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Crohn's Disease

What is Crohn's disease?

Crohn's disease is a chronic (long-lasting) disease that causes inflammation in your digestive tract. It can affect any part of your digestive tract, which runs from your mouth to your anus. But it usually affects your small intestine and the beginning of your large intestine.

Crohn's disease is an inflammatory bowel disease (IBD). Ulcerative colitis and microscopic colitis are other common types of IBD.

What causes Crohn's disease?

The cause of Crohn's disease is unknown. Researchers think that an autoimmune reaction may be one cause. An autoimmune reaction happens when your immune system attacks healthy cells in your body. Genetics may also play a role, since Crohn's disease can run in families.

Stress and eating certain foods don't cause the disease, but they can make your symptoms worse.

Who is more likely to develop Crohn's disease?

There are certain factors that may raise your risk of Crohn's disease:

  • Family history of the disease. Having a parent, child, or sibling with the disease puts you at higher risk.
  • Smoking. This may double your risk of developing Crohn's disease.
  • Certain medicines, such as antibiotics, birth-control pills, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. These may slightly increase your chance of developing Crohn's.
  • A high-fat diet. This may also slightly increase your risk of Crohn's.
What are the symptoms of Crohn's disease?

The symptoms of Crohn's disease can vary, depending where and how severe your inflammation is. The most common symptoms include:

  • Diarrhea
  • Cramping and pain in your abdomen
  • Weight loss

Some other possible symptoms are:

  • Anemia, a condition in which you have fewer red blood cells than normal
  • Eye redness or pain
  • Fatigue
  • Fever
  • Joint pain or soreness
  • Nausea or loss of appetite
  • Skin changes that involve red, tender bumps under the skin

Stress and eating certain foods such as carbonated (fizzy) drinks and high-fiber foods may make some people's symptoms worse.

What other problems can Crohn's disease cause?

Crohn's disease can cause other problems, including:

  • Intestinal obstruction, a blockage in the intestine
  • Fistulas, abnormal connections between two parts inside of the body
  • Abscesses, pus-filled pockets of infection
  • Anal fissures, small tears in your anus that may cause itching, pain, or bleeding
  • Ulcers, open sores in your mouth, intestines, anus, or perineum
  • Malnutrition, when your body does not get the right amount of vitamins, minerals, and nutrients it needs
  • Inflammation in other areas of your body, such as your joints, eyes, and skin
How is Crohn's disease diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • A family history
  • A physical exam, including:
    • Checking for bloating in your abdomen.
    • Listening to sounds within your abdomen using a stethoscope.
    • Tapping on your abdomen to check for tenderness and pain and to see if your liver or spleen is abnormal or enlarged.
  • Various tests, including:
    • Blood and stool tests.
    • A colonoscopy.
    • An upper GI endoscopy, a procedure in which your provider uses a scope to look inside your mouth, esophagus, stomach, and small intestine.
    • Diagnostic imaging tests, such as a CT scan or an upper GI series. An upper GI series uses a special liquid called barium and x-rays. Drinking the barium will make your upper GI tract more visible on an x-ray.
What are the treatments for Crohn's disease?

There is no cure for Crohn's disease, but treatments can decrease inflammation in your intestines, relieve symptoms, and prevent complications. Treatments include medicines, bowel rest, and surgery. No single treatment works for everyone. You and your provider can work together to figure out which treatment is best for you:

  • Medicines for Crohn's include various medicines that decrease the inflammation. Many of these medicines do this by reducing the activity of your immune system. Certain medicines can also help with symptoms or complications, such as nonsteroidal anti-inflammatory drugs and anti-diarrheal medicines. If your Crohn's causes an infection, you may need antibiotics.
  • Bowel rest involves drinking only certain liquids or not eating or drinking anything. This allows your intestines to rest. You may need to do this if your Crohn's disease symptoms are severe. You get your nutrients through drinking a liquid, a feeding tube, or an intravenous (IV) tube. You may need to do bowel rest in the hospital, or you may be able to do it at home. It will last for a few days or up to several weeks.
  • Surgery can treat complications and reduce symptoms when other treatments are not helping enough. The surgery will involve removing a damaged part of your digestive tract to treat:
    • Fistulas
    • Bleeding that is life threatening
    • Intestinal obstructions
    • Side effects from medicines when they threaten your health
    • Symptoms when medicines do not improve your condition

Changing your diet can help reduce symptoms. Your provider may recommend that you make changes to your diet, such as:

  • Avoiding carbonated drinks
  • Avoiding popcorn, vegetable skins, nuts, and other high-fiber foods
  • Drinking more liquids
  • Eating smaller meals more often
  • Keeping a food diary to help identify foods that cause problems

In some cases, your provider may ask you to go on a special diet, such as a diet that is:

  • High calorie
  • Lactose free
  • Low fat
  • Low fiber
  • Low salt

If you are not absorbing enough nutrients, you may need to take nutritional supplements and vitamins.

