Crohn’s Disease

Who is affected?

• There is no national database of people who have Crohn’s Disease. The following estimates are taken from the forthcoming IBD Guidelines to be published by the British Society of Gastroenterology in 2004.
• Affects between 30,000 and 60,000 people in the UK, that’s about 1 in 1200
• Between 3,000 and 6,000 new cases are diagnosed each year
• The most common age for diagnosis is between 15 and 25.
• Crohn’s disease affects men and women equally.
• In 1996, a study from South Glamorgan reported a doubling of the number of children diagnosed with Crohn’s disease between 1983 and 1993, and, in 1999, a study of children in Scotland has reported a 50% increase over 10 years in the incidence of Crohn’s disease in children aged 16 or under.

Symptoms and Treatment

• Crohn’s disease can affect anywhere from the mouth to the rectum but most commonly affects the small intestine. It causes inflammation, deep ulcers and scarring to the wall of the intestine and often occurs in patches with healthy tissue in between. There is no cure for Crohn’s disease at present.
• The main symptoms are pain, urgent diarrhoea, severe tiredness and loss of weight. Crohn’s is quite often associated with other inflammatory conditions affecting the joints, skin and eyes. Most patients will be treated with drugs, including steroids, to reduce inflammation or by means of special liquid feeds to rest the bowel. Surgery may be required to remove narrowed or damaged parts of the intestine.
• The condition is named after Dr Burril Crohn, one of the three doctors who first identified the disease in 1932.

The cause of Crohn’s disease

The cause has not yet been identified.

Recent Research

• Research is focusing on why some families have a greater predisposition to Inflammatory bowel disease (both Crohn’s disease and the related Ulcerative colitis) than other families and on the process of inflammation which is created when the immune system responds to a foreign agent. It is possible that patients are over-reacting to some stimulus or that their immune system fails to control the level of inflammation after responding to the stimulus.
• Both Crohn’s disease and Ulcerative colitis are more common among close relatives of people who have IBD than in the general population. There are some families in which Crohn’s disease affects one person and Ulcerative colitis another, suggesting that the two disorders share an inherited susceptibility. Family studies in London, Oxford, Paris and elsewhere have identified the location of two genes which pre-dispose to the conditions, but their function is not yet known. It is likely that, at least for some patients, an inherited susceptibility interacts with unidentified environmental factor(s) to induce the disease. Particular genes may also help to determine the severity of the illness.
• There has been publicity about the possibility that an organism called Mycobacterium paratuberculosis (MAP) may be a cause of Crohn’s disease. This is based on the work of Professor John Hermon-Taylor from St George’s Hospital in London, who believes that MAP, which causes Johne’s disease in cattle and sheep with symptoms very similar to Crohn’s disease, is transferred through milk and water systems to affect a proportion of the population. An expert review group set up by NACC has found that the evidence for MAP causing Crohn’s Disease remains inconclusive
  -The possibility that food might be the cause of Crohn’s disease has appeal, but no specific dietary cause has been found. Some patients find that their symptoms improve if they omit certain foods, and liquid diets are sometimes used in treatment as an alternative to drugs. The European Union is currently funding a major study into diet.