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Crohn's Disease (CD)

In this section, you or a loved one can find out more about medical treatments and practical information about Crohn's disease. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step toward becoming an active decision-maker in your care plan.

WHAT IS CROHN'S DISEASE?

Crohn's disease is an inflammatory Bowel disease that causes inflammation and Ulcers in your digestive tract. Crohn's disease (CD) is a long-term (Chronic) disease that causes all or part of the Bowel (gastrointestinal [GI] tract), where food is digested in the body, to become severely inflamed (red and swollen). Crohn's disease causes sores (Ulcers) in the Bowel. It is one of the two most common conditions associated with inflammatory Bowel disease, the other being ulcerative colitis (UC).

These two conditions should not be confused with irritable Bowel syndrome (IBS—also called spastic colon or nervous colitis), which is a disorder that affects the muscle contractions of the colon. Irritable Bowel syndrome does not involve intestinal inflammation and is a much less serious disease than CD or UC. But the symptoms are very similar, which often leads to misdiagnosis.

WHAT CAUSES CROHN'S DISEASE?

Scientists do not yet know what causes Crohn's disease(CD). They suspect that CD inflammation may be caused by a combination of an overactive Immune system, environmental factors, the microbiome (bacteria in the colon), and a person's own Genetics. It is not clear what is the direct cause of the inflammation or what causes some people's Immune systems to "go into overdrive" trying to protect the body. One way the Immune system tries to protect the body is through inflammation, and the Immune systems of people with CD seem to produce over-reactive, poorly controlled inflammation in the GI tract. Scientists believe that once the CD patient's Immune system is "turned on," it does not know how to properly "turn off." As a result, inflammation damages the Bowel and causes CD symptoms. This failure of the Immune system to "turn off" is why the main goal of medical therapy for CD is to help patients regulate their Immune system.

While the causes of CD are not known, there's agreement about what doesn't cause CD. Scientists no longer believe that diet and stress can cause CD. However, stress, certain foods or inadequate nutrition may aggravate symptoms, so easing stress and maintaining a proper diet and good nutrition can really help reduce the frequency and severity of CD symptoms.

Genes

Scientists suspect that Genes may play a role. It is not yet completely understood how or why certain Genes or changes in Genes are associated with CD, but it is a major focus of current research. People who have a parent, sibling or child with CD have a much higher risk of developing it themselves.

Immune system

Normally, the immune Cells protect the body from Infection. In people with CD, however, the Immune system mistakes food, non-harmful bacteria and other things that are supposed to be in the Bowel for substances that pose a threat. In response, it attacks the Bowel lining and produces Chronic inflammation. This inflammatory reaction continues without proper control, which then damages the Bowel wall. When the Bowel wall is damaged, CD symptoms occur, such as diarrhea and abdominal pain.

Risk factors

Risk factors are personal characteristics that are known to be associated with a greater likelihood of having a disease or condition. But these risk factors, such as age or where you live, do not necessarily cause CD. Also, absence of a risk factor may not mean protection from CD.

Risk factors may include:

  • Age: There is good evidence that the younger you develop the disease, the more aggressive it will be.

  • It's also thought that if you develop the disease early in life, Genetics are likely playing an important causative role. If disease onset is later in life, it is thought to be more due to environmental factors.

  • Isotretinoin Acne medication use: Isotretinoin is an oral medication (Accutane) sometimes used to treat scarring Acne that doesn't respond to other treatments. There is conflicting information as to whether isotretinoin use alone or in combination with 

    Antibiotics can increase the risk of CD. Some studies have suggested a possible link, while other studies have found no such evidence.

  • Cigarette smoking: Smoking has been associated with an increased risk of developing CD and also worsening of CD (Flares). Smoking also aggravates pain and other symptoms and increases the risk of complications. If you already have CD and still smoke, quitting may improve symptoms. Talk to your doctor about the many available smoking cessation options and support programs.

  • Some pain relievers: Ibuprofen, naproxen and aspirin have been shown to cause sores in the lining of the GI tract (gastrointestinal ulceration) and may make CD worse. Acetaminophen poses a much lower risk. Discuss the use of any pain medication with your doctor.

ARE THERE OTHER COMPLICATIONS?

The severity of Crohn's disease (CD) symptoms can differ widely from person to person and depends on many factors including how much of the colon is affected. The digestive system is the part of the body that is affected most directly, but complications can potentially affect other parts of the body as well.

