Bay Biosciences provides high-quality, fresh frozen samples, matched fresh frozen sera (serum), plasma, and peripheral blood mononuclear cells (PBMC) bio-fluids from patients diagnosed with Crohn’s disease.
The sera (serum), plasma and PBMC biofluid specimens are processed from Crohn’s disease patient’s peripheral whole-blood using customized collection and processing protocols.
Fresh frozen tissue and matched biofluid samples are collected from unique patients diagnosed with Crohn’s disease.
Bio-samples are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
Crohn’s Disease Overview
Crohn’s disease is a type of inflammatory bowel disease (IBD). It can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. It is an autoimmune disorder, meaning your body’s immune system mistakenly attacks healthy tissue in your body.
Crohn’s disease is chronic (ongoing) disease requiring lifetime monitoring, and may appear and disappear at various times. Initially, it may affect only a small part of the gastrointestinal tract, but the disease has the potential to progress extensively.
Crohn’s disease can involve some parts of the GI tract and skip other parts. Most commonly Crohn’s disease develops in the small intestine and the colon.
It most commonly affects the end of the small intestine (the ileum) where it joins the beginning of the colon. Crohn’s disease may appear in “patches,” affecting some areas of the GI tract while leaving other sections completely untouched.
In Crohn’s disease, the Inflammation may extend through the entire thickness of the bowel wall.
The disease primarily involves the intestinal system, but it also has a variety of other manifestations and can affect the skin, joints, bones, eyes, kidney, and liver. Despite major treatment advances in past decades, no cure is available yet for Crohn’s disease.
Crohn’s disease appears early in life; approximately one-sixth of patients have symptoms before 15 years of age.
Although the cause is unknown, doctors suspect a genetic influence, since many members of the same family may be affected. Crohn’s disease affects the Jewish population more than the general population.
According to the Crohn’s & Colitis Foundation approximately 780,000 Americans currently have Crohn’s disease. Although it typically starts in childhood or early adulthood, it can develop at any age.
Signs and Symptoms Crohn’s Disease
Signs and symptoms of Crohn’s disease vary, depending on which part of the gut the disease affects. The symptoms of Crohn’s disease often develop gradually, certain symptoms may also become worse over time.
Following are the early common symptoms of Crohn’s disease:
- Abdominal Pain
- Abdominal cramps
- Anemia
- Anal fissures
- Blood in stool
- Delayed growth (in younger children), which often occurs before gastrointestinal symptoms begin
- Diarrhea
- Fatigue
- Fever
- Feeling a frequent need for bowel movements
- Feeling as the bowels are not empty after bowel movement
- Loss of appetite
- Rectal bleeding
- Mouth ulcers
- Ulcers in the gut
- Unexplained Weight Loss
During a flare a Crohn’s disease patient may also develop the following symptoms:
- Arthritis
- Delayed growth or sexual development, in children
- uveitis
- Liver or bile duct inflammation
- Skin rashes and inflammation
- Uveitis
Symptoms in Female Crohn’s disease Patients
About half of the female patients who develop Crohn’s disease do so before the age of 35. It can have some specific symptoms in females, such as:
- Irregular menstruation, due to effects on hormone function.
- Iron deficiency, as Crohn’s disease affects the absorption of nutrients and can lead to intestinal bleeding.
- Pain during sex, if symptoms affect areas near the anus or vagina.
- Discomfort about sex, as Crohn’s can affect a person’s libido and body image, as well as causing pain and other types of discomfort.
Crohn’s disease does not appear to affect fertility, but research suggests that it is harder to conceive when the disease is active and after surgery.
Having an inflammatory bowel disease (IBD), such as Crohn’s, does not keep a person from becoming pregnant. However, a person with Crohn’s disease is more likely to:
- Give birth to an infant with a low birth weight
- Need a cesarean delivery
- Have a preterm delivery
Non-Intestinal Symptoms of Crohn’s Disease
Crohn’s disease patients sometimes experience non-intestinal symptoms that are more problematic than the bowel problems. These include the following:
- Colitic arthritis, an arthritis that migrates along the body and affects knees, ankles, hips, wrists and elbows
- Pericholangitis, inflammation of the tissues around the bile ducts
- Kidney stones
- Urinary tract complications
- Fistulas
Causes of Crohn’s Disease
Exact cause of IBD is unknown, but IBD is the result of a defective immune system. In IBD, the immune system responds incorrectly to environmental triggers, which causes inflammation of the gastrointestinal tract.
Following factors ay increase the risk of inflammation:
According to CCFA 20% of patients with Crohn’s disease also have a parent, child, or sibling with the disease.
A bacterium or virus may also play a role. A research study suggests that there is a link between the bacterium Escherichia coli and Crohn’s disease.
Patients with Crohn’s disease are also more likely to develop intestinal infections from bacteria, viruses, parasites, and fungi. This can affect the severity of symptoms and create complications.
Crohn’s disease and its treatments can also affect the immune system, making these types of infections worse.
Yeast infections are common in Crohn’s disease and can affect both the lungs and the intestinal tract. It’s important that these infections are diagnosed and properly treated with antifungal medications to prevent further complications.
