Crohn's Disease

Crohn's disease is named after Burrill B. Crohn, the physician who described the disease in a paper written in 1972. Crohn's disease can also be referred to as Morbus Crohn's, Granulomatous Enteritis, Regional Enteritis, or Terminal Ileitis. Attacks of Crohn's disease may affect patients in their teens or early twenties, and tend to recur throughout the individual's life.

The History of Crohn's Disease

Crohn's disease is an inflammatory bowel disease of an undetermined cause that afflicts more than five-hundred thousand people in the United States and is not biased in regards to whom it strikes. People unlucky enough to get Crohn's Disease include the old and young; rich as well as poor; men, women, and children of white, black, and Asian descent; the disease does not discriminate against age, social class, gender or color. Crohn's primarily attacks the digestive system in the areas of the ileum, which is part of the small intestine and the large intestine (also known as the colon), but can occur in any section of the gastrointestinal tract. Although Crohn's disease afflicts all age groups, initial diagnosis generally occurs before the age of thirty.

Throughout historical medical literature, during the 19th century, various cases were reported by physicians describing what is known as Crohn's disease today. Although it was not named until 1932, the first reported case of Crohn's Disease was in 1806 by Doctors Combe and Sanders to the Royal College of Physicians in London, England (Crohn's Disease History, 2001). Seventeen years later an Edinburgh physician by the name of John Abercrombie documented one hundred forty-four cases in which there was a clearly outlined difference in ileal and colonic diseases. In comparison to known facts of Crohn's Disease today, the Edinburgh physician was most likely describing Crohn's and ulcerative colitis, another inflammatory bowel disease.

Almost a hundred years later, in 1913, there was surgical evidence of the disease as reported in the paper 'Chronic Intestinal Enteritis' written by Dr. Kennedy Dalziel, a Scottish physician working at the Western Infirmary in Glasgow. The most famous report came in 1932 from research done at Mount Sinai Hospital in New York. Dr. Burrill B. Crohn first presented a paper titled 'Terminal Ileitis' to the 83rd Annual Session of the American Medical Association. The paper listed information on fourteen surgical cases mostly operated on by surgeon, Dr. A. A. Berg. The paper prompted more medical research in the area, which lead to the three-man team of gastroenterological Drs. Burrill B. Crohn, Leon Ginzburg, and Gordon D. Oppenheimer. The three doctors studied the disease of the ileum that was once thought to be intestinal tuberculosis (NFIC, 1983). Crohn, Ginsberg, and Oppenheimer later presented their paper 'Regional Ileitis.' The threesome recorded cases of "non specific granulomas of the intestine" (Crohn's Disease History, 2001).

There was no appropriate medical terminology to describe the many manifestations of the disease. It was in England that the name Crohn's was widely used by local physicians (Crohn's Disease History, 2001). In the western world, the disease was called "Terminal Ileitis" for many years. The name involving the word 'terminal' frightened patients although the disease was not fatal with treatment (NFIC, 1983). Later, the name "Regional Ileitis" came into use, but as it was discovered that the disease could in fact involve any area of the gastrointestinal tract, not just the terminal ileum, the name Crohn's was gradually used widespread (Crohn's Disease History, 2001). The disease is referred to as Crohn's due to the fact that Burrill B. Crohn's name was the first listed in the landmark paper (Researchers, 2001). Dr. Berg unfortunately did not want his name published on the important paper, if he had, Crohn's would be known by a different name today (Crohn's Disease History, 2001).

It wasn't till May 2001 that the first gene for Crohn's disease was identified. The discovery was made by a team of Inflammatory Bowel Disease researches led by Dr. Judy Cho, an assistant professor of medicine and a researcher in the Martin Boyer Laboratories at the University of Chicago, and Dr. Gabriel Nuňez, an assistant professor of pathology at the University of Michigan (Researchers, 2001). To collaborate the findings of the American based scientists, an independent research team in France released their findings showing that they had found the same gene. The French research team was lead by Dr. Jean-Pierre Hugot and Dr. Gilles Thomas.

What is Crohn's Disease?

Crohn's disease, also referred to as regional ileitis, is a chronic, long term, inflammatory disease that affects the digestive tract. It can affect the digestive system anywhere between the mouth and the anus, but usually affects the final section of the small intestine, the ileum. Inflammation of the inner lining of the colon and rectum is caused by Ulcerative Colitis, while Crohn's disease is an inflammation that extends into the deeper layers of the intestinal wall. Crohn's disease can also affect the also affect the colon, the regional lymph nodes, and the mesentery (outside covering of the intestines). The disease can be aggravated by a bacterial infection. It begins with the development of patches of inflammation on the intestinal wall, which can spread from one part of the digestive tract to another. It sometimes only develops in one place and does not spread any further. The inflammation causes the thickening of the intestinal wall, which sometimes causes an obstruction in these areas, or scar tissue, which narrows the passageways. The figure below represent an abnormal intestine that has been afflicted with crohn's disease.

The Symptoms of Crohn's Disease

The symptoms of Crohn's disease sometimes act like an appendicitis attack and can also be accompanied by the following common signs:

 Abdominal right-sided tenderness and pain

 Appetite and weight loss

 Possible diarrhea and bloody stools

 Fever

 Abdominal distention

 Nausea, vomiting, and a general sick feeling.