National Institute of Diabetes and Digestive and Kidney Diseases

Cryptosporidiosis

What is cryptosporidiosis?

Cryptosporidiosis is a contagious disease that causes watery diarrhea. It is caused by parasites called Cryptosporidium, or Crypto . These parasites live in soil, food, and water. They are found in every region of the United States and throughout the world. Crypto can also be found on surfaces or dirty hands that have been contaminated with the stool (poop) of humans or animals that have the infection.

How is cryptosporidiosis spread?

You can become infected with Crypto by swallowing the parasite if it is in your food, drinking water, or water that you swim in. You can also get infected when you touch something that has been contaminated, and then you touch your eyes, mouth, or nose. Another way that Crypto can spread is through sexual contact.

Who is more likely to get cryptosporidiosis?

Certain people are more likely to get Crypto; they include:

  • Children and workers at childcare centers
  • Older adults (ages 75 years and older)
  • People who take care of other people with Crypto
  • International travelers
  • Backpackers, hikers, and campers who drink unfiltered, untreated water
  • People, including swimmers, who swallow water from contaminated sources
  • People who touch infected animals, often cows or sheep
What are the symptoms of cryptosporidiosis?

The most common symptom of cryptosporidiosis is watery diarrhea. Other symptoms include:

  • Dehydration
  • Weight loss
  • Stomach cramps or pain
  • Fever
  • Nausea and vomiting

The symptoms generally begin 2 to 10 days after becoming infected with the parasite. In people with healthy immune systems, the symptoms can last about 1 to 2 weeks. Occasionally, the symptoms can last longer or come and go for up to 30 days.

People with weakened immune systems may develop a serious, chronic illness. Some reasons why you might have a weakened immune system could include:

  • Having HIV
  • Having cancer
  • Having a genetic condition that affects the immune system
  • Taking certain medicines, such as chemotherapy and medicines needed after an organ transplant

Some people may not have any symptoms at all.

Contact your health care provider if you have watery diarrhea that lasts more than a few days, especially if you have a weakened immune system.

How is cryptosporidiosis diagnosed?

Cryptosporidiosis is diagnosed by examining stool samples, usually under a microscope. People with Crypto can have many parasites in their stool one day but not as many the next day. So you may need to give the lab three stool samples collected on three different days. This helps make sure that your diagnosis is correct.

What are the treatments for cryptosporidiosis?

Most people with cryptosporidiosis get better without treatment. It usually takes about one to two weeks. It's important to drink plenty of fluids to prevent dehydration if you are pregnant. Infants and young children should also get extra fluids. They should get extra fluids. If you are pregnant or if you think that you or your child are severely dehydrated, contact your provider about how to get enough fluids. Some people who are dehydrated may need to get intravenous (IV) fluids in a hospital.

Over-the-counter anti-diarrheal medicine might help slow down diarrhea, but do not take it without first asking your provider. There is a medicine to treat diarrhea caused by Crypto in people with healthy immune systems. You and your provider can talk about whether that medicine is right for you.

Can cryptosporidiosis be prevented?

To lower your chance of getting or spreading Crypto:

  • Wash your hands often with soap and water, especially after using the toilet, changing diapers, or touching animals. You also need to wash your hands before eating or preparing food. Alcohol-based hand sanitizers are not effective against Crypto.
  • Only drink water that you know is safe.
  • Only drink milk and apple cider that have been pasteurized.
  • Don't eat uncooked foods when traveling in countries where the food supply might be unsafe.
  • Never go swimming when you have diarrhea.
  • Don't swallow water when you go swimming.
  • Use condoms or dental dams every time you have sex. This will also help prevent other sexually transmitted infections.

Centers for Disease Control and Prevention

Depression

What is depression?

Depression is more than a feeling of being sad or irritable for a few days. It's a serious mood disorder. As one of the most common mental disorders in the United States, depression can affect how you think, feel, and your everyday life. You may not know why you feel this way, but even basic daily activities such as sleeping, eating, or working may become difficult. Depression often needs long-term treatment but getting help at the earliest sign of a problem can help manage your symptoms.

