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Crohn's disease

Mr S. D is a young 25 year old male patient who presented to my office with complaints of episodic severe pain in lower abdomen area.  He also has been having diarrhea and passes fresh to sometimes altered blood mixed with his stools.  He recently also has been having significant weakness and weight loss to the tune of 15 pounds in last 3 months.  He has been physically active and likes to play football but for last 2 months, he gets short of breath while playing and cannot keep up with his team mates on the football field.  I performed a colonoscopy which revealed severe inflammation and ulcers in the entire colon.  Biopsies were taken which revealed findings compatible with Crohn's disease affecting the colon.  Crohn's disease is a disease which can affect the entire gastrointestinal system and is characterised by ulceration in the lining of the bowel.  This leads to blood loss in the stool and therefore anemia.  It also leads to loss of protein and therefore patients begin to lose weight and start losing muscle mass.  This causes weakness.  Although, we are not clear what causes the disease, we have very good treatments.  The most recent advance in traetment is the addition of biologic therapy which involves giving injections(intravenously or sub cutaneously) antibodies against a protein(tumor necrosis factor) which plays an important role in causing tissue damage in the intestine.  This patient was started on one such agent and his repeat colonsocopy 3 months later revealed almost complete healing of his colon inflammation.  He is now feeling much better and has resumed playing football.

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