Crohn’s disease and Ulcerative Rectocolitis are chronic inflammatory bowel diseases, as explained by Professor Silvio Danese, Head of the Centre for Inflammatory Bowel Diseases at Humanitas, a guest in the Tutta Salute study on Rai3.
“These pathologies are a bit similar because they are both responsible for inflammation of the intestine, but they differ because they affect different segments of the intestine. Ulcerative rectocolitis always affects the colon, while Crohn’s disease can affect the entire digestive tract, from the mouth to the rectum.
There is a significant increase in these diseases, including in children. There are three factors that can determine its onset: genetic predisposition, the environment (especially the microbiome) and an abnormal immune response that leads to inflammation.
“Among the environmental causes, the use of antibiotics in childhood is often called into question: some studies in fact show that patients exposed several times to antibiotics run an increased risk as adults to develop Crohn’s disease or ulcerative retreats,” emphasizes prof. Danese.
What are the symptoms?
“Diarrhea with the presence of blood in the stools is one of the classic symptoms; there can then be recurrent abdominal pain and in some patients slimming can occur when the symptoms last a long time.
In some cases, the symptoms are atypical and do not involve the intestine, such as joint pain, inflammation of the skin or eyes,” says the specialist.
Therefore, warning signs should be considered: nocturnal diarrhea, slimming in the last three months, recurrent fistulae and frequent febrile; in these cases it is advisable to consult a doctor.
Crohn’s disease: The Problem of Diagnostic Delay
The diagnosis of these diseases is not easy, so it is essential to turn to specialized centers that have a multidisciplinary team.
“One of the fundamental problems with Crohn’s disease is diagnostic retardation because patients often have symptoms that are exactly the same as irritable bowel syndrome. It is estimated that one in three patients has a diagnostic delay of more than ten years.
However, early diagnosis is essential to avert the risk of complications. Crohn’s disease in fact leads to progressive damage: the intestine can tighten, perforate, create abscesses and the patient may need repeated surgery.
A study has just been published that goes precisely in this direction: patients with treatment in the so-called initial phase respond much better to biological drugs,” said Prof. Danese.
Treatment of inflammatory bowel diseases
“Many of the drugs are indicated for both diseases, as it is initially the case with the administration of cortisone or immunosuppressants. Today, however, we have innovative, intelligent and very specific drugs: they are biological drugs, capable of blocking the tumor necrosis factor, a sort of inflammation button.
A new study has allowed us to understand that the therapy of patients must be modulated not only taking into account the symptoms, but also considering the markers of inflammation. If the patient is well and in full remission, it is still necessary to check that the inflammation is completely extinguished; in this way it is really possible to modify the natural history of the disease”, concluded prof. Danese.
Watch the whole interview with Professor Silvio Danese, from minute 11.35, click here.
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