This view has been bolstered recently by novel immunological and clinical studies that have confirmed gross aberrations in this early response, consistent with subsequent genetic studies that highlighted molecules important for innate immune function. The suggestion therefore is that Crohns pathogenesis actually results from partial immunodeficiency, a theory that coincides with the frequent recognition of a virtually identical, non-infectious inflammatory bowel disease arising in patients with congenital monogenic disorders impairing phagocyte function. Causes
While the exact cause or causes are unknown, Crohns disease seems to be due to a combination of environmental factors and genetic predisposition. Crohns is the first genetically complex disease in which the relationship between genetic risk factors and the immune system is understood in considerable detail. Each individual risk mutation makes a small contribution to the overall risk of Crohns (approximately 1:200). The genetic data, and direct assessment of immunity, indicates a malfunction in the innate immune system. In this view, the chronic inflammation of Crohns is caused when the adaptive immune system tries to compensate for a deficient innate immune system. Genetics
Crohns has a genetic component. Because of this, siblings of known people with Crohns are 30 times more likely to develop Crohns than the general population.The first mutation found to be associated with Crohns was a frameshift in the NOD2 gene (also known as the CARD15 gene), followed by the discovery of point mutations. Over 30 genes have been associated with Crohns; a biological function is known for most of them.
It is usually thought to be due to an inability of the ileum to reabsorb bile acids after resection of the terminal ileum and was the first type of bile acid malabsorption recognized. Mental health
Crohns may result in anxiety or mood disorders, especially in young people who may have stunted growth or embarrassment from fecal incontinence. Counselling as well as antidepressant or anxiolytic medication may help some people manage.As of 2017 there is a small amount of research looking at mindfulness-based therapies, hypnotherapy, and cognitive behavioural therapy. Alternative medicine
It is common for people with Crohns disease to try complementary or alternative therapy. These include diets, probiotics, fish oil, and other herbal and nutritional supplements. Acupuncture is used to treat inflammatory bowel disease in China, and is being used more frequently in Western society. At this time, evidence is insufficient to recommend the use of acupuncture. A 2006 survey in Germany found that about half of people with IBD used some form of alternative medicine, with the most common being homeopathy, and a study in France found that about 30% used alternative medicine. Homeopathic preparations are not proven with this or any other condition, with large-scale studies finding them to be no more effective than a placebo. There are contradicting studies regarding the effect of medical cannabis on inflammatory bowel disease, and its effects on management are uncertain. Prognosis
Crohns disease is a chronic condition for which there is no known cure. It is characterised by periods of improvement followed by episodes when symptoms flare up.