Young People 'Cron Disease' Surge, Prevention and Treatment?
Nov 03, 2024
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Professor Ko Bong-min of the Department of Gastroenterology at Soonchunhyang University Bucheon Hospital said "According to the Korean Intestinal Research Society, there were about 18,000 Crohn's disease patients as of 2019, more than doubling from 7,777 in 2010. Recently, the prevalence rate has been increasing due to environmental factors, westernized eating habits, and stress."
Crohn's disease is a chronic inflammatory disease in which abnormal inflammation occurs repeatedly inside the intestine, mainly in young people in their 20s and 30s. The main symptoms include chronic abdominal pain and diarrhea, weight loss, fatigue, and bloody stools, and symptoms such as intermittent pain like squeezing after meals and abdominal distention, nausea, and vomiting appear in the presence of small intestine stenosis. Unlike irritable bowel syndrome, which has similar symptoms, Crohn's disease does not repeat constipation and diarrhea, and is characterized by nightly diarrhea, mucous excrement, bloody stool, hindsight, nausea, fever, loss of appetite, weight loss, and fatigue.
A third of Crohn's disease patients are known to experience various extraintestinal manifestations such as joint, skin, and eye symptoms. The most commonly observed extraintestinal manifestations include joint diseases such as peripheral neuropathy, joint pain, and low back pain. Oral ulcers and nodular erythema occur as skin diseases, and uveitis, iris, and episcleritis characterized by ocular pain, dazzling, and congestion should be identified as eye diseases.
Although the cause and pathogenesis of Crohn's disease are not yet clear, it is known that several environmental changes due to industrialization work in patients with genetic predisposition. 5% to 10% of all inflammatory bowel diseases are family related, and most of the rest develop sporadically regardless of family or heredity.
For accurate diagnosis, Crohn's disease should be diagnosed by combining medical history and physical examination, blood test, stool test, endoscopy, biopsy, imaging test, etc. Through endoscopy, the intestinal tract identifies the site of invasion and performs a tissue biopsy. Gastric endoscopy, small intestine endoscopy, colonoscopy, and capsule endoscopy are used as endoscopy, and CT, MRI, and gastrointestinal ultrasound are used as imaging tests.
Treatment of Crohn's disease aims not only to alleviate symptoms but also to prevent structural intestinal damage or physical disorders through healing mucosal lesions, and treatment methods include drug treatment and surgical treatment using 5-ASA, immunosuppressants, steroids, biological agents, and submucosal agents. Customized treatment for each patient is performed in consideration of the severity of the disease, activity, invasion site, disease type, prognostic factor, age, accompanying disease, and patient preference.
Drugs should be selected in consideration of drug efficacy, administration method, and side effects. Immunomodulators are used as the first treatment drug in most patients, and steroids can be used during acute exacerbation. Recently, various biological agents have greatly improved patient prognosis and quality of life. In particular, infliximab, an anti-TNF drug first approved in December 2000, had a significant impact on improving treatment outcomes, and adalimumab, betolizumab, and eusteminumab are actively used. Recently, a sub-particle system has been developed and used.
Professor Ko Bong-min said "Dysplasia caused by repeated inflammation of Crohn's disease is also known to affect the development of colorectal cancer. However, according to domestic studies, the risk of developing colorectal cancer 10 years after diagnosis of Crohn's disease was reported to have decreased significantly from 2.9% in 2006 to 1% in 2014. Thanks to the continued development of treatments, strategies for remission maintenance treatment, and the implementation of appropriate colonectomy..."
To prevent Crohn's disease, it is necessary to watch out for westernized eating habits, reduction of infectious diseases, and air pollution, represented by increased consumption of refined sugar fatty acids, artificial sweeteners, fast foods, and meat, and decreased consumption of fiber, fruits and vegetables, which are reported to be associated with the onset of inflammatory bowel disease.
For Crohn's disease patients, balanced eating, drinking plenty of water, and regular exercise are recommended. A low FODMAP (Fermentable, Oligosaccharide, Disaccharides, Monosaccharides And Polyols) diet is recommended during active Crohn's disease periods such as diarrhea or abdominal pain. It is recommended to drink plenty of water and eat frequently, in small amounts. You should reduce your intake of processed foods and abstain from drinking and abstaining from alcohol. Excessive stress and heavy physical work can also worsen symptoms, so caution is needed.
Professor Ko Bong-min said "There is a misunderstanding that Crohn's disease is fatal, but if symptoms are controlled through appropriate treatment and management, you can maintain a normal life. However, if the treatment is missed due to incorrect information, and it develops into chronic and fibrosis progresses, surgical treatment may be necessary. Therefore, if you have suspicious symptoms, you should visit a medical institution quickly for accurate examination and customized treatment.
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