A Crohn-betegség egy krónikus, gyulladásos bélbetegség, amely világszerte emberek millióinak életét nehezíti meg. Magyarországon körülbelül 55 000 embert érint, és az előfordulása folyamatosan növekszik. Bár a betegség pontos oka ismeretlen, a tünetek – mint a hasi fájdalom, a hasmenés és a fáradtság – jelentősen befolyásolhatják a mindennapokat. Sokan, akik ezekkel a panaszokkal küzdenek, bizonytalanok és félnek a kivizsgálástól, pedig a korai diagnózis és a megfelelő kezelés kulcsfontosságú.
In this article, we explain in detail exactly what Crohn’s disease is, what symptoms it involves, and how it is diagnosed. We look in detail at the lifestyle changes that can help alleviate symptoms and improve quality of life. Our aim is to help you navigate issues relating to the condition with clear and reliable information, and to encourage you to take the necessary medical steps. The Endomedix Gastroenterology Centre Our specialists are committed to supporting patients through the use of state-of-the-art diagnostic procedures and personalised treatments.
What exactly is Crohn’s disease?
Crohn’s disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the digestive tract, from the mouth to the anus. However, it most commonly affects the final section of the small intestine (terminal ileum) and the large intestine. The other main type of inflammatory bowel disease is ulcerative colitis; however, unlike ulcerative colitis, Crohn’s disease can affect all layers of the digestive tract’s wall, and there may be healthy sections of intestine between the inflamed areas.
The condition usually presents in young adulthood, but can develop at any age. As a result of the inflammatory process, the intestinal wall thickens, and ulcers, narrowings (stenosis) and fistulas may form, which can lead to further complications.
The most common symptoms of Crohn’s disease
The severity and nature of the symptoms vary from person to person, depending on which part of the digestive system is affected. The condition alternates between active and dormant (remission) phases.
Common complaints:
- Abdominal pain: It often occurs in the lower right-hand side of the abdomen and may be cramp-like in nature.
- Diarrhoea: It is not usually accompanied by bleeding, but it is persistent.
- Weight loss and loss of appetite: Due to inflammation and poor nutrient absorption.
- Fatigue and general weakness: It is a consequence of anaemia and chronic inflammation.
- Elevated temperature, fever: Particularly during the active phases of the illness.
- Tactile abdominal terime: Due to the inflamed intestinal loops sticking together.
- Perianal symptoms: Fistulas, abscesses or skin tags appearing in the area around the rectum may also be signs of Crohn’s disease.
It is important to note that the symptoms may not be limited to the digestive system. Joint pain, skin problems and eye inflammation may also occur as side effects of the condition.
Diagnosing Crohn’s disease
Several tests are required to reach an accurate diagnosis, as the symptoms may resemble those of other conditions. The doctor will first ask the patient in detail about their medical history, and then recommend laboratory and imaging tests.
Diagnostic steps:
- Laboratory tests: A blood count can reveal the extent of anaemia and inflammation. A stool test can help to rule out infections and detect hidden bleeding.
- Endoscopic examinations: A kolonoszkópia (vastagbéltükrözés) elengedhetetlen a diagnózishoz. A vizsgálat során az orvos egy vékony, hajlékony eszközzel (endoszkóp) tekinti meg a vastagbél és a vékonybél utolsó szakaszának nyálkahártyáját. Jellemző a szakaszos gyulladás, a fekélyek és az úgynevezett „utcakő-rajzolat”. A vizsgálat során szövettani mintavétel (biopszia) is történik, amely megerősítheti a diagnózist a jellegzetes granulomák kimutatásával.
- Capsule endoscopy: If there is a suspicion that hard-to-reach parts of the small intestine are also affected, a capsule endoscopy may be required. The patient swallows a small capsule fitted with a camera, which travels through the digestive tract and takes pictures. The Endomedix Gastroenterology Centre Modern capsule endoscopy techniques enable a thorough and gentle examination of the small intestine.
- Imaging studies: An abdominal ultrasound, a CT or MRI scan (enterography) can help to identify thickening of the intestinal wall, narrowings and abscesses.
