Crohn's Disease is a disease in which there is chronic inflammation of the intestines. Primarily there are ulcerations of both types of intestines that is the small and large intestines, but the illness can affect any part of the entire digestive tract from the mouth to the anus. Crohn's disease is very similar in its manifestation to another illness of similar type which affects similar body organs in similar way, which is known as Ulcerative Colitis. Ulcerative colitis and Crohn's disease have no medical cure. Once the diseases begin, they tend to fluctuate between periods of inactivity (remission) and activity (relapse). Crohn’s disease commonly begins during adolescence and early adulthood, but it also can begin during childhood and later in life. Crohn's disease tends to be more common in relatives of patients with Crohn's disease. It also is more common among relatives of patients with ulcerative colitis. The cause of Crohn's disease is unknown. Crohn's disease is not contagious. Diet may affect the symptoms in patients with Crohn's disease. Activation of the immune system in the intestines is most likely to be important in Crohn's disease. Normally, the immune system defends the body against harmful bacteria, viruses, fungi, and other foreign invaders. Activation of the immune system causes inflammation within the tissues where the activation occurs. Normally, the immune system is activated only when the body is exposed to harmful invaders. In patients with Crohn's disease the immune system is activated in the absence of any external invader. The continued abnormal activation of the immune system results in chronic inflammation and ulceration. The susceptibility to abnormal activation of the immune system is genetically inherited. Thus, first degree relatives (brothers, sisters, children, and parents) of patients with Crohn's disease are more likely to develop these diseases. In the early stages, Crohn's disease causes small, scattered, shallow, crater-like areas (erosions) on the inner surface of the bowel. These erosions are called aphthous ulcers. With time, the erosions become deeper and larger, ultimately becoming true ulcers (which are deeper than erosions) and causing scarring and stiffness of the bowel. As the disease progresses, the bowel becomes increasingly narrowed, and ultimately can become obstructed. Deep ulcers can puncture holes in the wall of the bowel, and bacteria from within the bowel can spread to infect adjacent organs and the surrounding abdominal cavity. The different subtypes of Crohn's disease and their symptoms are:

1. Crohn's colitis
2. Crohn's enteritis
3. Crohn's terminal ileitis
4. Crohn's entero-colitis and ileo-colitis

Crohn's terminal ileitis and ileo-colitis are the most common types of Crohn's disease.
Up to one third of patients with Crohn's disease may have one or more of the following conditions involving the anal area:

   1. Swelling of the tissue of the anal sphincter, the muscle at the end of the colon that controls defecation.

   2. Development of ulcers and fissures (long ulcers) within the anal sphincter. These ulcers and fissures can cause bleeding
      and pain with defecation.

   3. Development of anal fistulae (abnormal tunnels) between the anus or rectum and the skin surrounding the anus). Mucous
      and pus may drain from the openings of the fistulae on the skin.

   4. Development of peri-rectal abscesses (collections of pus in the anal and rectal area). Peri-rectal abscesses can cause
       fever, pain and tenderness around the anus.

Crohn's disease doesn't just affect you physically only but it takes an emotional toll as well. If signs and symptoms are severe, your life may revolve around a constant need to run to the toilet. In some cases, you may barely be able to leave the house. When you do, you might worry about an accident, and this anxiety only makes your symptoms worse.

Even if your symptoms are mild, gas and abdominal pain can make it difficult to be out in public. You may also feel hampered by dietary restrictions or embarrassed by the nature of your disease. All of these factors — isolation, embarrassment and anxiety — can severely alter your life. Sometimes they may lead to depression.

You may also find it reassuring to be among people who understand what you're going through.
Some people find it helpful to consult a psychologist or psychiatrist who's familiar with inflammatory bowel disease and the emotional difficulties it can cause. Although living with Crohn's disease can be discouraging, the outlook is brighter than it was even just a few years ago.
Lifestyle and other remedial measures:
Sometimes you may feel helpless when facing Crohn's disease. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

Diet:
There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up in your condition. It's a good idea to try eliminating from your diet anything that seems to make your signs and symptoms worse. Here are some suggestions that may help:

• Limit dairy products. Like many people with inflammatory bowel disease, you may find that problems, such as diarrhea, abdominal pain and gas, improve when you limit or eliminate dairy products. You may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods. If so, try substituting yogurt or low-lactose cheeses, such as Swiss and cheddar, for milk. Or use an enzyme product, such as Lactaid, to help break down lactose. In some cases, though, you may need to eliminate dairy foods completely. If you need help, a registered dietitian can help you design a healthy diet that's low in lactose. Keep in mind that with limiting your dairy intake, you'll need to find other sources of calcium, such as supplements.

• Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Foods that may be especially troublesome include butter, margarine, peanut butter, nuts, mayonnaise, avocados, cream, ice cream, fried foods, chocolate and red meat.

• Experiment with fiber. For most people, high-fiber foods, such as fresh fruits and vegetables and whole grains, are the foundation of a healthy diet. But if you have inflammatory bowel disease, fiber may make diarrhea, pain and gas worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. You may also find that you can tolerate some fruits and vegetables, but not others. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and with very crunchy foods such as raw apples and carrots.

• Avoid problem foods. Eliminate any other foods that seem to make your signs and symptoms worse. These may include "gassy" foods such as beans, cabbage and broccoli, raw fruit juices and fruits — especially citrus fruits — spicy food, popcorn, alcohol, caffeine, and foods and drinks that contain caffeine, such as chocolate and soda.

Eat small meals. You may find you feel better eating five or six small meals rather than two or three larger ones.
Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
Consider multivitamins. Because Crohn's disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful.
Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Stress:
Although stress doesn't cause Crohn's disease, it can make your signs and symptoms much worse and may trigger flare-ups. Stressful events can range from minor annoyances to a major event such as job loss or the death of a loved one.

When you're stressed, your normal digestive process changes. Your stomach empties more slowly and secretes more acids. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.

Although it's not always possible to avoid stress, you can learn ways to help manage it. Some of these include:

• Exercise: Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.

• Biofeedback: This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.

• Regular relaxation and breathing exercises: An effective way to cope with stress from Crohn's disease is to regularly relax and exercise. You can take classes in yoga and meditation or practice at home using books or tapes.

• You can also practice progressive relaxation exercises: These help relax the muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all the tension go. Next, tighten and relax your calves. Continue until muscles in your body, including those in your eyes and scalp, are completely relaxed.

• Deep breathing also can help you relax: Most adults breathe from their chests. But you become calmer when you breathe from your diaphragm — the muscle that separates your chest from your abdomen. When you inhale, allow your belly to expand with air; when you exhale, your abdomen naturally contracts. Deep breathing can also help relax your abdominal muscles, which may lead to more normal bowel activity.

• Hypnosis: Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you as you imagine your intestinal muscles becoming smooth and calm.

• Other techniques: Set aside at least 20 minutes a day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.

Role of Homeopathy in Crohn’s Disease:
The illness has more close association with emotional disturbance of a person, though not in triggering the illness but definitely in triggering the flair ups and also as one of the major maintaining factor of the illness. Homeopathy as a system of alternative medicine focuses more on achieving emotional balance of a person through homeopathic remedies and through personalized care given by Homeopathic physician in the form of counseling as well as indulging in to one to one interaction with his patients. This is a holistic approach towards cause of chronic and longstanding illness which is not getting better with conventional medicine. Homeopathic constitutional medicine has proved to be effective in decreasing symptom severity, decreasing the duration, frequency and intensity of the flair ups of the disease. Homeopathic treatment also effectively takes care of the emotional disturbance the patient undergoes due to lifestyle changes and social difficulty. Homeopathic physician is well trained in handling these issues in patient’s life as he has studied the patient not only from diagnosing the disease point of view but from understanding the person, the soul behind the illness. Apart from the illness he knows what his patient feels and thinks and how he behaves in a particular situation in his life so he is in a better position to handle him not as a patient of Crohn’s Disease but as a human being who is undergoing a stressful illness which is worsening day by day. Constitutional Homeopathic treatment is the best approach to the treatment of Crohn’s disease. The flair ups may be controlled by acute remedies or organ remedies or phase remedies or intercurrent remedies.



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