Digestive system complications

  • Bowel Blockage: The most common complication of CD is blockage of the Bowel. This happens when there is a narrowing (stricture) due to scar Tissue that has formed in the wall of an inflamed part of the GI tract. Sometimes the narrowing can cause difficulty in food passing through (a blockage).

  • Ulcers: Chronic inflammation can lead to open sores (Ulcers) anywhere in your GI tract, including your mouth, ileum (the part of the GI tract leading to the anus); in the genital area (perineum) and around the anus. These Ulcers can be very uncomfortable and in the case of Crohn's, may sometimes bleed.

  • Fistulas: A fistula is an abnormal connection between different parts of your Bowel, between your Bowel and skin, or between your Bowel and another organ, such as the bladder or vagina. When internal fistulas develop, food may bypass areas of the Bowel that are necessary for absorption. With CD, an external fistula can cause continuous drainage of Bowel contents to your skin. In some cases a fistula may become infected and form an Abscess – this can be life-threatening if left untreated. Fistulas around the anal area (perianal) are the most common.

  • Anal fissure: Anal fissures are cracks, or clefts, in the anus or in the skin around the anus where Infections can occur. They are often associated with painful Bowel movements and can lead to a perianal fistula.

  • Malnutrition: Diarrhea, abdominal pain, and cramping may make it difficult for you to eat or for your Bowel to absorb enough nutrients to keep you properly nourished. Anemia is common in people with CD.

Other health problems

In addition to inflammation and Ulcers in the Bowel, CD can cause problems in other parts of the body, such as Arthritis, inflammation of the eyes or skin, clubbing of the fingernails, kidney stones, gallstones and, occasionally, inflammation of the Bile ducts. People with long-standing CD may also develop Osteoporosis, a condition that causes bones to become weak and brittle.

WHAT ARE THE SYMPTOMS OF CROHN'S DISEASE?

People with CD suffer a wide range of symptoms, most of them mild to moderate, depending on which part of the colon is affected. The disease is usually relapsing and remitting, which means that there can be periods of disease flare (active disease) and Remission (temporary end to the medical signs and symptoms).

Common symptoms include:

Crohn's disease affects all the layers of the Bowel wall – causing inflammation and Swelling, as well as Ulcers . In turn, this irritation may lead to bleeding. It also prevents the Bowel from absorbing nutrients from food.

If you have CD, you may experience any or all of the following symptoms:

  • Diarrhea (sometimes bloody)

  • Stomach cramps or pain

    • Where the pain is felt depends on which part of the Bowel is affected. The last part of the small Bowel (ileum) is the part most likely to have inflammation and scarring. Consequently, a common area of pain is the lower right side of the abdomen – first time pain here is sometimes mistaken for appendicitis.

A sudden change or worsening of pain may indicate a complication (see below), so you should speak to your healthcare provider immediately if one is suspected.

  1. Unexplained weight loss

  2. Fever

  3. Dehydration

  4. Failure to grow (in children)

  5. Fatigue

  6. Loss of appetite

The symptoms can be exhausting and may also reduce your appetite. Diarrhea, cramping, and pain can even become worse when you eat because of the increased intestinal activity afterwards. But Crohn's disease is not the same in everyone. The severity of symptoms varies depending on the level of Immune system activity and which areas of the Bowel are affected. And symptoms may change over time.

Call a doctor right away if you have been diagnosed with CD and you have one or more of the following symptoms, because your condition may have worsened:

  1. Fever over 101°F (38.3°C) or shaking chills

  2. Lightheadedness, passing out or rapid heart rate

  3. Stools that are almost always bloody

  4. Severe dehydration, such as passing little or no urine for 12 or more hours

  5. Severe belly pain or severe pain and bloating

  6. Evidence of Pus draining from the area around the anus, or pain and Swelling in the anal area

  7. Repeated vomiting

  8. Not passing any stools or gas

LIFESTYLE OPTIONS

For most people, regardless of having Crohn's disease (CD) or not, Exercise, healthy eating and good sleep habits are recommended. A healthy lifestyle can lead to enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.

Nutrition and fluid intake

While diet is not thought to cause CD, people experiencing symptoms of the disease often find some foods aggravating. It may be helpful to keep (and regularly review) a food diary to better understand how your body is reacting to various foods. Many people find soft, bland foods make them feel better than spicy ones. Several small meals may work better than two or three large ones. If you are lactose intolerant, you may want to avoid dairy products.

In addition, Chronic diseases like CD tend to increase the body's energy needs. Since CD can cause a loss of appetite, staying nourished make take extra effort. In General, it's best to maintain a high-quality, well-balanced diet with ample fluids. Working with a registered dietitian may be beneficial.

