Crohn’s disease is a chronic inflammatory bowel disease (IBD) that primarily affects the gastrointestinal (GI) tract. It is characterized by inflammation, which can occur anywhere along the digestive tract from the mouth to the anus, although it most commonly affects the small intestine and the beginning of the large intestine (colon). Crohn’s disease is a lifelong condition that can cause a variety of symptoms and complications.
Some of the common symptoms of Crohn’s disease include:
Abdominal pain and cramping: This can range from mild to severe and is often located in the lower right abdomen.
Diarrhea: Chronic and sometimes bloody diarrhea is a common symptom.
Fatigue: Inflammation and other factors can lead to fatigue and a general sense of low energy.
Weight loss: Reduced appetite and malabsorption of nutrients can result in weight loss.
Loss of appetite: Inflammation can lead to decreased appetite and difficulties in maintaining a healthy diet.
Fever: Inflammation and infection can cause fever, especially during flare-ups.
Joint pain: Inflammatory processes can affect the joints, leading to pain and stiffness.
Skin and eye problems: Some individuals with Crohn’s disease might experience skin rashes and eye inflammation.
The exact cause of Crohn’s disease is not fully understood, but it is believed to result from a combination of genetic, environmental, and immune system factors. The immune system in individuals with Crohn’s disease mistakenly attacks the healthy tissues of the digestive tract, leading to inflammation and the symptoms associated with the condition.
Crohn’s disease is a chronic condition with periods of flare-ups (active disease) and periods of remission (minimal to no symptoms). Treatment aims to manage symptoms, reduce inflammation, and improve quality of life. Treatment approaches might include medications to control inflammation, suppress the immune response, and alleviate symptoms.
In severe cases, surgery might be necessary to remove damaged portions of the intestine or address complications such as strictures (narrowing) or fistulas (abnormal connections between organs).
It’s important for individuals with Crohn’s disease to work closely with healthcare professionals, including gastroenterologists, to develop a personalized treatment plan and to manage the condition effectively.
What Testing is Done for Diagnosing Crohn’s Disease?
Diagnosing Crohn’s disease typically involves a combination of medical history assessment, physical examination, laboratory tests, and imaging studies. During the medical history assessment, a healthcare provider will inquire about the individual’s symptoms, their duration, and any family history of inflammatory bowel disease (IBD).
A physical examination might reveal signs of abdominal tenderness, swelling, or other indicators of inflammation. Laboratory tests such as blood tests can be conducted to assess for markers of inflammation, anemia, and nutritional deficiencies.
Additionally, stool samples may be analyzed to rule out infections and assess for the presence of blood or inflammation. To visualize the gastrointestinal tract, imaging studies like endoscopy and imaging techniques such as colonoscopy, upper endoscopy, capsule endoscopy, and imaging scans (such as CT scans and MRIs) are used.
These tests can help identify inflammation, ulcers, strictures, and other abnormalities characteristic of Crohn’s disease. Biopsy samples collected during endoscopy can provide further insight into the nature and extent of the inflammation.
The diagnosis of Crohn’s disease requires the integration of all these findings, as well as the exclusion of other conditions with similar symptoms, to arrive at an accurate and comprehensive diagnosis.
How is Crohn’s Disease Managed?
Crohn’s disease is managed through a combination of medical treatments, lifestyle modifications, and ongoing monitoring. The primary goal of management is to achieve and maintain remission (periods of minimal to no symptoms) while improving the individual’s quality of life.
Medical interventions often include medications that target inflammation, suppress the immune response, and alleviate symptoms such as abdominal pain, diarrhea, and fatigue. These can include anti-inflammatory drugs, immunomodulators, biologics, and, more recently, Janus kinase (JAK) inhibitors.
Lifestyle modifications, such as stress management techniques, regular exercise, and adequate hydration, can also play a crucial role in symptom control.
For severe cases or complications like strictures and fistulas, surgical intervention might be necessary to remove damaged sections of the intestine or address complications.
Regular follow-up with healthcare providers is important to monitor disease activity, adjust treatment plans, and manage potential side effects of medications. Crohn’s disease management is individualized, with treatment plans tailored to each person’s specific needs and response to therapies.
