Thursday, December 4, 2014

Crohn's disease

Introduction :-
  • Crohn's disease is caused by a combination of environmental, immune and bacterial factors in genetically susceptible individuals. It results in a chronic inflammatory disorder, in which the body's immune system attacks the gastrointestinal tract possibly directed at microbial antigens. While Crohn's is an immune related disease, it does not appear to be an autoimmune disease (in that the immune system is not being triggered by the body itself). The exact underlying immune problem is not clear; however, it may be an immunodeficiency state. About half of the overall risk is related to genetics with more than 70 genes found to be involved. Tobacco smokers are two times more likely to develop Crohn's disease than nonsmokers. It also often begins after gastroenteritis. Diagnosis is based on a number of findings including: biopsy and appearance of the bowel wall, medical imaging and description of the disease. Other conditions that can present similarly include:irritable bowel syndrome and Behcet's disease.
  • There are no medications or surgical procedures that can cure Crohn's disease.Treatment options help with symptoms, maintain remission, and prevent relapse. In those newly diagnosed a corticosteroid may be used for a brief period of time to quickly improve the disease with another medication such as either methotrexate or a thiopurine used to prevent recurrence. An important part of treatment is the stopping of smoking among those who do. One in five people with the disease are admitted to hospital each year, and half of those with the disease will require surgery for the disease at some point over a ten year period. While surgery should be used as little as possible, it is necessary to address some abscesses, certain bowel obstructions, and cancers. Checking for bowel cancer via colonoscopy is recommended every few years, starting eight years after the disease has begun. 

For More Details :-
Causes :-

Pathophysiology :-
  • During a colonoscopybiopsies of the colon are often taken to confirm the diagnosis. Certain characteristic features of the pathology seen point toward Crohn's disease; it shows a transmural pattern of inflammation, meaning the inflammation may span the entire depth of the intestinal wall. Ulceration is an outcome seen in highly active disease. There is usually an abrupt transition between unaffected tissue and the ulcer - a characteristic sign known as skip lesions. Under a microscope, biopsies of the affected colon may show mucosal inflammation, characterized by focal infiltration of neutrophils, a type of inflammatory cell, into the epithelium. This typically occurs in the area overlying lymphoid aggregates. These neutrophils, along with mononuclear cells, may infiltrate the crypts, leading to inflammation (crypititis) or abscess (crypt abscess). Granulomas, aggregates of macrophage derivatives known as giant cells, are found in 50% of cases and are most specific for Crohn's disease. The granulomas of Crohn's disease do not show "caseation", a cheese-like appearance on microscopic examination characteristic of granulomas associated with infections, such as tuberculosis. Biopsies may also show chronic mucosal damage, as evidenced by blunting of the intestinal villi, atypical branching of the crypts, and a change in the tissue type (metaplasia). One example of such metaplasia, Paneth cell metaplasia, involves development of Paneth cells (typically found in the small intestine and a key regulator of intestinal microbiota) in other parts of the gastrointestinal system.

Signs & Symptoms :-

Management :-

Treatment in Homoeopathy :-

One Single Simple Drug Substance In Its Most Suitable Potency, According To Symptom Similarity Based On Totality! "
Some Examples Are :-

