Crohn's disease and the complex diagnosis
Crohn's disease is a bowel disease that causes severe inflammation, especially in the intestinal mucosa. But usually not only the intestine is affected: Inflammation can occur in the entire digestive tract, from the mouth to the anus. The complaints are very individual for each person affected. This is only one reason why it usually takes a long time for a doctor to diagnose Crohn's disease.
Nonspecific symptoms complicate the diagnosis of Crohn's diseaseCommon symptoms of Crohn's disease are diarrhea, severe abdominal pain and fever. In addition to many other complaints directly in the digestive tract, acute inflammations can also cause general fatigue and even growth disorders in children.
Crohn's disease often occurs for the first time between the ages of 15 and 40. Especially if the symptoms recur over a longer period of time, the suspicion of a chronic inflammatory bowel disease becomes stronger at some point.
Crohn's disease: Diagnosis is a processThe disease cannot be identified from the typical symptoms of Crohn's disease alone - because the symptoms also apply to other clinical pictures. If Crohn's disease is suspected, the diagnosis involves several tests and detailed examinations.
A precise differentiation from other diseases, such as ulcerative colitis, is important for further therapeutic measures. And even if Crohn's disease has been diagnosed, tests help the doctor to determine how far the disease has progressed.
The medical consultationOn the way to a diagnosis of Crohn's disease, a visit to a gastroenterologist is the first step. This doctor, who specializes in gastrointestinal diseases, asks the patient's medical history for the exact symptoms and how often and at what intervals they occur.
A palpation of the lower abdomen is beside the conversation usually one of the first measures. Crohn's disease can cause inflammation in the entire digestive tract. Particularly frequently, the intestinal section in the area of the right lower abdomen is affected. The demarcation to an inflammation of the appendix is difficult alone with this symptom: Because also then the right lower abdomen is hardened and pressure-sensitive. However, an inflammation of the visual appendix usually occurs much more abruptly than Crohn's disease.
Possible examinations and tests on the way to diagnosis
If the doctor suspects that Crohn's disease is involved, tests can help to make a reliable diagnosis. The following tests provide important clues:
- Stool sample: Inflammation values in the stool indicate that inflammation of the mucous membrane is present, and the doctor can rule out other causes of the symptoms (such as bacterial infection).
- Blood count: if Crohn's disease is suspected, the blood values also help with the diagnosis. Various signs in the blood indicate inflammation in the body, for example too many white blood cells or elevated C-reactive protein levels. Crohn's disease can also be accompanied by deficiency symptoms or anemia.
- Ultrasound: during an ultrasound, the doctor can detect a thickened intestinal wall, abscesses, fistulas or other changes due to the inflammation.
- Colonoscopy: in a comprehensive colonoscopy, the doctor can assess the surface of the mucous membrane. Normally it is smooth, but in Crohn's disease patients it becomes rough and uneven over time. Other long-term consequences such as ulcers, abscesses or constrictions are also quickly noticed during a colonoscopy. In addition, the doctor can take a tissue sample directly and thus gain further insights.
- Gastroscopy: since Crohn's disease does not only occur in the intestine, a gastroscopy is often necessary.
- MRI: using a contrast medium, the doctor can also detect a thickened intestinal wall or swollen lymph glands in the MRI.
- Capsule endoscopy: in capsule endoscopy, the patient swallows a capsule with an integrated camera. During this gentle examination, the doctor can get a picture of the entire digestive tract.
Crohn's disease: After diagnosisOnce Crohn's disease has been diagnosed, it is necessary to determine how advanced the disease is: At what intervals does the patient have relapses and have complications already occurred due to the protracted inflammation? These can be fistulas - i.e. connections between the intestine and other organs or even the skin - or intestinal constrictions.
Once the doctor has got a clear picture, he develops the right therapy. Suitable medications are almost always part of it. Because even if the illness is currently at rest, medication helps to keep it under control. Crohn's disease is not curable, but the goal is to prolong the remission phases and prevent new inflammations.
Maintain the intestinal flora for improved wellbeingA change of diet is often part of the therapy program. This helps, among other things, to keep the bacteria of the intestinal flora as balanced as possible so that your intestines are resistant.
With the stabilization of the intestinal flora also high-quality probiotic food supplements can help. They contain bacteria cultures, which settle in the intestine and increase the variety of intestinal bacteria.