Expert explains

Treat Crohn’s disease early and efficiently

The inflammation in Crohn's disease can affect not only the bowel, but the entire digestive tract.

(Bild: stock.adobe.com, Krone KREATIV)

Crohn's disease is a chronic inflammatory bowel disease that can occur in all parts of the digestive tract - from the oral cavity to the rectum - and can damage the tissue. The disease can now be managed well. 

Typical symptoms of Crohn's disease are prolonged diarrhea (over six weeks and without any other cause), abdominal pain, but also fever and weight loss, as gastroenterologist Dr. Alexander Eser explains. "Depending on the type of disease, an inflammatory narrowing (stenosis) sometimes occurs in the affected areas, which means that food can no longer pass through the digestive tract. This section of the intestine must then be stretched endoscopically or surgically removed."

The expert continues: "Fistulas can also develop. The inflammation makes its way out of the intestine, can affect neighboring organs or be the local cause of abscesses. Fistulas in the perineal region often cause problems with bowel and urinary incontinence." In addition, inflammation in the colon increases the risk of bowel cancer. It is therefore important for patients with Crohn's disease in which the colon is also affected to undergo special and, above all, earlier cancer screening.

Effective medication is available 
"Until 25 years ago, steroids and/or immunosuppressants were the main drugs used to treat Crohn's disease. These have an unfavorable side effect profile with moderate efficacy. Fortunately, so-called 'advanced therapies' are now available, which combat inflammation in a very targeted manner with excellent efficacy and few side effects," continues Dr. Eser.

These include biologics - antibody constructs that specifically bind individual inflammatory messengers and thus switch them off. These are administered as an infusion or injection under the skin. "Small molecules" are newer on the market. "These are small molecules that can be taken as tablets due to their structure. They block a group of signaling molecules that are needed to maintain inflammation in the mucous membrane, but also in the joints and skin, or prevent inflammatory cells from migrating into the digestive tract. They are characterized by a particularly rapid onset of action."

A suitable therapeutic agent can now be found for almost every affected person. However, as it is not possible to predict exactly which substance group will respond best to which patient, it is important to have a detailed consultation and continuous monitoring with a specialist in order to adapt or change the treatment concept if necessary. If left untreated, the intense and profound inflammation can lead to the first permanent damage to the digestive tract after less than two years. It is therefore important to start effective treatment quickly.

Many bodily functions are impaired 
Complaints that affect or contribute to digestion, bowel movements, intimate areas or sex life should definitely be addressed with the therapist. Dr. Eser: "On the one hand, they are stressful for the patient, on the other hand, they can be an important indication that the underlying disease Crohn's disease may not be sufficiently controlled."