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Crohn’s disease is an increasingly common gastrointestinal (GI) disease. This inflammatory disease is chronic and immune-mediated, which requires a comprehensive approach. Treatment in Germany is aimed at symptom control, prevention of complications.
Symptomatology
Crohn’s disease or granulomatous enteritis can affect any part of the GI tract. Inflammation takes over all walls of the intestine, and ulcers and scars are formed. Chronic inflammation affects both adults and children.
Four groups of symptoms are distinguished:
- general
- intestinal
- fistula
- extraintestinal manifestations
Enteritis is a very insidious pathology. It requires complex diagnostic manipulations to make a diagnosis, as well as careful collection of anamnesis and complaints. In German clinics, a personalized approach is carried out with the involvement of specialists from different fields.
The symptoms of chronic inflammation vary greatly, but in most cases they are:
- diarrhea for more than 6 weeks
- abdominal pain
- weight loss
General symptoms include increased fatigue, decreased or complete lack of appetite, and fever up to 37-37.5C. All this is a consequence of diarrhea and abdominal pain.
The clinical picture will differ depending on the localization of pathology, the severity of the process, how long the chronic inflammation lasts. Abdominal pain requires the exclusion of acute appendicitis. Weight loss, nausea and vomiting, accompanying enteritis, require the exclusion of oncologic processes. Fistulous form is characterized by anal fissures and fistulas of the rectum. In this case, pathological processes are long-healing and often only after numerous operations help to suspect chronic inflammation. Weight loss occurs due to the development of anorexia, and at later stages of the process due to the syndrome of absorption disorders in the GI tract.
Enteritis may present with symptoms unrelated to intestinal damage. The intestines may be affected:
- eyes
- joints
- oral cavity
- skin
- liver
- kidneys
Conjunctivitis and arthritis develop most often.
The consequences are serious enough to require surgical treatment.
- organ wall perforation
- scar formation
- ulcers
- fistulas
Diagnosis of pathology
The intestine is a rather tortuous organ, so diagnosis is difficult. The gastroenterology departments of German medical institutions are equipped with all the necessary equipment to perform diagnostics safely and comfortably for the patient. If chronic inflammation is suspected, after a thorough interview and examination of the patient, blood, urine and fecal analysis is performed. Depending on the severity, there will be changes in all tests. The blood test will show inflammatory changes, the stool test may show signs of bleeding.
After that, endoscopic and radiologic examinations of the GI tract are performed. In the arsenal of German institutions such methods are available as:
- fibrogastroduodenoscopy — examination of the stomach and duodenum using a gastroscope
- irrigoscopy — examination of the colon using radiologic methods
- rectomanoscopy — examination of the rectum
- colonoscopy — evaluation of the colon.
In addition, virtual colonoscopy is a common procedure in German clinics. It is the least invasive procedure, during which air is pumped into the intestine, after which a series of images are taken and a 2D and 3D picture of the intestine is formed.
All these techniques require preliminary preparation. During the endoscopic methods, a biopsy of the damaged tissue is performed for further histological analysis.
In addition to endoscopic methods, clinics use ultrasound of the abdominal cavity. Having at their disposal the highest-class equipment, the specialist can detect intestinal pathology with a high probability.
Video capsule endoscopy is becoming increasingly popular. The patient swallows a miniature camera that follows the gastrointestinal tract and takes many pictures, which are immediately sent to the doctor’s computer. After analyzing them, the doctor makes a conclusion.
Computerized or magnetic resonance imaging (CT or MRI) is also performed to diagnose the pathology. It allows to examine other organs and surrounding tissues in addition to the intestinal cavity.
Treatment
Unfortunately, enteritis is incurable. However, doctors in Germany have every opportunity to achieve long-term remission. There are several directions in the therapy of this pathology:
- inflammation reduction
- relieve pain
- repair of affected areas
- prevention of complications
Therapy of the pathology is quite aggressive and includes the use of drugs from several groups: immunosuppressors, hormonal agents, NSAIDs, analgesics. Specialists of German clinics select an individual therapy scheme based on the severity of the condition, stage of the process, localization of the process, as well as personal preferences of the patient.
The clinic consults with nutritionists, who will help to choose the right diet to maintain adequate digestion. Many clinics in Germany are already using innovative therapies. These include stem cell therapy and extracorporeal methods of blood purification of immune components.
If necessary, surgical treatment is performed: resection of the affected area, plasty of the narrowed bowel due to scarring, removal of the intestine (colostomy).
A special feature of surgeries in Germany is their minimal invasiveness. In addition, laser technology, radiofrequency ablation and surgery with the da Vinci robot are used in some cases.
Choosing a clinic and the cost of therapy
The cost of treatment depends on many factors. These include:
- оtreating physician’s experience
- treatment regimens
- diagnostic measures
- complications
- associated pathology.
Approximate treatment prices are listed below:
Diagnosis by endoscopic method — from 1092 Euros
Diagnosis and conservative treatment — from 1800 Euros
Partial resection of the affected part of the intestine — from 7600 Euros
General rehabilitation — from 300 Euro
German medicine means modern technologies, experienced specialists and individual approach. For more than 10 years, a team of the best experts under the leadership of Maxim Rykov has been working for the right choice of clinic. Knowledge of English and German languages allows to solve any medical cases, ask for a second opinion.
Crohn’s disease is characterized by a relapsing course, which requires constant dynamic monitoring.