So an abscess is basically a collection of puss or bacteria, and in patients who have the fistulizing type of Crohn's disease with inflammation, essentially causes a burrowing type of a hole through their intestines. The bacteria from the digestive tract forms a collection and that can be very dangerous and may require antibiotics and even potentially surgery to drain that area.
Crohn's disease is an inflammatory bowel disease. Essentially it's an autoimmune disorder. We don't know exactly all the details of why people get Crohn's disease, but we've come a long way over the last decade or two. Essentially Crohn's disease can affect anywhere from the mouth all the way down to the anus. So people can have Crohn's disease of the small intestine. That's about, I would say about 80% of people have Crohn's disease that is limited to their small intestine. There's about 50% of people who have Crohn's disease that is just in their colon. Okay. And there are minority of Crohn's disease patients that it only affects the upper digestive tract so the stomach or the upper intestines. There are a number of symptoms that people can have with Crohn's disease. It can start out as something as simple as just fatigue or a little bit of anemia. Weight loss can be the only symptom. And then there are more substantial symptoms such as abdominal pain. One can have nausea, vomiting, there's a blockage. Diarrhea is a very common symptom in patients with Crohn's disease. And occasionally they also get bleeding. Rectal bleeding. So those are some of the main symptoms that patients with Crohn's disease can experience.
So Crohn's disease, as I mentioned can affect different parts of the digestive tract. We have what we call Crohn's Colitis, which is Crohn's, specifically of the colon. There's Crohn's ileocolitis, which means Crohn's disease that affects the last portion of the small intestine as well as the colon. And then there's just small bowel Crohn's disease. That's the most common type of Crohn's disease that affects anywhere in the small bowel. Minority of patients may have Crohn's disease that is isolated to the upper digestive tract, so the esophagus or the stomach or the upper digestive intestines. In terms of the presentation, there are different phenotypes, different kinds. There's inflammatory Crohn's disease where there's inflammation in those different parts that I just described. There's what we call fibrostenosing Crohn's disease. Those are people who the inflammation causes narrowing of the intestines and they often are predisposed to blockages what we call bowel obstructions. The other form of Crohn's disease, is what we call fistulizing Crohn's disease, fistulizing Crohn's disease, one of the most severe forms of Crohn's disease. And that's where the inflammation actually causes basically a burrowing of the inflammation from one intestine through to another part of the intestine. And you get connections between, say, the colon and the small intestine, and you can get connection between the intestine, other organs such as the bladder. And that can cause a lot of morbidity.
So there's approximately 1.4 million people with inflammatory bowel disease as a whole in the United States. So about 50/50 Crohn's disease and ulcerative colitis, which is another form of inflammatory bowel disease, anywhere between two to about 20% per hundred thousand life years. So very technical terms. Essentially, it's a fairly common disorder in the United States. In certain populations we see it more. In Caucasians in European western European, Jewish background we also see more prevalence of Crohn's disease.
Crohn's disease can be a very serious condition if not dealt with and treated appropriately. However, there are so many great medications nowadays that most patients with Crohn's disease are able to lead relatively normal lives. Decades ago, patients with Crohn's disease, would end up in the hospital when they had a flare of their disease. Now patients can see their physicians and usually get outpatient care to control their symptoms. And we have great safe medications now that can control Crohn's disease for many, many, many years. So patients with Crohn's disease have a very good prognosis. They can lead normal lives and their life expectancy is not necessarily shorter than anybody else. There are people who run their own companies, very successful people who have Crohn's disease, and you wouldn't know it.
So patients ask, "how long do I need to be on these medications?" That's a very good question. It really depends. It depends what kind of medications patients are on. Certain medications we're able to wean off. Whereas other medications, we like to keep long term. In general, what patients need to understand is Crohn's disease is a chronic autoimmune condition. Meaning, if you stop your medications it is very likely that the inflammation will recur and you may not be symptomatic right off the bat. And so a lot of patients say, but I'm doing really well. Unfortunately, over time the inflammation builds up, and then patients get into trouble once it's too late. And so I always encourage patients that when they found the medication that works for them as long as their doctor deems it to be safe long term, that they should stay on the medication, assuming they don't have any side effects or there'd been no complications. Because once you get Crohn's disease under control, it's very, very important to keep the treatment on board. Oftentimes patients get tired of being on a medication. The problem is that when you stop sometimes these medications, they may not necessarily work again down the road if you try to use them again. And so it's very important to work closely with your physician to make sure that a treatment, regimen is developed that suits your quality of life, your personality, your needs, your disease severity and that you can be on long term.
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