Crohn’s Disease: Definition, Etiology, Pathogenesis, Treatment and MCQs for for NEET, GPAT, CSIR NET JRF

Crohn’s Disease: Definition, Etiology, Pathogenesis, Treatment and MCQs for for NEET, GPAT, CSIR NET JRF

INTRODUCTION: –

1.] This disease was first discovered in the year 1932.

2.] Crohn’s disease is a chronic inflammatory bowel disease (IBD) characterized by inflammation of the digestive or gastrointestinal (GI) tract. It can affect any part of the GI tract, from the mouth to the anus, but it is more commonly found at the end of the small intestine (the ileum) where it joins the beginning of the large intestine (or colon). There is no known medical cure for Crohn’s disease. However, therapies are available that may greatly reduce the symptoms of Crohn’s disease and possibly bring about a long-term remission.

ETIOLOGY: –

The signs and symptoms are from mild to severe and may develop gradually or come suddenly without warning.

  • Diarrhoea
  • Abdominal pain and cramping
  • Bloody stools
  • Ulcers
  • Reduced appetite and weight loss
  • Fever and fatigue
  • Digestive tract problems

PATHOGENESIS: –

The inflammation in the walls of the digestive tract leads to pain, malabsorption of nutrients and poor osmosis so water stays in the digestive system causing diarrhoea. It also causes damage to the tissue in mucosal lining. The digestive system contains 70% of the immune system and provides a physical barrier against the outside world. It is selectively permeable, which means that only small particles of food and water should be able to pass through the walls. The damage to the walls is commonly known as “Leaky Gut”. When the substances that should not be in the blood stream are found by the immune system, which is on surveillance all the time, it mounts an attack on them. This is where antibodies may be created to new foods or substances. If the problem goes unchecked overtime the immune system becomes over alert and starts to attack the digestive tissues causes more inflammation and more leaky gut.

Image Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60026-9/fulltext ( https://doi.org/10.1016/S0140-6736(12)60026-9)

TREATMENT: –

It involves drug therapy or surgery. Several drugs which control inflammation are anti-inflammatory drugs Sulfasalazine, Mesalamine and Corticosteroid.

  • Immune system suppressors- Azathioprine and 6-mercaptopurine and infliximab works by neutralizing a protein produced by the immune system known as tumour necrosis factor (TNF). Ciclosporin and antibiotic Metronidazole is used to heal Crohn’s related fistulas.
  • Other medication- Antidiarrheals relieve signs and symptoms of mild to moderate diarrhoea. Acetaminophen is used to for relieving pain.
  • Iron supplements
  • Vitamin B12 injections
  • Surgery
  • Diet

MULTIPLE CHOICE QUESTIONS: –

1.] You can get crohn’s disease in your mouth?

a. True

b. False

2.] What is crohn’s disease?

a. Caused by an allergy to gluten

b. Closely related to celiac disease

c. A chronic inflammatory disease of the intestine

d. A curable digestive disease

3.] What causes crohn’s disease?

a. Stress

b. Lack of vitamin D

c. Inflammation of the bowel by specific chemicals

d. The cause of crohn’s disease is unknown

4.] Crohn’s disease is closely related to ulcerative colitis?

a. True

b. False

5.] How is crohn’s disease treated?

a. Antibiotics

b. Surgery

c. Inflammation suppressant medication

d. All of the above

6.] Which of the following are liquid diets that allow the digestive system to rest?

a. Gluten-free diet

b. Elemental diet

c. Detox diet

d. Low fat diet

7.] If you have crohn’s disease, you may be short on?

a. Vitamin B-12

b. Vitamin A

c. Both (a) and (b)

d. None of the above

8.] How does the Crohn’s disease affect the intestine?

a. Crohn’s disease causes ulceration in intestine

b. Crohn’s disease causes intestines to narrow

c. Crohn’s disease causes intestine to stiffen

d. All of the above

9.] Symptoms of crohn’s disease can include rectal bleeding?

a. True

b. False

10.] Crohn’s disease is a digestive disease that also involves which additional system of body?

a. The lymphatic system

b. The CNS

c. The endocrine system

d. The immune system

 

SOLUTIONS: –

1.] (a)

2.] (c) A chronic inflammatory disease of the intestine

3.] (d) The cause of crohn’s disease is unknown

4.] (a)

5.] (d)

6.] (b) Elemental disease

7.] (a) Vitamin B-12

8.] (d)

9.] (a)

10.] (d) The immune system

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REFERENCES: –

1.] Textbook of Pathology by Harsh Mohan; 7th edition; Page no.552.

2.] Robbin’s Basic Pathology; 5th edition; Page no.801 – 804.

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