What are the different types of depression?

The most common types of depression are major depression and persistent depressive disorder.

  • Major depression symptoms include a depressed mood or a loss of interest. Symptoms affect your daily activities and last for at least two weeks.
  • Persistent depressive disorder (also called dysthymia or dysthymic disorder) has less severe depressive symptoms, but they last longer, usually for at least two years.

Other types of depression can include:

  • Seasonal affective disorder comes and goes with the seasons. It usually starts in late fall and early winter and goes away during the spring and summer.
  • Bipolar disorder is sometimes called manic depression. This mood disorder can cause intense mood swings.
  • Depression with symptoms of psychosis is a severe form of depression that also has delusions (false beliefs) or hallucinations (seeing, hearing, or feeling something that isn't there).
What causes depression?

There are a variety of things that may cause depression, including genetic, biological, environmental, and psychological factors. Depression can happen at any age and can affect anyone, but it's more common in women. This is often due to the physical and hormonal changes that women have during menstruation, pregnancy, the postpartum period, and menopause. Other mental disorders or chronic medical conditions such as diabetes, cancer, or heart disease may occur with depression. This may make the chronic condition or depression worse.

In some cases, there is no clear cause for depression.

Who is at risk of depression?

You may be at a higher risk of depression if you have a close relative who has it or another mental health disorder. Going through trauma or stressful life events may raise your risk even more.

What are the symptoms of depression?

Depression doesn't look the same on everyone. The type and number of symptoms of depression can vary and don't always appear like sadness. Depression may affect you differently based on your:

  • Age. The symptoms of depression may be different in a child, who may appear more irritable than sad. Teens may act out or have excessive sleepiness. The symptoms for an older adult may not be as obvious as other age groups.
  • Sex. Men often show symptoms and coping behaviors differently than women. Rather than sad, men may appear angry or irritable.
  • Medical conditions. Some medicines and medical conditions may cause symptoms that look like depression. Chronic conditions may make depression worse.

Symptoms of depression are ongoing and affect your day-to-day life. They can include:

  • Feeling sad or "empty"
  • Losing interest in favorite activities
  • Overeating, or not wanting to eat at all
  • Sleeping too much, or not enough
  • Feeling very tired
  • Feeling hopeless, irritable, anxious, or guilty
  • Having aches and pains, headaches, cramps, or digestive problems
  • Having thoughts of death or suicide
  • Changing moods or behaviors
  • Increasing use of alcohol or drugs
  • Isolating from family and friends
How is depression diagnosed?

If you think you have depression, talk to your health care provider or a mental health provider. To be diagnosed with depression, your provider may use many tools:

  • A medical history will include asking about your symptoms and family history. To be diagnosed with depression, your symptoms must occur most of the day, nearly every day, for at least two weeks. One of the symptoms must be a depressed mood or a loss of interest in most activities.
  • Medical tests may be done to rule out other medical conditions. Certain medicines and medical conditions (such as viruses or thyroid disorders) may cause symptoms like depression.
  • A physical exam to make sure another issue isn't causing your symptoms.
  • A mental health evaluation by your provider or a mental health provider.
What are the treatments for depression?

Depression may need long-term treatment. Most treatments include medicines and/or psychotherapy (talk therapy):

  • Medicines such as antidepressants may help control your symptoms. You may need to try several medicines to find which works best for you. Medicine may take time to work and can have side effects. Don't stop taking your medicine without first talking with your provider. Contact your provider if you have any concerns about side effects from the medicine.
  • Psychotherapy (talk therapy) under the care of a mental health provider can help you recognize and change troubling emotions, thoughts, and behaviors. This may be done one-on-one or in a group setting. It can give you and your family support, education, skills, and coping strategies.
  • Light therapy has been shown to be effective for seasonal affective disorder (SAD).
  • Other treatments options may be considered if treatment isn't working or if depression is severe. These may include:
    • Electroconvulsive therapy (ECT) is a brain stimulation procedure that uses a mild electric current when you are under general anesthesia. ECT is most often used for severe depression that is not getting better with other treatments.
    • Repetitive transcranial magnetic stimulation (rTMS) is a brain stimulation procedure that uses magnetic waves to relieve depression. It's not as powerful as ECT, but with rTMS, you don't need anesthesia. It also has a low risk of negative effects on your memory and thinking.
Can depression be prevented?