An integrated approach involving gastroenterologists, dietitians, mental health professionals, and support groups helps individuals navigate their condition effectively and maintain a good quality of life.
Can Regenerative Medicine Help Crohn’s Disease?
Regenerative medicine, also known as stem cell therapy, is an emerging field that focuses on harnessing the body’s own regenerative capabilities to treat and repair damaged tissues or organs. Stem cells have the potential to differentiate into various cell types and promote tissue repair.
Mesenchymal stem cells (MSCs) are a type of adult stem cell that has gained attention for their potential therapeutic applications, including in the treatment of inflammatory and autoimmune conditions like Crohn’s disease. MSCs have the ability to modulate the immune response, reduce inflammation, and promote tissue repair, making them a promising candidate for regenerative medicine approaches. Potential mechanisms by which MSCs may benefit Crohn’s disease include:
Immunomodulation: MSCs have the ability to regulate immune responses, suppressing harmful inflammatory processes and promoting immune tolerance. This can help reduce the excessive immune response seen in Crohn’s disease.
Anti-Inflammatory Effects: MSCs secrete molecules that can dampen local inflammation and help create a more favorable environment for tissue healing.
Tissue Repair: MSCs have the potential to differentiate into various cell types, including those involved in tissue repair, thereby aiding in the regeneration of damaged intestinal tissue.
If you’re interested in MSC therapy for Crohn’s disease, discuss your options with a regenerative medicine specialist or healthcare provider who is knowledgeable to see if stem cell therapy is an opportunity for you to explore.
According to the CDC, an estimated 3.1 million adults (1.3%) in the United States have been diagnosed with inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis.
Characterized by abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition, CD is thought to be the result of swelling and inflammation of the tissue of the digestive tract.
To date, there is not a clearly prescribed method for the treatment or prevention of CD. However, recently, researchers have found stem cells to be a promising treatment option, primarily for the observed ability to regulate immunity, repair injury, and control inflammation.
Building on the positive findings of previous studies that have used autologous stem cells or adipose-derived stem cells to treat CD and its associated complications, Zhang et al.’s randomized controlled clinical trial examines the use of umbilical cord mesenchymal stem cells (UC-MSCs) as a treatment for CD.
This study followed 82 patients who had been diagnosed with CD and had received steroid maintenance therapy for more than 6 months. Half of the participants were randomly assigned to receive a series of four peripheral intravenous infusions of UC-MCSs/kg administered over the course of a four-week period. Then, by using the Crohn’s disease activity index (CDAI) Harvey-Bradshaw Index (HBI), and corticosteroid dosage, participants in both the control and experimental group were followed up with over a 12-month period.
At the conclusion of this study, Zhang et al. found that the group receiving umbilical cord mesenchymal stem cells infusion experienced a significant decrease in the required dosage of corticosteroid dosage and a significant improvement in the overall condition of the patients. These findings led the authors to conclude that UC-MSCs can attenuate immune malfunction in patients with CD. Considering these findings, the authors suggest that the mechanisms of UC-MSC efficacy in CD be elucidated to better understand the precise selection of patients who receive this specific stem-cell treatment in the future.
The authors point out that, while the specific mechanisms of alleviating CD by UC-MSCs remain obscure, it is suggested that the downregulation of proinflammatory cytokines serves a beneficial role in the process.
The authors also raise concerns over the safety of the clinical application of stem cells in this application, highlighting conflicting findings as to the safety of the process. Considering the prevalence of stem cells’ ability to regulate and suppress immunity in other studies, Zhang et al. infer that the patient infections observed during their trial were associated with immunosuppression by stem cells.
While the study suggested that the peripheral infusion of UC-MSCs was convenient and safe, the authors point out that there was little distribution of UC-MSCs in the intestinal tissue and risk of cells being retained in the pulmonary capillaries. As a result, the authors call for future studies comparing the efficacy of interventional infusion into the inferior mesenteric artery to that of peripheral infusion. To know more about mesenchymal stem cell treatment for Crohn’s disease visit Stemedix website and read more related article.
Crohn’s, or regional enteritis (or ileitis), is a chronic form of IBD. The disease is named after Dr. Burrill Crohn, an American gastroenterologist (1884-1983). In 1932, he was the first physician to describe this illness. Another IBD that is commonly diagnosed is ulcerative colitis.
