- What affects life expectancy?
- What is required of the patient?
- Effectiveness of treatment
- Negative effect of drugs
- What complications accompany illness?
- Labor activity
- Quality of life
- Is it possible for patients to have children?
- Related videos
Crohn's disease is a persistent, chronic bowel disease. It is possible to spread the inflammatory process to the stomach and esophagus, the oral cavity. The disease to date is considered incurable. The reason remains unclear, so it is difficult to choose a treatment.
The diagnosis is made only on the basis of evidence-based methods of examination, among which the main role belongs to the results of endoscopy and biopsy. How many live with Crohn's disease identified patients difficult to predict.
We give statistical average data. But we must take into account that they are calculated on the basis of large "swings" of indicators. Each case of illness is individual.
What influences life expectancy?
With confidence, experts note that the prognosis of life in Crohn's disease is affected by:
- the age of the patient in whom the initial signs appeared;
- timeliness of treatment;
- how often exacerbations occur;
- efficacy of medicines;
- individual susceptibility of the body to prescribed therapy;
- the severity of the patient's attitude towards the implementation of the doctor's recommendations;
- man's mood for healing.
What is required of the patient?
Patients with Crohn's disease should be aware of the danger of deterioration, it is possible to overestimate their priorities in the problem of how to live on. It will be required:
- strict adherence to a balanced diet;
- support of a mode of a food, rest, rational employment of working;
- to avoid sunbathing and sun exposure;
- refusal from alcohol, smoking;
- long-term use of maintenance doses;
- consent to surgical treatment if this slows down the course of the disease;
- ignoring any folk advice and therapies.
Climate change, moving to another zone is not desirable. Some authors insist on complete refusal of the patient from milk and products from it, considering that additional fermentation activates the inflammatory process in the intestine. Observations show that spontaneous recovery in Crohn's disease was recorded in 5.4% of patients.
treatment Modern therapy regimens allow for long periods of remission. A positive result is 1-2 exacerbations in 20 years. According to different authors, relapses are observed in 50-78% of patients.
It is established that the frequency of relapses does not depend on the localization, duration of the disease. There is a connection with the prevalence of pathology, the age of the patients. Especially often occur in children and young people.
Surgical treatment is necessary for 60% of patients. Refusal of a planned operation with sufficient preparation threatens the development of severe complications and the need for intervention for emergency indications. But the effectiveness will be worse, since the immunity of the patient suffers from every aggravation.
Timely surgical treatment( removal of the affected part of the intestine) can significantly reduce the number of relapses, but up to 65% of patients need a second operation for five years.
A number of patients in need of a primary stage in the removal of the gut on the skin of the abdomen( colostomy)
The total death rate for Crohn's disease is 2 times higher than the average in the same age groups. Among patients, he is greater among those who became ill before the age of twenty. If the patient does not leave bad habits, relapses will appear 2.8 times more often than for a patient who complies with the regime. At the same time, the forecast of the lethal outcome from complications increases 3.5-4.8 times.
Negative effects of drugs
In the treatment of Crohn's disease, strong drugs are used. Usually patients are warned about a possible negative effect, in order to timely adjust the dosage, to replace. Independently this can not be done. In order to remind about the negative properties of medicines, we give brief information about the consequences.
Antibiotics - you can expect increased sensitivity to a drug of a certain class. It is expressed in the itching of the skin, puffiness of the face, rashes. Corticosteroids are necessary drugs in therapy, but they have many side effects, especially if high doses are prescribed.
- edema due to delayed sodium and water;
- appearance of an elevated blood glucose level, sugar in the urine;
- osteoporosis, which is manifested by fragility of bones, fractures;
- increased likelihood of gastrointestinal or intestinal bleeding;
- decreased immunity;
- endocrine disorders( in girls and women, hair growth by male type, cessation of menstruation);
- development of glaucoma and cataract;
- a propensity for depression.
Immunomodulators - suppression of cells of the immune system contributes to a tendency to frequent colds, herpes infection( shingles), increases the risk of developing tumors, suppresses the functions of the sex glands, damages the liver cells.
The inclusion of drugs in the therapy scheme requires a course application, a gradual increase and decrease in dosage, prevention of airborne infection. Drug treatment should always be appointed taking into account individual sensitivity, target needs.
Standard regimens are adapted to a specific patient in accordance with the principle of "do no harm"
What complications accompany the disease?
Patients should know what undesirable consequences are dangerous for their lives. In the formation of deep ulcers, the intestinal wall is broken( perforation in 17.5% of patients) and the fecal masses exit into the abdominal cavity. The condition causes acute peritonitis.
A change in the internal wall of the intestine leads to constriction, contributing to intestinal obstruction( 53%).Ulcers and scar changes form fistulous passages in the intestine, bladder, in women in the uterus( frequency 17.5%).
Transition of infection contributes to the appearance of abscesses in different parts of the peritoneum, in the liver, on the surface of the skin, inside the fistula( in 12% of cases, abscesses between the intestines).The violation of absorption of nutrients in the intestine leads to exhaustion, affects metabolism. The patient shows signs of hypovitaminosis, anemia( anemia).
Anal cracks develop in the region of the terminal portion of the rectum. Colon cancer - Crohn's disease refers to precancerous diseases, this means a greater probability of transformation of the intestinal mucosa cells into malignant ones.
Labor activity of
Long-term follow-up of patients shows that ¼ part under the influence of treatment completely retains working capacity in its profession, capable of leading a habitual way of life.
For half of adult patients( according to other information, 29.5%), it is impossible to return to work because of persistent pains, diarrhea, fistula, consequences of metabolic disorders. They turn into disabled people.
Quality of life
The prognosis of life with Crohn's disease includes the person's ability to enter and build interpersonal, sexual relations, start a family. According to the observations of psychologists, most patients successfully adapt to the limitations of their disease.
Disregarding the need for frequent bowel movement helps to develop the habit of finding out the location of toilets in public places.
Patients are better off having a permanent supply of toilet paper, wet wipes
Adaptations are aggravated by repeated exacerbations. A person has a fear of appearing among other people, contact with others. If the patient perceives it as a significant stress load, then relatives should convince him to seek the help of a psychologist or psychiatrist.
Is it possible for patients to have children?
Doctors do not consider Crohn's disease a contraindication to pregnancy and childbirth. A woman is recommended to plan conception during a period of persistent remission. It is established that it is impossible to predict the course of pregnancy and its effect on the disease in advance. At ¼ of the patients, pregnancy promotes the abatement of inflammation of the intestine. The remaining 75% - either does not affect the disease, or is an exacerbation factor.
Obstetricians, who observe women with Crohn's disease, have to consult a gastroenterologist, take into account the existing deficiency of vitamin K, folic acid. The disturbance of metabolism in the maternal organism causes an increased risk of formation of defects in the fetus, bleeding. Therefore, a woman must be prescribed vitamins.
It is recommended to stay pregnant for a long time in the department of pathology of the perinatal center
. If you have an unplanned pregnancy while taking medications, you need to discuss the problem with your doctor and decide on the appropriateness of bearing.
The attention of scientists from different countries to Crohn's disease allows us to hope for the emergence of new drugs, methods of treatment. Patients need help from relatives and friends, create an enabling environment to remain a member of society, lead a normal life.