Where is Crohn's disease treated?

summary

Crohn's disease can occur in any part of the gastrointestinal tract. Patients should pay enough attention to the treatment of Crohn's disease, but it mainly occurs in the terminal ileum and right colon. The main symptoms were abdominal pain, diarrhea, intestinal obstruction, fever, nutritional disorders and other extraintestinal manifestations. So we must do a good job in the related work of this disease, then where is Crohn's disease treated well?.

Where is Crohn's disease treated?

First: medical treatment support and symptomatic treatment, give high calorie, high protein, low residue diet, supply sufficient vitamin D and iron. If necessary, whole blood, amino acids, albumin and other parenteral nutrition can be transfused. In order to reduce pain, can give sedative, analgesics, such as bacterial infection, can give appropriate antibiotics.

Second: surgical indications: acute intestinal perforation, chronic recurrent intestinal obstruction, abscess, intestinal fistula formation, refractory intestinal bleeding, anorectal disease and other diseases, all need early surgical treatment, resection of local lesions, but the postoperative recurrence rate is high.

Third, the mechanism of postoperative recurrence of Crohn's disease is unknown. Fecal flow, intestinal continuity, genetic and immune factors may play a role. Bypass ileostomy can effectively treat Crohn's colitis, but the risk of small intestinal Crohn's disease is low. It has been reported that there was no recurrence in the upper segment of ileostomy after 6 months of endoscopic and histological examination, but the recurrence rate of patients without ileostomy was as high as 71%; After 6 months of ileostomy closure, all patients had endoscopic or pathological recurrence. There is also evidence of increased colonization of "new terminal ileum" bacteria in patients with Crohn's disease after ileectomy. The number and species of bacteria in the "new terminal ileum" were significantly increased in patients with Crohn's disease and control group after ileostomy, but there was no such change after ileostomy. Case control study showed that the number of Escherichia coli and Enterococcus in patients with Crohn's disease was more, while Bifidobacterium and Ruminococcus were more in the control group. Early recurrence is associated with higher counts of Escherichia coli and Bacteroides. Fusobacteria can be isolated from these patients.

matters needing attention

There is a long way to go to determine the effective means of recurrence prevention so as to reduce postoperative recurrence. The emerging new methods of maintenance treatment have their own advantages and disadvantages, and the attitude of patients to postoperative maintenance treatment is quite different. This makes clinical decision-making more complex. It is important to encourage patients to quit smoking.