Exercise

Even light Exercise, especially when done regularly, can help reduce stress, improve mood and normalize Bowel function.

COMPLEMENTARY THERAPY OPTIONS

Vitamins and probiotics

As long as their own doctors agree, people with Crohn's disease (CD) may benefit from vitamin supplementation as well as introduction of "good" bacteria into the intestine.

Mind-body medicine

People with CD may want to manage stress by using methods that focus on the connection between emotions, the body and individual health. Examples include tai chi, biofeedback, hypnosis, yoga and meditation.

MEDICAL TREATMENTS

The goals of medical treatment for Crohn's disease (CD) are :

  1. Absence of symptoms (achieving Remission)

  2. Preventing Flares of disease (maintaining Remission)

  3. Improving personal quality of life

  4. Healing the gut

Medical Treatment

Medications: The goal of treating CD is to decrease or stop the inflammation. The type of medication that is prescribed depends on the severity of the disease. Common medications that can decrease inflammation are Corticosteroids , immunomodulators and drugs known as Biologics, which target specific pathways believed to be involved in the disease.

Other medications may include:

  • Antibiotics to prevent or control Infection

  • Aminosalicylates

  • Anti-diarrheal medications

  • Pain relievers including acetaminophen

  • Iron supplements to control anemia

Surgical treatments

Surgery is usually used an option after medical treatment fails. While no one wants to have an operation, sometimes it's the only way to control symptoms when medication is no longer effective.

Surgery options for Crohn's disease: Surgical options for CD vary and depend on the amount of inflammation in the Bowel. If surgery is an option, talk to your doctor about what surgery is right for you.

Surgeries often used in CD are:

  • Strictureplasty: dilation of narrowed parts of the Bowel without removing any Tissue

  • Surgery for Abscesses: drainage or removal of the Abscess

  • Surgery for fistulas: removal of the fistula

  • Resection: removing portions of the Bowel

  • Colectomy: removing the colon

  • Proctocolectomy: removing the colon and Rectum

 