Most cases of depression can't be prevented, but healthy lifestyle changes can have long-term benefits for your mental health. These can include:

  • Getting regular exercise
  • Having a consistent sleep schedule
  • Controlling stress

If you, or someone you love is depressed, see your provider or a mental health provider. It's important to get treatment at the earliest sign of a problem.

If you or someone you know has thoughts of hurting themselves or attempting suicide, get help right away. If it is an emergency, dial 911.

NIH: National Institute of Mental Health

Diabetes Type 2

What is type 2 diabetes?

Type 2 diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your main source of energy. It comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy. If you have diabetes, your body doesn't make enough insulin or doesn't use insulin well. The glucose then stays in your blood and not enough goes into your cells.

Over time, having too much glucose in your blood can cause health problems. But you can take steps to manage your diabetes and try to prevent these health problems.

What causes type 2 diabetes?

Type 2 diabetes may be caused by a combination of factors:

  • Being overweight or having obesity
  • Not being physically active
  • Genetics and family history

Type 2 diabetes usually starts with insulin resistance. This is a condition in which your cells don't respond normally to insulin. As a result, your body needs more insulin to help the glucose enter your cells. At first, your body makes more insulin to try to get cells to respond. But over time, your body can't make enough insulin, and your blood glucose levels rise.

Who is at risk for type 2 diabetes?

You are at higher risk of developing type 2 diabetes if you:

  • Are over age 45. Children, teenagers, and younger adults can get type 2 diabetes, but it is more common in middle-aged and older people.
  • Have prediabetes, which means that your blood glucose is high for you but not high enough to be called diabetes
  • Had diabetes in pregnancy or gave birth to a baby weighing 9 pounds or more.
  • Have a family history of diabetes
  • Are overweight or have obesity
  • Are Black or African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
  • Are not physically active
  • Have other conditions such as high blood pressure, heart disease, stroke, polycystic ovary syndrome (PCOS), or depression
  • Have low HDL (good) cholesterol and high triglycerides
  • Have acanthosis nigricans - dark, thick, and velvety skin around your neck or armpits
What are the symptoms of type 2 diabetes?

Many people with type 2 diabetes have no symptoms at all. If you do have them, the symptoms develop slowly over several years. They might be so mild that you do not notice them. The symptoms can include:

  • Increased thirst and urination
  • Increased hunger
  • Feeling tired
  • Blurred vision
  • Numbness or tingling in the feet or hands
  • Sores that do not heal
  • Unexplained weight loss
How is type 2 diabetes diagnosed?

Your provider will use blood tests to diagnose type 2 diabetes. The blood tests include:

  • A1C test, which measures your average blood glucose level over the past 3 months.
  • Fasting plasma glucose (FPG) test, which measures your current blood glucose level. You need to fast (not eat or drink anything except water) for at least 8 hours before the test.
  • Random plasma glucose (RPG) test, which measures your current blood glucose level. This test is used when you have diabetes symptoms and the provider does not want to wait for you to fast before having the test.
What are the treatments for type 2 diabetes?

Treatment for type 2 diabetes involves managing your blood glucose levels. Many people are able to do this by living a healthy lifestyle. Some people may also need to take medicine:

  • A healthy lifestyle includes following a healthy eating plan and getting regular physical activity. You need to learn how to balance what you eat and drink with physical activity and diabetes medicine, if you take any.
  • Medicines for diabetes include oral medicines, insulin, and other injectable medicines. Over time, some people will need to take more than one type of medicine to control their diabetes.
  • You will need to check your blood glucose regularly. Your provider will tell you how often you need to do it.
  • It's also important to keep your blood pressure and cholesterol levels close to the targets your provider sets for you. Make sure to get your screening tests regularly.
Can type 2 diabetes be prevented?

You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. If you have a condition which raises your risk for type 2 diabetes, managing that condition may lower your risk of getting type 2 diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Dietary Fiber

Fiber is a substance in plants. Dietary fiber is the kind you eat. It's a type of carbohydrate. You may also see it listed on a food label as soluble fiber or insoluble fiber. Both types have important health benefits.

Good sources of dietary fiber include:

  • Whole grains
  • Nuts and seeds
  • Fruit and vegetables

Dietary fiber adds bulk to your diet and makes you feel full faster, helping you control your weight. It helps digestion and helps prevent constipation. Most Americans don't eat enough dietary fiber. But add it to your diet slowly. Increasing dietary fiber too quickly can lead to gas, bloating, and cramps.

Centers for Disease Control and Prevention

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