Crohn’s Disease

Discusses Crohn’s Disease particularly treatment and is for patients and the public. It is the third in the series of five videos on inflammatory bowel disease.

This video will attempt to answer the following QUESTIONS;
• Which part of the intestine is commonly affected in Crohn’s disease (CD) ?
• What is step up therapy in CD?
• What is top down therapy in CD?
• What are the two commonly used drugs in step up therapy?
• Why is maintenance therapy important in CD ?
• What are the complications of CD if the patient has regular flare ups?
• Why is regular colonoscopy important after 8 to 10 years of chronic CD ?

WORD INDEX:
• Colon is the large intestine.
• Ileum is the last part of the small intestine.
• Crohn’s Disease is chronic inflammation of the full thickness of the digestive tract, anywhere from the mouth to the anus.
• Flare-up or relapse is the return of inflammation and symptoms after a period of remission.
• Remission happens when the inflammation resolves and the patient is well and has no symptoms.
• Maintenance therapy is indicated to prevent relapse or flare up.

SUMMARY;
• In 80 % of patients with Crohn’s Disease (CD) , the ileum is affected, often extending to the right side of colon. Colon is the large intestine.
• Ileum is the last part of the small intestine.
• Step up therapy is for mild CD, where less potent drugs with fewer side effects are used. If patient does not respond, then more powerful drugs are given.
• Top down therapy is for moderate to severe CD, where more powerful drugs with rapid onset of clinical resolution are used, but with more side effects.
• Two commonly used drugs in mild CD are steroids and mesalamine.
• Maintenance therapy is important to prevent relapses or flare ups, which can sometimes result in severe complications , necessitating surgery.
• Regular colonoscopy is indicated ( to detect precancerous lesions) after 8 to 10 years of the disease, as the risk of colon and small intestine cancer is increased.

The videos are easy to understand and tries to use everyday language as far as possible. The videos are full of images and follow a standard format of topic objective, word index, content and summary. Each topic covers diagnosis, investigation, management and prevention. Videos are an average of between 5 to 10 minutes. I created the videos, using my over 30 years of experience in managing patients with gut and liver problems . I am a gastroenterologist and hepatologist and was trained in Edinburgh, United Kingdom, and Tokyo and have worked in academia and the private sector.

As the adage goes “A picture is worth a thousand words”. I believe combining images and explanations using blackboards, helps one better understand a medical condition. With knowledge, a person gets a better sense of control, and hence is empowered to make informed decisions.