Crohn’s causes inflammation and irritation of the digestive system, specifically the large and small intestines. Crohn’s can cause stomach cramps and diarrhea. Periodic flare-ups of the disease are common. This is a chronic condition that can’t be cured. Treatments can help you manage your symptoms, allowing you to lead an active lifestyle.
A half million Americans are estimated to have Crohn’s. Men, women, and children can all be affected.
Crohn’s usually affects younger people, often in their 20s, 30s, or late teens. This condition can occur at any age. Both men and women are affected equally. Children can also develop Crohn’s. Smokers may be at a higher risk for Crohn’s than non-smokers.
What Are the Different Types of Crohn’s Disease?
Different sections of the digestive system can be affected by Crohn’s. The following are some of the types of Crohn’s Disease:
Ileocolitis: Inflammation of the small intestine or colon. Ileocolitis, the most common form of Crohn’s Disease, is inflammation.
Ileitis: Ileitis is a swelling and inflammation of the small intestine.
Gastroduodenal: Inflammation or irritation of the stomach and upper part of the small intestine, the duodenum.
Jejunoileitis: Jejunoileitis is a condition in which patches of inflammation appear on the small intestine’s upper half (called jejunum).
What Causes Crohn’s Disease?
No cause has been identified for Crohn’s. Some factors can increase your risk of developing Crohn’s disease, including:
Autoimmune diseases: Bacteria in the digestive system can cause your immune system to attack healthy cells.
Genes: IBD is often inherited. You may have an increased risk if you are related to someone with Crohn’s disease. There are specific gene mutations that can increase the risk of developing Crohn’s.
Smoking: Smoking cigarettes can double your risk for Crohn’s.
What Are the Symptoms Associated With Crohn’s Disease?
Crohn’s patients can experience flare-ups (severe symptoms) and remissions (no or mild symptoms). Remission can last for weeks or even years. It’s impossible to predict when a flare-up will occur.
Symptoms of Crohn’s include:
Pain in the abdomen
Chronic diarrhea
Feeling full
Fever.
Loss of appetite
Weight loss.
Skin tags that are not normal (usually found on the buttocks)
Anal fissures.
Anal fistulas.
Blood clots in the rectum.
How Is Crohn’s Disease Diagnosed?
People with Crohn’s disease are often first diagnosed when they experience diarrhea, abdominal cramping, or unexplained weight loss. Contact your pediatrician if you suspect your child has Crohn’s.
Your healthcare provider might order these tests to determine the cause of symptoms:
Blood test: The test looks for high levels of white blood cells, which may indicate infection or inflammation. Tests also check for anemia, which is a low red cell count. Anemia affects one-third of people with Crohn’s disease.
Stool test: A stool sample is examined to determine if it contains bacteria or parasites. This test can be used to rule out infections that cause chronic diarrhea.
Colonoscopy: A colonoscopy is a procedure in which your doctor examines the interior of your colon using an endoscope. This thin tube has a camera and light attached. Your doctor will take a tissue sample (biopsy) taken from the colon to check for signs of inflammation.
CT scan: CT scans create images of the digestive system. This tells your doctor how severe the inflammation of the intestines is.
Upper GI endoscopy (GI): Your doctor inserts a thin, long tube called an Endoscope into your mouth. A camera attached to the endoscope allows your doctor to see inside. Your doctor may take tissue samples during an upper endoscopy.
Upper gastrointestinal (GI) exam: X-rays during the upper GI examination allow your doctor to watch a barium liquid move through your digestive system.
What Are the Complications of Crohn’s Disease?
Crohn’s can cause serious complications, including:
Abscesses: Abscesses are pus-filled pockets that form in the abdomen or digestive tract.
Anal fissures: Anal fissures can cause itching, pain, and bleeding.
Bowel obstructions: Scar tissue, fistulas, or narrowed intestines can cause bowel obstructions. Gases and waste matter build up. Surgery is required if there is a large or small bowel blockage.
Colon cancer: Colon cancer is increased by Crohn’s in the large intestine.
Fistulas: IBD may cause abnormal, tunnel-like openings in the intestinal wall called fistulas. Sometimes, these fistulas become infected.
