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Who’s who in Crohn’s disease? A medical fieldwork guide

Crohn’s disease is a lifelong condition in which parts of the digestive system become inflamed. The areas of inflammation are often patchy with sections of normal gut in between, and these inflammation patches may be small or extend quite a distance along part of the gut.

Crohn’s disease can affect any part of the digestive system, from the mouth to the anus, but it’s most likely to affect the end of the small intestine.  As well as affecting the lining of the bowel, Crohn’s may also go deeper into the bowel wall.

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written by GKA
Junior-Doctors

Crohn’s disease is one type of a condition called inflammatory bowel disease (IBD). Along with colitis, it is one of the most common types of IBD, with other less common types including microscopic colitis. People with Crohn’s disease and colitis also have an increased risk of bowel cancer.

It isn’t yet known what causes Crohn’s disease, but it is believed to be a combination of genetics, an abnormal reaction of your immune system to certain bacteria in the intestine, and an unknown trigger such as a virus, diet, stress, or smoking.

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Statistics

  • Crohn’s disease affects an estimated 115,000 people in the UK and millions more worldwide
  • People of any age can get Crohn’s, but it usually appears for the first time between the ages of 10 and 40
  • One in four people who are newly diagnosed are under 16 years old
  • The condition is more common in urban areas and developed countries
  • And it is more likely to appear in white people of European descent
  • Around 60-75% of people with Crohn’s disease will need surgery to repair damage to their digestive system
  • People who smoke are twice as likely to get Crohn’s disease than non-smokers
  • It is slightly more common in women than men

Symptoms

The symptoms of Crohn’s disease usually start in childhood or early adulthood, and the main symptoms of the disease are:

  • Diarrhoea
  • Stomach aches and cramps
  • Blood in the poo
  • Tiredness
  • Weight loss

Other symptoms of Crohn’s disease include a high temperature, feeling and being sick, joint pains, sore, red eyes, patches of painful, red and swollen skin, and mouth ulcers. Children with Crohn’s disease may also grow more slowly than usual.

The symptoms of Crohn’s disease may be constant, or they may come and go every few weeks or months. When they come back, it is known as a flare-up, and periods between flare-ups are known as remission.

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Diagnosis

Crohn’s disease can be difficult to diagnose because it can have similar symptoms to lots of other conditions. GPs will ask about symptoms and diet, as well as any medicines and family history. They might also feel and examine the patient’s tummy and they could also ask for a blood and stool sample.

If Crohn’s disease is suspected, the patient will be sent to a gastroenterologist for further investigation where they will undergo tests to confirm Crohn’s. These tests could include a colonoscopy, a biopsy and an MRI or CT scan.

Treatment

Whilst there’s no cure for Crohn’s disease, there are treatment options available to reduce or control symptoms. One example are medicines to reduce inflammation in the digestive system, usually in the form or steroid tablets which can be taken for a few months. If steroids on their own aren’t working, patients can be prescribed immunosuppressants to help stop the symptoms of Crohn’s disease coming back. These are taken as a tablet or injection and may be needed for several months or years.

If other medicines aren’t helping, stronger biological medicines such as adalimumab, infliximab, vedolizumab and ustekinumab can also be taken as a long-term treatment option. These are given via injection or drip every two to eight weeks and may be needed for several years. Another treatment option is surgery to remove a small part of the digestive system. Additionally, for children and young adults, a liquid diet can also help to reduce symptoms whilst avoiding the risk of slower growth that can happen with steroids.

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Who treats it

There is usually a team of healthcare professionals involved in the treatment of Crohn’s disease and IBD, including specialist doctors such as gastroenterologists, GPs and specialist nurses. A typical team treating Crohn’s disease includes but isn’t limited to:

Gastroenterologists

Gastroenterologists are physicians who investigate, diagnose, treat and prevent all gastrointestinal (stomach and intestine) and hepatological (liver, gallbladder, biliary tree and pancreas) diseases. When it comes to the treatment of Crohn’s disease, they will correctly diagnose Crohn’s disease by performing tests such as endoscopies, and are also involved in the treatment plan and management of the condition. At GKA, we have 198 gastroenterologists on our healthcare market research panel.

Specialist nurses

Specialist IBD nurses provide specialist care, procedures, education and support to patients. As well as providing follow-up and day-to-day care, they will be the patient’s main point of contact if they have any questions. At GKA, we have access to 296 specialist nurses via our healthcare market research panel.

General Practitioners

GPs will usually be the first point of call for Crohn’s sufferers. If a GP suspects Crohn’s disease, they will refer the patient to specialist gastroenterologists for additional tests. Once Crohn’s has been diagnosed, GPs will be involved in the management of the condition and provide advice on everything from treatment to diet.

Dieticians

Because a number of Crohn’s flare-ups are due to diet, dieticians are a key member of the treatment team. They will work together with patients to help them manage and control the symptoms of Crohn’s and also devise diets to compensate for nutrient deficiencies, for example, if the patient is on a liquid diet.

Surgeons

Specialist surgeons, such as colorectal surgeons, will perform a variety of procedures to repair damage caused by Crohn’s disease to the lower digestive tract, such as removing affected parts of the digestive system.

Our experience

As well as gastroenterologists and specialist nurses, at AGKA we also have over 2,000 GPs and 168 surgeons on our dedicated healthcare market research panel. In recent years, we have carried out a number of studies on Crohn’s disease and IBD, including projects on biologics treatments. So if you’re looking to conduct a market research study on Crohn’s, then you’ve come to the right place!
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