Source: Crohn's & Colitis foundation of America - www.ccfa.org

A localized collection of pus surrounded by inflamed tissue.
A disorder of the skin caused by inflammation of the skin glands and hair follicles; specifically, a form found mainly in adolescents and marked by pimples especially on the face.
A research study that compares the investigational drug or treatment to standard-of-care therapy (compared to placebo).
AIDS (acquired immunodeficiency syndrome) is the most advanced stage of infection with human immunodeficiency virus (HIV). HIV/AIDs can be spread through unprotected sex with an infected person or by sharing drug needles or through contact with the blood of an infected person.
A surgical connection made between two structures (usually tubular ones) such as blood vessels or loops of the bowel.
Male hormones used to control the production of estrogen.
A type of arthritis of the spine that causes inflammation between the vertebrae (bones that make up the spine) and in the joints between the spine and pelvis. In some people, ankylosing spondylitis can affect other joints.
Chemical substances that stop the growth of or kill bacteria, parasites and fungus. Antibiotics do not treat viral infections – antiviral drugs may treat some viruses.
Medications that block cholinergic neurotransmitter systems.
Apocrine glands are special sweat glands found in hairy areas of the body such as the armpits and groin.
The practice of using essential oils (generally plant-based) to improve health or a person’s mood.
The use of art that helps people manage physical and emotional problems by expressing themselves creatively.
A condition that causes pain and inflammation within a joint.
A rare childhood disease that affects the brain as well as other parts of the body.
Ophthalmic atropine may be used before eye examinations to dilate (open) the pupil (the black part of the eye). This medication can also be used to relieve pain caused by swelling and inflammation of the eye.
An illness that occurs when the body tissues are attacked by its own immune system. The immune system is designed to “seek and destroy” disease in the body, including infectious agents. Patients with autoimmune diseases frequently have unusual antibodies circulating in their blood that target their own body tissues.
In a a trial protocol, an explanation of what is known so far about the medical product being studied.
Relating to or caused by bacteria. Often used to describe the origin of an infection.
A disease involving inflammation of the blood vessels; it may affect many parts of the body.
An antibacterial ingredient often used in acne medications. It is a flammable white granular solid used as a bleaching agent for flour, fats, waxes and oils, and in pharmaceuticals.
When a point of view prevents objective judgment on issues relating to the patient. In clinical studies, bias is controlled through blinding and randomization.
A yellow or greenish liquid made by the liver that helps the body digest fats.
Therapy involving natural or manufactured substances that change the way cells behave. Biological therapies can cause certain cells to stop growing, block the release of hormones or strengthen the body’s immune system.
The removal of samples of tissue, cells or fluids from the living body. Biopsies can be taken using a biopsy instrument that is passed through the skin or through an endoscope into the organ in question, or is collect by open surgery. A trained specialist (pathologist) examines the tissue under a microscope to establish a precise diagnosis such as cancer.
A clinical trial is called blinded or “masked” when patients don’t know whether they are in the experimental or control arm of the study.
An anticoagulant agent used to prevent blood clots. In heart or blood vessel disease, or poor blood flow to your brain, doctors may recommend a blood thinner. Blood thinners can decrease the risk of heart attack and stroke by reducing the formation of blood clots in arteries and veins.
A localized swelling and inflammation of the skin usually resulting from bacterial infection of a hair follicle and adjacent tissue, having a hard central core, and forming pus.
A bone scan is a procedure that checks for abnormal areas or damage in the bones. Prior to the scan, a very small amount of radioactive material is injected into a vein. This collects in the bones and is detected by a scanner (a special camera that takes pictures of the inside of the body).
Another name for the intestines: the small bowel (duodenum, jejunum and ileum), and the large bowel (colon and rectum).
BRCA 1 is a gene on the human chromosome 17 and BRCA 2 is a gene on chromosome 13. These genes normally help to control cell growth. A person who inherits certain mutations (changes) in one or both of these genes has a higher risk of getting breast, ovarian, prostate, and other types of cancer.
Medication used to block an enzyme responsible for breaking down levodopa before it reaches the brain; carbidopa is always given in combination with levodopa
A cancer that starts in the skin or in tissues that line or cover internal organs.
A strong but flexible, somewhat elastic tissue found in some parts of the body (such as the nose, the outer ear, and some joints).
A clouding of the lens in the eye which may affect vision. Cataracts commonly occur in older people.
A non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, tenderness, swelling and stiffness associated with osteoarthritis (arthritis due to a breakdown of the lining of the joints), rheumatoid arthritis, and ankylosing spondylitis.
The basic building blocks of the body's tissues. The human body is made up of many different types of cells. Human cells vary in size, but all can only be seen with a microscope.
Aclear, colorless body fluid found in the brain and spine that acts as a cushion or buffer for the brain's cortex, providing basic mechanical and immunological protection to the brain inside the skull. It also constitutes the content of the ventricles, cisterns, and sulci of the brain, as well as the central canal of the spinal cord.
The layer of blood vessels and connective tissue that rests between the white of the eye and retina (at the back of the eye). The choroid is part of the uvea and supplies nutrients to the inner parts of the eye.
Persisting over a long period of time. Relating to disease, one that is slow in progressing and long lasting.
A structure in the eye that releases a transparent liquid (aqueous humor) inside the eye.
A medical condition in which hard scar tissue largely replaces soft, healthy tissue in the liver. Severe scarring of the liver can prevent it from functioning well. It is important to know that cirrhosis is the end result of many kinds of injury to the liver, such as alcohol, hepatitis C, autoimmune liver disease and others (alone or in combination). Therefore, any chronic liver disease that is severe and progressive can result in cirrhosis.