Malnutrition: Chronic diarrhea may make it difficult for the body to absorb nutrients. Lack of iron is a common problem among people with Crohn’s disease. A lack of iron can cause anemia (low red cell count). This occurs when organs are not getting enough oxygen.
Ulcers: Ulcers are open sores that can appear in the mouth, stomach, or rectum.
How Can I Prevent Crohn’s Disease?
Crohn’s is not preventable. Healthy lifestyle changes can reduce symptoms and flare-ups.
Stop smoking.
Eat a healthy, low-fat diet.
Exercise regularly.
Manage stress.
When Should I Consult a Doctor?
You should call your healthcare provider if you have the following:
Blood in the stool
Constipation.
Extreme weight loss.
Fever.
Inability to pass gas.
Nausea and vomiting.
Severe abdominal discomfort.
Signs that a flare-up is about to occur.
Uncontrollable diarrhea.
Anemia can cause weakness or fatigue.
Crohn’s disease can cause unpredictable flare-ups that disrupt your life. Speak to your doctor about what you can do to control the disease. You can live a healthy life by managing symptoms and making lifestyle changes.
How Is Crohn’s Disease Treated or Managed?
The treatment for Crohn’s Disease varies depending on your symptoms’ cause and severity. The goal of treatment for children is to maintain remission, induce remission, and manage any Crohn’s complications over time.
You may be prescribed one or more of the following treatments to treat Crohn’s Disease by your healthcare provider:
Antibiotics: Antibiotics are used to treat or prevent infections. Abscesses can form from severe conditions. Severe infections can also cause fistulas.
Antidiarrheal medication: Antidiarrheal medications such as loperamide (Imodium A(r)) can stop severe diarrhea.
Biologics: Biologics contain monoclonal antigens to suppress the immune system.
Bowel rest: Your provider may suggest you go without food and drink for a few days or longer. You may need to receive intravenous nutrition (parenteral nutrition) to get the required nutrition. You can only drink the prescribed liquids or use a feeding tube.
Corticosteroids: Corticosteroids such as prednisone, cortisone, and others can reduce inflammation caused by autoimmune diseases.
Immunomodulators: These medications calm inflammation by suppressing a hyperactive immune system. These include azathioprine, cyclosporine, and other drugs.
Surgery: Surgery can be used to treat the complications of Crohn’s. Surgery may be required to treat intestinal perforations, blockages, or bleeding.
Stem Cell Research for Crohn’s Disease
Scientists are delving into stem cell research to explore its potential as a treatment option for the complications associated with Crohn’s disease. Exciting developments in this field have demonstrated the effectiveness of stem cell therapy in promoting disease remission and significantly improving symptoms of Crohn’s disease.
Promoting Remission with Stem Cells
For individuals with Crohn’s disease, periods of remission with few symptoms are possible. While maintaining long-term remission can be challenging, appropriate treatment and care can help achieve this goal. Collaborating with healthcare providers to develop personalized treatment plans that address individual needs is crucial. The aim is to enhance the quality of life for patients rather than providing a complete cure.
Addressing Inflammation with Stem Cells
Inflammation is significant in various disorders, including heart disease, diabetes, and inflammatory bowel disease (IBD), such as Crohn’s disease. Treatment approaches for these conditions often revolve around reducing inflammation within the body. Whether through medications, dietary and lifestyle adjustments, or natural methods, the objective is to minimize inflammation and its detrimental effects. Stem cell research offers a promising avenue for using these remarkable cells to combat inflammation and improve the overall well-being of individuals with Crohn’s disease. To learn more about Crohn’s Disease and what Stemedix has to offer, contact a care coordinator today!
A recent study has shown how stem cells may be able to help Crohn’s disease patients who suffer from perianal fistulas. The researchers specifically investigated how stem cell therapy for Crohn’s Disease compared to conventional approaches including antibiotics and immunosuppressors. Because research is still in its infancy, there has been great interest in how to best address perianal fistulas in Crohn’s disease patients.
For their study, the scientists studied adults between the ages of 19 and 68. The patients were divided into three groups: one group received mesenchymal stem cell therapy applied locally, another received a combination of cellular and anti-cytokine therapy, and a third received a combination of immunosuppressors and antibiotics. The researchers looked at the impact of these three therapeutic interventions on the frequency of relapses of perianal fistulas and evaluated patients with the index of perianal activity of Crohn’s disease (PCDAI).