Nux Vomica (Colubrina)
  • Stomach: Sour taste, and nausea in the morning, after eating. Weight and pain in stomach; worse, eating, some time after. Flatulence and pyrosis. Sour, bitter eructations. Nausea and vomiting, with much retching. Ravenous hunger, especially about a day before an attack of dyspepsia. Region of stomach very sensitive to pressure. Epigastrium bloated, with pressure as of a stone, several hours after eating. Desire for stimulants. Loves fats and tolerates them well. Dyspepsia from drinking strong coffee. Difficult belching of gas. Wants to vomit, but cannot.
  • Abdomen: Bruised soreness of abdominal walls. Flatulent distension, with spasmodic colic. Colic from uncovering. Liver engorged, with stitches and soreness. Colic, with upward pressure, causing short breath, and desire for stool. Weakness of abdominal ring region. Strangulated hernia. Forcing in lower abdomen towards genitals. Umbilical hernia of infants.
  • Stool: Constipation, with frequent ineffectual urging, incomplete and unsatisfactory; feeling as if part remained unexpelled. Constriction of rectum. Irregular, peristaltic action; hence frequent ineffectual desire, or passing but small quantities at each attempt. Absence of all desire for defecation is a contra-indication. Alternate constipation and diarrhea-after abuse of purgatives. Urging to stool felt throughout abdomen. Itching, blind hemorrhoids, with ineffectual urging to stool; very painful; after drastic drugs. Diarrhea after a debauch; worse, morning. Frequent small evacuations. Scanty stool, with much urging. Dysentery; stools relieve pains for a time. Constant uneasiness in rectum.
Mercurius Corrosivus
  • Stomach: Incessant, green, bilious vomiting. Epigastrium very sensitive.
  • Abdomen: Bruised sensation; cecal region and transverse colon painful. Bloated; very painful to least touch.
  • Stool: Dysentery; tenesmus, not relieved by stool; incessant. Stool hot, bloody, slimy, offensive, with cutting pains and shreds of mucous membrane.
Ornithogalim Umbellatum
  • Stomach: Tongue coated. Agonizing feeling in chest and stomach, starting from pylorus with flatus that rolls in balls from one side to the other; loss of appetite, phlegmy retching and loss of flesh. Gastric ulceration even with hemorrhage. Pains increased when food passes pyloric outlet. Vomiting of coffee-ground-looking matter. Distention of stomach. Frequent belching of offensive flatus. Painful sinking across epigastrium.
Arsenicum Album
  • Stomach : Cannot bear the sight or smell of food. Great thirst; drinks much, but little at a time. Nausea, retching, vomiting, after eating or drinking. Anxiety in pit of stomach. Burning pain. Craves acids and coffee. Heartburn; gulping up of acid and bitter substances which seem to excoriate the throat. Long-lasting eructations. Vomiting of blood, bile, green mucus, or brown-black mixed with blood. Stomach extremely irritable; seems raw, as if torn. Gastralgia from slightest food or drink. Dyspepsia from vinegar, acids, ice-cream, ice-water, tobacco. Terrible fear and dyspnea, with gastralgia; also faintness, icy coldness, great exhaustion. Malignant symptoms. Everything swallowed seems to lodge in the esophagus, which seems as if closed and nothing would pass. Ill effects of vegetable diet, melons, and watery fruits generally. Craves milk.
  • Abdomen.–Gnawing, burning pains like coals of fire; relieved by heat. Liver and spleen enlarged and painful. Ascites and anasarca. Abdomen swollen and painful. Pain as from a wound in abdomen on coughing.
  • Rectum.–Painful, spasmodic protrusion of rectum. Tenesmus. Burning pain and pressure in rectum and anus.
  • Stool.–Small, offensive, dark, with much prostration. Worse at night, and after eating and drinking; from chilling stomach, alcoholic abuse, spoiled meat. Dysentery dark, bloody, very offensive. Cholera, with intense agony, prostration, and burning thirst. Body cold as ice. Hemorrhoids burn like fire; relieved by heat. Skin excoriated about anus.
  • Stomach: Nausea and faintness when rising up. Abnormal hunger, loss of taste. Thirst for large draughts. Vomiting of bile and water immediately after eating. Worse, warm drinks, which are vomited. Stomach sensitive to touch. Pressure in stomach after eating, as of a stone. Soreness in stomach when coughing. Dyspeptic ailments during summer heat. Sensitiveness of epigastrium to touch.
  • Abdomen : Liver region swollen, sore, tensive. Burning pain, stitches; worse, pressure, coughing, breathing. Tenderness of abdominal walls.
  • Stool: Constipation; stools hard, dry, as if burnt; seem too large. Stools brown, thick, bloody; worse in morning, from moving, in hot weather, after being heated, from cold drinks, every spell of hot weather.
  • Stomach: Dyspepsia due to farinaceous and fermentable food, cabbage, beans, etc. Excessive hunger. Aversion to bread, etc. Desire for sweet things. Food tastes sour. Sour eructations. Great weakness of digestion. Bulimia, with much bloating. After eating, pressure in stomach, with bitter taste in mouth. Eating ever so little creates fullness. Cannot eat oysters. Rolling of flatulence. Wakes at night feeling hungry. Burning eructations rise only to pharynx there burn for hours. Likes to take food and drink hot. Sinking sensation; worse night.
  • Abdomen: Immediately after a light meal, abdomen is bloated, full. Constant sense of fermentation in abdomen, like yeast working; upper left side. Hernia, right side. Liver sensitive. Brown spots on abdomen. Dropsy, due to hepatic disease. Hepatitis, atrophic from of nutmeg liver. Pain shooting across lower abdomen from right to left.
  • Stool: Diarrhea. Inactive intestinal canal. Ineffectual urging. Stool hard, difficult, small, incomplete. Hemorrhoids; very painful to touch, aching.
Nux Moschata
  • Stomach: Excessively bloated. Flatulent dyspepsia. Hiccough, and craving for highly-seasoned food.
  • Abdomen: Paralytic weakness of intestines. Enormously distended. Stool is soft, and yet is unable to expel it, even with long straining. Faintness during or after stool. Protruding piles.
  • It affects chiefly the duodenum, small intestines, liver, and rectum. Gastro-enteritis with colicky pain and bilious vomiting. Stool is watery with jelly-like mucus, painless, profuse. Gushing and offensive.
  • Stomach: Hot, sour belching; nausea and vomiting. Thirst for large quantities of cold water. Vomiting of hot, frothy mucus. Heartburn; gagging or empty retching. Vomiting of milk.
  • Abdomen: Distended; heat and emptiness. Sensation of weakness or sinking. Can lie comfortably only on stomach. Liver region painful, better rubbing part. Rumbling and shifting of flatus in ascending colon.
  • Rectum: Diarrhea of long standing; early in morning; during teething, with hot, glowing cheeks while being bathed or washed; in hot weather after acid fruits. Morning, painless diarrhea when not due to venous stasis or intestinal ulceration. Green, watery, fetid, profuse, gushing. Prolapse of rectum before or with stool. Constipation; clay-colored, hard, dry, difficult. Constipation alternating with diarrhea. Internal and external piles.
Vertarum Album
  • Stools large, with much straining until exhausted, with cold sweat. Diarrhea very painful, watery, copious, and forcibly evacuated, followed by great prostration. Evacuations of cholera morbus and true cholera when vomiting accompanies the purging.
& The List Goes On.....
For More Details :-

Take Care Of Your Body,

It's The Only Place You Have To Live In.

With Best Regards, Karnav Thakkar :) :)

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