HEAL 1302: Crohn's Disease: Women, Hormones, and Prevention

This report examines Crohn's disease, an inflammatory bowel disease, focusing on its pathogenesis, symptoms, treatment, and lifestyle factors. The report highlights the disease's impact on women, particularly concerning hormonal changes during their lifespan and the resulting severity of symptoms. It covers the disease's causes, including the role of the immune system, and discusses common symptoms such as diarrhea, abdominal pain, and fatigue. Furthermore, the report details diagnostic methods, treatment options (medications and immunomodulators), and preventive measures related to diet, physical activity, and lifestyle habits, such as avoiding smoking and excessive alcohol consumption. The report also discusses the prognosis of the disease and concludes by emphasizing the importance of lifestyle habits in managing and preventing Crohn’s disease, especially in women.

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02 Apr 2019
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Abstract
Crohn’s disease has an occurrence rate of 10.6 per 100,000 population and is considered as an
autoimmune and chronic complication. Among women, the symptoms vary than men, which is
associated with the changes in the hormonal level. In the present report, the discussion is focused
on the pathogenesis, symptoms, treatment measures, and lifestyle habits that are associated with
this disease.
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Introduction
Crohn's disease is an inflammatory bowel disease (IBD), in which the inflammation in
the digestive tract leads to debilitating and painful complications. The inflammation mainly
spread to the deep layers of bowel tissues (Al-Hussaini et al., 2016). Until date, there exists no
particular cure, however, therapeutic measures can reduce the symptoms. This is a chronic
condition which affects the digestive system and occurs when the body's immune system act
against the mucous system of the gut.
Population at risk
Every year, approximately 31000 new cases appear that are related to Crohn's disease.
The incidence rate is 10.6 per 100,000 among which 6.7 cases are of women. Importantly, more
than 50% of women with Crohn's disease are under the age of 35 during diagnosis (Peery et al.,
2015). Particularly in UAE, a rise in 15% of cases has been witnessed since 2007 (Al-Hussaini et
al., 2016).
Crohn's disease
The disease is often linked with ulcerative colitis and inflammatory conditions small
intestine and large intestinal region. The complication is more severe in women due to the
changes in the hormonal level and thus causes irregularity in menstrual periods (Marrie et al.,
2017).
Hormonal changes during the lifespan of women
Particularly in women, the changes in hormonal levels and stress factor play a crucial role
as a trigger factor for Crohn's disease. The fluctuating level of estrogen and progesterone,
particularly act menopause, active menstruation phase, and woman taking birth control pills
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shows a more severe symptom of Crohn's disease. It also affects during the peak reproductive
years of a woman, and the complication mainly occurs in fistula region of the colon. As a result,
it causes irregular periods, diarrhoea, and abdominal cramps.
Sign and symptoms
Common symptoms include diarrhoea, abdominal pain, and fatigue. Furthermore, the
inflammation also leads to rectal bleeding, weight loss, as well as iron deficiency due to
bleeding. In addition to this, the complications also include fever and burning flares experience.
Particularly in women, it affects the hormonal level which disturbs the menstrual cycle
(Merghati-Khoei, Pirak, Yazdkhasti & Rezasoltani, 2016). The active condition of the disease
also causes pain during movement and sex, particularly near the region of anus and vagina. The
symptoms in women are different in men, as due to menstrual cycle disturbance and hormonal
changes.
Detection
Apart from the intervention of symptoms and previous medical history, Conn's disease
also includes a certain diagnosis based on specific tests. This includes colonoscopy for inspection
inside the bowel for inflammation, CT and MRI scans, biopsy for the collection of tiny pieces
from bowel region for testing (Torres, Mehandru, Colombel & Peyrin-Biroulet, 2017).
Treatment and management plan
Medications such as corticosteroids and oral or rectal aminosalicylic acid (5-ASA), is
known to control the inflammation and related symptoms. The immunomodulators such as
azathioprine, thiopurine. Cyclosporine and tacrolimus are often used to reduce the immune
response of body and reduction of inflammation (Torres, Mehandru, Colombel & Peyrin-
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Biroulet, 2017). Antibiotics (metronidazole and ciprofloxacin) may be prescribed by the doctor,
depending upon complication.
Preventive measures
The preventive measures mainly include following the medications as prescribed.
Additionally, special attention is required for the management of diet and physical activities. In
particular, high fibrous and fat-rich foods are avoided (Torres, Mehandru, Colombel & Peyrin-
Biroulet, 2017). Increased consumption of water and mild to moderate physical activity
including routine walking is recommended for recovery and management of health.
Prognosis
The prognosis of Crohn's disease can only be made based on symptoms and clinical tests.
However, maintaining a proper diet and physical activity can help in controlling the hormonal
level and prevention of this disease.
Lifestyle habits
Stress is known to cause of hormonal fluctuation which in turn is responsible for the
occurrence of Crohn's disease. Smoking, on the other hand, is known to cause disease onset as
well as progression. Drinking worsens liver disease and causes proliferated inflammation in the
gut, which then induces the onset of Crohn’s disease (Feuerstein & Cheifetz, 2017).
Relevant images
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Fig1: Animated figure showing the digestive tract and the internal region of colon in Crohn’s
diseased condition.
Fig2: The difference between internal colon region in disease (left) and normal (right) condition
(Feuerstein & Cheifetz, 2017).
Conclusion
In summary, the complication of Crohn’ disease do not have a particular cure, however, it
can be controlled with therapeutic and lifestyle habits. The disease is more complicated in
women due to the fluctuating hormonal level. In this report, it is learned that lifestyle habits such
as smoking, alcohol consumption, and fat-rich foods tend to trigger the onset of the disease.
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References
Al-Hussaini, A., El Mouzan, M., Hasosah, M., Al-Mehaidib, A., ALSaleem, K., Saadah, O. I., &
Al-edreesi, M. (2016). Clinical pattern of early-onset inflammatory bowel disease in
Saudi Arabia: a multicenter national study. Inflammatory bowel diseases, 22(8), 1961-
1970.
Feuerstein, J. D., & Cheifetz, A. S. (2017). Crohn disease: epidemiology, diagnosis, and
management. In Mayo Clinic Proceedings, 92(7), 1088-1103.
Marrie, R. A., Walld, R., Bolton, J. M., Sareen, J., Walker, J. R., Patten, S. B., & Katz, A.
(2017). Increased incidence of psychiatric disorders in immune-mediated inflammatory
disease. Journal of psychosomatic research, 101, 17-23.
Merghati-Khoei, E., Pirak, A., Yazdkhasti, M., & Rezasoltani, P. (2016). Sexuality and elderly
with chronic diseases: A review of the existing literature. Journal of research in medical
sciences: the official journal of Isfahan University of Medical Sciences, 21, 10-19.
Peery, A. F., Crockett, S. D., Barritt, A. S., Dellon, E. S., Eluri, S., Gangarosa, L. M., & Schmidt,
M. (2015). Burden of gastrointestinal, liver, and pancreatic diseases in the United
States. Gastroenterology, 149(7), 1731-1741.
Torres, J., Mehandru, S., Colombel, J. F., & Peyrin-Biroulet, L. (2017). Crohn's disease. The
Lancet, 389(10080), 1741-1755.
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