Crohn’s Disease is one of the most common forms of Inflammatory Bowel Disease or IBD, affecting around 1 in every 650 people in the UK today. It can affect any part of the digestive system from the mouth to the anus, but is most commonly found in the small intestine and/or colon. Often occurring in patches, it causes inflammation, deep ulcers and scarring to the wall of the intestine. The cause or causes have not yet been identified, but both genetic factors and environmental triggers are likely to be involved; it’s slightly more common in women than in men, and it’s more common in smokers.
Interestingly, and for reasons that are not yet understood, there are certain groups in whom Crohn’s disease is much more common. In London, the most important group is Ashkenazi Jews who have a prevalence at least five times higher than the surrounding populations.
The main symptoms are pain in the abdomen, urgent diarrhoea, general tiredness and loss of weight. Crohn’s is sometimes associated with other inflammatory conditions affecting the joints, skin and eyes. The severity of the symptoms fluctuates unpredictably over time. Patients are likely to experience flare-ups in between intervals of remission or reduced symptoms.
It is a chronic disease, meaning that it is ongoing and lifelong, but whilst there is currently no cure there are various options for Crohn’s disease treatment in London which can help to reduce and control symptoms.
There are lots of excellent resources on the Internet which describe the up-to-date treatments available. We recommend that you explore http://www.crohnsandcolitis.org.uk where you can read more about Crohn’s disease and other forms of IBD.
Here at the London Gastroenterology Centre, our specialist consultants can offer diagnosis and Crohn’s disease treatment in London, which may range from dietary treatments to surgical treatments, depending on the severity of your condition. These treatments can help to reduce your symptoms and deal with complications, and are aimed at improving your quality of life and, where possible, keeping the condition in remission.
Crucially, we take the approach of ‘aggressive physician, conservative surgeon’. By this we mean that surgery should be considered as the last option in patients with Crohn’s and should only be used after medical approaches including diet and drugs have failed. To this end, we have specialist dietititians to advise you. We also have access to the latest biological therapies.
Another important concept is step up versus step down treatment. Many doctors start with the lowest dose of drugs and build up. Traditionally, the starting point is to use steroids. If these fail, second line drugs such as azathioprine are used. Only if these fail, are biologics such as Infliximab or Humira used. There is increasing evidence that this approach leads to worse outcomes long term.
We assess our patients carefully. We will often suggest a much more aggressive treatment initially to get the disease under excellent control. Long term management then becomes around dietary control to keep the patient well. This means that people need to take less steroids long term and yet remain in better health.
Crohn’s disease needs a partnership between the patient and their physician. We pride ourselves on offering a patient-centred approach. We listen and guide. We offer wide ranging support. Our patients are very happy with their interactions with the doctors. Please see our testimonials page and find out what patients say about our service.
To find out more about Crohn’s disease treatment at our London clinic, or to discuss treatment with our specialists, please get in touch using the form below.