and each patient  shows a very different individual progression of the disease. Crohn's of the tonsils has recently been reported here and a few patients here have reported ulcerations of the mouth. I started off with Crohn's colitis and had enteropathic arthritis in the knees, erythema nodosum, iritis (inflammation of the eye) and sickness/nausea 6-7 years prior to diagnosis. With hindsight, I had the general Crohn's malaise (chronic tiredness) most of my life and was always stomach focused. You might find the following articles useful. The first one is my particular favourite. http://www.umm.edu/patiented/articles/what_crohns_disease_inflammator... http://www.geocities.com/crohn_disease_ibd/crohns_disease.htm http://ibscrohns.about.com Side-effects of medication can be found at www.rxlist.com www.drugs.com. I also suggest that you keep a diary of events and make sure that you obtain copies of all his patient reports/notes to facilitate getting a second opinion if necessary. It is very important to keep an eye on the doctors - getting a diagnosis is a big enough struggle - finding the right treatment including competent nutritional advice (Crohn's affects growth in youngsters) is the next hurdle.  If they realize that the patient and family are keeping factually abreast of them this will hopefully keep them on their toes. The doctors are easier to convince if you have something in writing like a patient diary or notes on key symptoms. A patient diary has also been key in obtaining disability allowance for some patients here - to demonstrate to the judge the unpredictable relapsing/remitting nature of the disease. Familiarize yourself with the extra intestinal symptoms (eyes, joints, liver, pancreas, kidney, lungs, skin, etc.) of Crohn's because these can be a sign that the disease is active although nothing may show up in blood tests. I hope that your son finds an extremely competent gastroenterologist. If there are any doubts as to the doc's ability a second opinion should be sought as soon as possible. I can’t add to the wonderful and informative posting from vanny...but just to let u know welcome to the group and sorry your son is going through this...but this group is a good place for Crohn’s and uc families to be... There is a post from Vanu just yesterday on the 14th Dec.  I responded to that post under Kureforcrohns. Are you able to access that post.    It is cumbersome to repeat myself.    It is my layman's cause of Crohn’s.  Don't be upset if that is the diagnosis.  It is a manmade illness in my opinion and understanding what brings it on will help immensely. Especially you son is only 16, he should be able to get well.  Let the doctor make the diagnosis and follow his instructions, but read my post and you may be able to circumvent much of the baloney associated with this illness.  The cause is weird, but the harm is terrible.   This is an illness like no other and acts like no other.  If you cannot access my post attached to Vanu's post, write me at Advocate...@aol.com  and I will repeat the message.  The younger the child, the better chance of being well.   The adults have too many of their own doubts to relate to the cause as I state it. The best thing you can do is learn as much as you can about Crohn's Disease. A good place to start is the CCFA, http://www.ccfa.org.  My website also has a simple, easy to understand, explanation.