Types of Crohn’s Disease
There are five types of Crohn’s disease. Each type affects different part of the gastrointestinal (GI) tract:
- Ileocolitis: This is the most common type, and it affects the small and large intestines. Symptoms include diarrhea, unexplained weight loss, and pain in the lower and middle abdomen.
- Ileitis: This type only affects the small intestine. The symptoms are the same as those of ileocolitis, but a patient with a severe case could develop fistulas or an inflammatory abscess.
- Gastroduodenal Crohn’s disease: This affects the stomach and the beginning of the small intestine. Symptoms may include nausea, vomiting, loss of appetite, and unexplained weight loss.
- Jejunoileitis: This type of Crohn’s disease causes spots of inflammation in the upper area of the small intestine, called the jejunum. Symptoms include abdominal cramping after meals, diarrhea, and in severe cases, fistulas.
- Crohn’s colitis: This type of Crohn’s disease only affects the large intestine, or colon. Symptoms may include diarrhea, rectal bleeding, and damage around the anus, such as ulcers, fistulas, and abscesses. It can also cause joint pain and skin lesions.
Complications of Crohn’s Disease
If symptoms are severe and frequent, the risk of complications is higher. A person with any of the following complications may need surgery.
- Fistulas involving a channel forming between two parts of the gut
- Internal bleeding which could be life threatening
- Intestinal obstructions
- Perforation in the wall of the gut, which can lead to leakage, infections, and abscesses
- Strictures, which involves part of the gut narrowing, causing a buildup of scar tissue and a partial or complete blockage of the intestine
In addition Crohn’s disease patients may have the following:
- Food absorption problems
- Higher risk of colorectal cancer
- Iron and other essential nutrients deficiency
- Severe infections
The progression of Crohn’s disease is marked by the occurrence of stricturing complications or intestinal and perianal penetrating complications, typically requiring surgery. One study found that nearly 60 percent of Crohn’s disease patients had surgery within 20 years of having the disease.
Diagnosis of Crohn’s Disease
Crohn’s disease can be difficult to diagnose because it can have similar symptoms to many other diseases. A single diagnostic test cannot give definite diagnosis of the Crohn’s disease therefore doctors usually start by eliminating other possible causes of the patients symptoms.
Following are some of the diagnostics tests used for the diagnosis of Crohn’s disease:
- Blood tests can help your doctor look for certain indicators of potential problems, such as anemia and inflammation.
- A stool test can help the doctor detect blood in your gastrointestinal (GI) tract.
- Doctor may perform an endoscopy to get a better image of the inside of your upper gastrointestinal tract.
- A doctor may perform a colonoscopy to examine the large bowel.
- CT scans and MRI scans imaging tests gives more detail than an average X-ray. Both tests allow the doctors to see specific areas of the tissues and organs.
- Your doctor will likely have a tissue sample, or biopsy, taken during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.
Once the doctor has completed reviewing all the necessary tests and ruled out other possible reasons for the patients symptoms, they may reach a final conclusion that the patient has Crohn’s disease.
These tests maybe repeated several times more to investigate for affected areas and determine how the disease is progressing.
Treatment of Crohn’s Disease
There is no cure for Crohn’s disease but the disease can be managed. A variety of treatment options exist that can lessen the severity and frequency of your symptoms.
Treatment for Crohn’s disease is mainly treated by medication, surgery, and nutritional supplements. The aim is to control Inflammation, resolve nutritional problems, relieve symptoms, and reduce the occurrence of flares.
The course of treatment will depend on:
- A patients response to previous treatments
- Complications the patients have
- How side effects of medications might affect the patient
- Severity of the case
- Other medical conditions
- Part where the inflammation occurs
Some Crohn’s disease patients go for long periods, even years, without experiencing any symptoms. These are periods of remission. However, symptoms usually flare up again.
As the duration of remission varies greatly, it can be hard to know how effective treatment is and how long remission will last.
Doctor’s might recommend medication, diet changes, a spell of bowel rest, surgery to remove or repair parts of your digestive tract, or a combination of these.
Medication
Usually drugs are the first choice of treatment for Crohn’s disease. The medications reduce the body’s inflammatory response. This helps curb down the symptoms and gives the patients intestines time to rest.
Following are some of the medications used for the treatment of Crohn’s disease:
- Aminosalicylates: These dugs help tame inflammation in your digestive tract. The doctors are more likely to prescribe them for newly diagnosed patients with Crohn’s disease and have mild symptoms.
These anti-inflammatory drugs include balsalazide (Colazal) and mesalamine (Lialda).
- Antibiotics: Usually antibiotics are used during Crohn’s disease flare ups and when the patients develop an abscess or fistula.
- Antidiarrheal drugs and fluid replacements: When the inflammation subsides, diarrhea usually becomes less severe. However, a person may still need something to address diarrhea and abdominal pain.