Lifestyle advice for people with Crohn’s disease
Although Crohn’s disease requires treatment with medication and, in some cases, surgery, lifestyle also plays a key role in keeping symptoms under control and improving quality of life. A suitable diet, stress management and regular exercise can all help to achieve longer symptom-free periods.
The role of diet
Nincs egyetlen, mindenki számára tökéletes „Crohn-diéta”, mivel az egyéni tolerancia rendkívül változó. A cél egy olyan kiegyensúlyozott étrend kialakítása, amely biztosítja a szükséges tápanyagokat anélkül, hogy súlyosbítaná a tüneteket.
Általános javaslatok:
- Keep a food diary: Make a note of what you eat and how you feel afterwards. This will help you identify which foods are causing your symptoms.
- Frequent, small meals: Eating 5–6 smaller meals a day puts less strain on the digestive system than three large main meals.
- Grate coating: During the active phase of the condition, particularly in cases of strictures, foods high in fibre (e.g. raw vegetables, whole grains) may worsen symptoms. In such cases, it is recommended to eat puréed, steamed or peeled vegetables and fruit. During the remission phase, fibre intake can be gradually increased.
- Foods to avoid: Many patients experience symptoms caused by fatty, spicy foods, dairy products (due to lactose intolerance), fizzy drinks and alcohol.
- Fluid replacement: Because of diarrhoea, it is important to drink plenty of fluids, primarily in the form of water and herbal teas.
- Nutritional supplementation: Due to poor absorption, vitamin and mineral deficiencies (e.g. iron, vitamin B12, vitamin D, calcium, zinc) are common. You should definitely consult your doctor about taking supplements to address these deficiencies.
The importance of stress and rest
Although stress does not in itself cause Crohn’s disease, it has been shown to worsen symptoms and trigger flare-ups. Learning stress management techniques is crucial.
- Relaxation techniques: Yoga, meditation or deep breathing can help reduce tension.
- Adequate sleep: Aim for 7–8 hours of restful sleep a day, as exhaustion makes you more susceptible to flare-ups of the condition.
- Psychological support: Do not hesitate to seek help from a professional (psychologist) if you feel that the emotional strain of the illness is more than you can bear.
The effects of physical activity
A rendszeres, mérsékelt intenzitású testmozgás csökkenti a stresszt, javítja a hangulatot és erősíti az immunrendszert. A kutatások szerint a fizikai aktivitás csökkentheti a Crohn-betegség kialakulásának kockázatát is.
- Choose a form of exercise that you enjoy and that isn’t too strenuous: walking, swimming, cycling or gentle yoga could be good options.
- During the active phase of the illness, avoid strenuous exercise and listen to your body.
Treatment options
The treatment of Crohn’s disease is complex; its aim is to reduce inflammation, achieve and maintain remission, and prevent complications.
Kezelési módszerek:
- Drug therapy: Various groups of medicines are available, such as anti-inflammatory aminosalicylates, steroids (for treating flare-ups), immunosuppressants that suppress the immune system, and modern biological therapies. Treatment is always prescribed by a specialist gastroenterologist.
- Surgical treatment: Műtétre akkor lehet szükség, ha a gyógyszeres kezelés hatástalan, vagy súlyos szövődmények (pl. bélelzáródás, tályog, nem gyógyuló sipoly) alakulnak ki. A sebészi beavatkozás során a beteg bélszakaszt eltávolítják.
When should you see a doctor?
If you experience persistent abdominal pain, diarrhoea, unexplained weight loss or any of the symptoms mentioned above, you should definitely consult your GP or a specialist gastroenterologist. Don’t be afraid of the tests! Early diagnosis and starting the right treatment are crucial to avoiding more serious complications and maintaining your quality of life.
From Endomedix Gastroenterology Centre Our experienced specialists and state-of-the-art diagnostic facilities ensure that an accurate diagnosis is made and that the most effective, personalised treatment can be started. Don’t put off your consultation – take a step towards better health today!
