Strategies in the Treatment of Crohn’s Disease

Abstract

Crohn’s disease (CD) is a chronic inflammatory condition that affects the gastrointestinal tract (GIT) with uncertain etiology. A retrospective study was conducted in which medical record of 58 Crohn’s disease patients at the Yammah hospital and Bethlehem Arab Society for Rehabilitation was reviewed between November 2016 and March 2017. This study’s results indicate that about 51.7% of patients went to doctors with mild disease, 27.6% of patients went in with moderate disease, and 13.8% of patients went to doctors with severe disease. Our findings indicate that the gastroenterologists included in the study do not use the Crohn’s Disease Activity index to evaluate the disease score; instead, disease severity is determined according to their experience. As such, results that used patient records are likely influenced by doctor’s experience. Abdominal pain is a very common condition in 52% of Crohn’s Disease patients; this pain can be either acute or chronic in nature. Other symptoms may include diarrhea, reported in 15.7% of CD patients. As for the location of disease, the most commonly affected part of GIT is the ileum, in 49.1% of CD patients. The second most commonly affected part of GIT is the ileum and colon. The age category most affected is between 15-30 years old, with 58.6% of patients in this age range. The medication of choice in CD patients is the immunomodulatory drug 5-Aminosalysilic acid, used in 66.7% of cases. Moreover, in some patients with moderate to severe disease, a combination of drugs, such as corticosteroids, azathioprine and infliximab, is used to achieve remission. Also, 17.2% of patients used corticosteroids with other medications. In conclusion, the study characterized CD patient population in Palestinian Bethlehem area hospitals. The study indicates that doctors need to be encouraged to use Crohn’s Disease activity index to obtain a disease score. Medication use seems to be consistent with guidance although excessive use of corticosteroids is evident.