Their results showed that the combined cellular and anti-cytokine therapy improved perianal lesions in Crohn’s disease patients more so than did the immunosuppressor and antibiotic combination. Specifically, with the stem cell and anti-cytokine approach, fistulas remained closed longer and fistulas recurred less frequently. Future research should help to determine if and how this stem cell approach can provide an effective and safe long-term therapy for Crohn’s disease patients with perianal fistulas.
Reference: Knyazev, OV et al. (2018). Stem cell therapy for perianal Crohn’s disease. Ter Arkh, 90(3), 60-66.
Over the past few years, data has accumulated showing the promise for cell-based therapies to help in treating Inflammatory bowel disease with stem cells. Specifically, stem cells appear to offer the opportunity to overcome several weaknesses associated with conventional therapies that have targeted perianal Crohn’s disease.
Based on these positive results, scientists and healthcare providers have become more adamant about understanding the broader role stem cells could play in the treatment of all inflammatory bowel disease. A new review published in Current Gastroenterology Reports discusses this specific issue and offers insights into the direction of stem cell research as it relates to inflammatory bowel disease.
The authors of this review discuss data from over a dozen clinical trials that have already been conducted on the impact of stem cell therapies in Crohn’s disease. Thus far, much of the success of regenerative medicine for the treatment of Crohn’s disease has been for the specific treatment of perianal Crohn’s disease, which occurs when the digestive and gastrointestinal inflammation associated with Crohn’s disease extends to the anal area.
Given the frequency with which the lining of the intestine is inflamed in inflammatory bowel disease, including both perianal Crohn’s disease and non-perianal Crohn’s disease, research efforts are focusing more and more on how stem cells may be able to combat this type of luminal disease. The authors put forth suggestions for the types of information that researchers should aim to obtain if we are to adequately treat intraluminal disease with regenerative medicine.
The potential of stem cells to address inflammatory bowel disease that has been demonstrated so far provides hope that this type of strategy will help not only patients with perianal Crohn’s disease but those with other forms of inflammatory bowel disease as well. More research should help to determine if and how these therapies can be deployed to help this patient population.
Reference: Lightner, A.L. (2019). Stem cell therapies for inflammatory bowel disease. Current Gastroenterology Reports, 21(4), 16.
Crohn’s disease, a form of chronic inflammatory bowel disease, affects an estimated 700,000 people in the United States, affecting men and women equally. While the disease is characterized by abnormal inflammation in the gastrointestinal and digestive tracts, some people with the illness develop perianal Crohn’s disease. In this case, the inflammation extends to areas around the anus. The precise proportion of Crohn’s disease patients who develop perianal Crohn’s disease is debated, but the need for better treatments for the condition is not. A new and unique treatment is the use of stem cells to treat Perianal Crohn’s Disease.
Unfortunately, though there are several drug and surgical interventions that have been developed to treat perianal Crohn’s disease, each of the available treatment options suffers critical limitations, including risks for adverse side effects. There is no available therapeutic approach that successfully achieves long-term remission.
Based on the need for – and lack of – more efficacious interventions for perianal Crohn’s disease and the ability of cell-based therapies to address similar types of disease, researchers have positioned that stem cell therapy may be a promising avenue for the relevant patient population. A recent review published in the Journal of Crohn’s and Colitis covers the research that has been conducted to address this possibility and the data that suggest that mesenchymal stem cells could provide a safe and effective way to treat perianal Crohn’s disease without the unwanted side effects associated with conventional treatment options.
In this review, the authors cover clinical trials on cell-based therapies for perianal Crohn’s disease, including phase 1, phase 2, and phase 3 randomized controlled trials. The authors consider the differences in outcomes between conventional treatments and cell-based therapies and offer suggestions for the direction of research into the use of stem cells for the treatment of perianal Crohn’s disease.
Reference: Lightner, A.L. & Faubion, W.A. (2017). Mesenchymal stem cell injections for the treatment of perianal Crohn’s disease: What we have accomplished and what we still need to. Journal of Crohn’s and Colitis, 11(10), 1267-1276.
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