- Corticosteroids (steroids): Steroids calm the immune system and ease swelling. The doctor might prescribe these drugs for a short time if the Crohn’s disease onset is moderate to serious. Corticosteroids can cause serious side effects therefore long term use of these are not recommended. Because steroids weaken the immune system, they can make you more likely to get an infection.Following are some of the side effects of steroids:
- Acne
- Headache
- Hair growth on the face
- Night sweats
- Swelling of the face (called “moon face”)
- Trouble sleeping
- Weight gain
Following are some of the more serious side effects of steroids:
- Cataracts
- Diabetes
- Glaucoma
- High blood pressure
- Weakened bones and fractures
Biologic Therapies
Biologics: These type of drugs are developed from living organisms which target certain proteins that the immune system makes which lead to inflammation.
There are different types of biologic drugs, and each patient reacts to these differently. Biologics reduce the body’s immune response by targeting proteins that lead to inflammation.
Following are some of the biologic therapies fused for the treatment of Crohn’s disease:
- Adalimumab (Humira)
- Certolizumab pegol (Cimizia)
- Infliximab (Remicade)
According to The American Journal of Gastroenterology (AJG), studies suggest that using biologics can reduce the likelihood of needing abdominal surgery for Crohn’s disease patients.
Biologics also appear to reduce the risk of adverse effects of corticosteroids.
Biologic treatments can have side effects, including nausea, vomiting and weakened resistance to infection.
Bowel Rest
Crohn’s disease patients maybe advised by the doctors to bowel rest specially if their symptoms are serious. Bowel rest is just what it sounds like, your intestine takes off work for several days to several weeks.
Patients won’t eat anything during the bowel rest. Instead, they might only drink clear liquids. Or you could get nourishment through an IV or a feeding tube.
This treatment often works well to help the patients intestines heal.
Diet and Nutrition
Crohn’s disease is not caused by any certain food or foods. But symptoms like appetite loss and diarrhea can keep you from getting enough nutrients or drain them from your body.
Following are some of the foods and ingredients that could aggravate the symptoms or trigger a flare-up of Crohn’s disease:
- Fat
- Intense spices
- Lactose, a protein found in dairy products
- Sugar
There’s no one diet that doctors recommend for Crohn’s disease. Many patients find that soft, bland foods work best for them, especially when they’re in a flare.
Following methods are gentle to your body and can help you maintain a healthy diet:
- Eat four to six small meals a day instead of two to three large ones.
- Stay hydrated. Drink enough water
- to keep your pee clear or very pale yellow.
- Use simple cooking methods: boil, poach, grill, or steam.
- Know which foods your body handles best and keep your kitchen stocked with them.
Surgery
Most of the Crohn’s disease may eventually need surgery. This can relieve symptoms that have not responded to medication. It may also help address complications, such as an abscess, perforation, or blockage, as well as bleeding.
Removing part of the intestine can help, but it does not cure Crohn’s disease. Inflammation often returns to an area next to the area that was removed. Some of the patients may require more than one procedure in their lifetimes.
A patient may need a colectomy, in which a surgeon removes the whole colon, or large intestine. This procedure may also involve making a small opening in the front of the abdominal wall and bringing the tip of the end of the small intestine into this opening, forming a stoma, through which feces exits the body.
A pouch then collects the fecal matter. Doctors confirm that people with stomas can lead typical, active lives.
If the surgeon can remove the diseased section of the intestine and reconnect the healthy areas, no stoma is necessary.
Surgery is not an option for everyone, however. It is also important to know that the disease will recur after the surgical procedure.
Following are some common types of surgery for Crohn’s disease:
- Strictureplasty: This procedure opens up a blockage that happens when long-lasting swelling thickens the walls of the digestive tract.
- Bowel Resection: The surgeon removes damaged parts of the small or large intestine, then joins the two healthy ends.
- Proctocolectomy or colectomy: In this procedure a surgeon removes the colon (large intestine) or rectum, or both. The surgery changes the path of the digestive tract so waste can pass through your body. In a proctocolectomy, the waste is diverted to an ostomy bag placed on the outside of your body. In a colectomy, the waste moves from the lower part of your small intestine to the anus.
- Fistula Removal: This procedure might be done when meds don’t heal the ulcers, which form tunnels to drain pus from an infection. A surgeon might close the fistula with a plug or medical glue, or drain the infection.
Vitamins for Crohn’s Disease
During flares of the Crohn’s disease, patients may not be able to eat much healthy food. That means your body won’t be getting enough healthy nutrition.
When you don’t get enough of certain vitamins and minerals, the body has deficiency, which can be managed by the use of supplements.
Crohn’s disease can make the patients feel sick and tired because they are not able to eat the right foods. It may affect how the medication works, too, and it can stop kids from growing normally.
It is difficult to absorb carbohydrates, fats, water, and vitamins and minerals. Surgery for Crohn’s disease can also cause this problem if too much of your small intestine is removed. Sometimes patients don’t want to eat because of anxiety, pain, diarrhea and changes in taste.
Following essential nutrients are likely to have lower levels in Crohn’s disease patients:
- Calcium
- Folic Acid
- Iron
- Magnesium
- Potassium
- Vitamins A,E and K
- Vitamin D
- Vitamin B12
- Zinc
Your doctor may recommend supplements to replenish the above nutrients in the body and prevent other problems.
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