Crohn's disease

Crohn’s disease is devious. It is not fatal on its own, but it is chronic, very incapacitating and incurable. This inflammation of the digestive tract attacks above all the intestine and the colon. Flare-ups of the disease alternate with phases of remission. The main symptoms of the disease are abdominal pains and diarrhoea, possibly accompanied by bleeding. The general condition of the patient can be affected: weight loss, fatigue, fever, a loss of appetite, etc. The illness can also be accompanied by complications, which can be quite serious, requiring hospitalization: intestinal occlusion, abscesses or a perforation of the digestive tract.

Crohn’s disease is typically multifactorial: at least three different genetic zones have already been identified which clearly play a role in the development of the disease. And researchers expect to find more, perhaps as much as five to ten times more! But we now know, after having carried out studies on twins, that the genetic component has an impact factor of no more than 50%. Environmental factors also have to be taken into account. Smoking encourages the outbreak of the disease. It is also suspected that dietary factors play a role, but the scientific evidence regarding this remains incomplete. The disease can also be influenced by a microbial agent, a virus or bacteria.

For many a long year, doctors treated Crohn’s disease with general anti-inflammatory medicines (corticoids) and drugs working on the immune system (immuno-suppressants). But new treatments saw the light of day in the mid 1990s. These targeted in more subtle ways the inflammatory mechanisms implicated in Crohn’s disease, and involve principally antibodies which neutralise the activity of substances which have a significant impact on the development of intestinal inflammation, notably anti-TNF. More effective, they nonetheless come with undesirable secondary effects. When the patient does not respond to available treatment it is often the case that surgery has to be carried out. It consists of removing part of the digestive tract. The issue at stake in contemporary research is to develop more effective medicine, with reduced secondary effects, which would attack the precise causes of Crohn’s disease.

Part of the jejunum infected by the Crohn's Disease