Eye disease with symptoms that include blind spots, blurred vision and other vision problems as well as floaters. Most people are exposed to CMV in their lifetime but typically only those with weakened immune systems become ill from CMV infection.
Can spread from one person or organism to another by direct or indirect contact.
Corticosteroids are a group of natural and synthetic analogs of the hormones secreted by the pituitary gland. They are prescribed on a short-term basis as fast-working medication for particularly severe and painful symptoms.
Corticosteroids are a group of natural and synthetic analogs of the hormones secreted by the pituitary gland. They are prescribed on a short-term basis as fast-working medication for particularly severe and painful symptoms.
Also known as Cowden disease, involves a mutation in the tumor suppressor gene phosphatase and tensin homolog (PTEN).
A type of inflammatory bowel disease that causes irritation of the digestive, or gastrointestinal (GI) tract.
Treatments used to diminish some side effects of cancer treatments, particularly bone marrow suppression. CSFs stimulate the bone marrow so that it increases its production of blood cells. With more blood cells the risk of infection, anemia and bleeding is reduced.
Also known as intermediate uveitis, it affects the ciliary body.
A medication used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer that occurs mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin). Cyclophosphamide belongs to a group of cancer medicines called alkylating agents.
A noncancerous, closed pocket of tissue that can be filled with fluid, pus, or other substance. Cysts feel like large peas under the surface of the skin.
Inflammation of an entire digit (a finger or toe), which can sometimes be painful. Dactylitis can occur in psoriatic arthritis and ankylosing spondylitis.
A medical condition that causes a persistent feeling of sadness, loss of interest, and hopelessness.
A dermatologist is a medical doctor specializing in the skin, the diseases of the skin, and the relationship of skin lesions to overall disease.
If a person has diabetes, their body is not able to properly use the sugar that is released from the food they eat. These sugars build up in the body and can make them feel nauseated, very hungry, very thirsty or very sick, with frequent urination.
Diagnostic examination used to x-ray the breast in patients who have signs or symptoms of disease, such as pain, a lump or nipple discharge. Doctors may use diagnostic mammography to look for tumors or other abnormalities.
A neurotransmitter that regulates movement and emotions.
Medications that work in a similar way to dopamine.
Ductography is an x-ray of the breast ducts (tubes that carry milk from the lobules to the nipple).
The point at which a tendon or ligament or muscle inserts into bone, where the collagen fibers are mineralized and integrated into bone tissue. Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone, points where recurring stress or inflammatory autoimmune disease can cause inflammation or occasionally fibrosis and calcification. One of the primary entheses involved in inflammatory autoimmune disease is at the heel, particularly the Achilles tendon.
A chemical substance in animals and plants that aids natural biological processes (such as digestion).
Estrogen is a hormone made by the body that helps develop and maintain female sex characteristics and plays a role in the growth of long bones. Estrogen can also be made in the laboratory. Estrogen may be used for birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.
An estrogen receptor is a protein found inside the cells of the female reproductive tissue, some other types of tissue, as well as some cancer cells. The hormone estrogen will bind (attach to) the receptors inside the cells and may cause the cells to grow.
Activity requiring physical effort, carried out especially to sustain or improve health and fitness.
Extreme tiredness, exhaustion that doesn’t get better with rest.
An episode when the symptoms of a disease or condition break out or intensify rapidly, become suddenly worse or more painful.
Small spots occasionally seen in the field of vision. Floaters may appear as dots, threads or cobwebs.
A doctor who specializes in the study of digestive organs including the liver.
Carries the information inside each cell of the body that determines biological traits, which are features or characteristics that are passed on by parents.
Relating to, caused by, or controlled by genes.
The genetic makeup of an organism or group of organisms with reference to a single trait, set of traits, or an entire complex of traits; the sum total of genes transmitted from parent to offspring.
A group of diseases associated with damage the eye's optic nerve. Glaucoma occurs when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Without treatment, people with glaucoma may slowly lose their peripheral (side vision). Over time, blindness may result.
A sugar occurring in many fruits, animal tissues and fluids, etc., and having a sweetness about half that of ordinary sugar.
The GCP defines international quality standards that governments can incorporate into regulations for clinical trials involving human subjects. Good Clinical Practice guidelines include standards on how clinical trials should be conducted. These also define the roles and responsibilities of clinical trial sponsors, investigators, and monitors. Monitors are hired by the sponsor to verify that the data/information at the site (hospital, clinic) is accurate.
A deep narrow pit that is formed by the tubular infolding of the epidermis and that encloses the root of the hair and into which oil glands often secrete.
Hemodialysis is a process where a machine filters wastes, salts and fluid from the blood when the kidneys are no longer healthy enough to do this on their own.
A liver disease caused by the hepatitis A virus (HAV). HAV causes the liver to swell and prevents it from working well. HAV is passed from person to person through fecal matter. Most often it is transmitted because of poor hand-washing after using the bathroom or changing a diaper, or before preparing and eating food. Unlike Hepatitis B and hepatitis C, it does not become chronic (long-term).
A liver disease caused by the hepatitis B virus (HBV). HBV causes the liver to swell and prevents it from working well. HBV is passed from person to person through bodily fluids such as blood, semen or vaginal secretions. Most often it is transmitted through sexual contact or from an infected mother to her infant during birth.
A doctor who specializes in the study of the liver.
HER2 is a type of protien(made with instructions from the HER2 gene) that helps to control cell growth. When the HER2 protein is made in larger than normal amounts by cancer cells, the cells may grow more quickly and can spread to other parts of the body.
There are two approved forms of testing that utilizes a biopsy of breast tissue and/or breast tumor cells to observe either how much of the HER2 protein is present in the tumor or how many copies of the HER2 gene that instruct the rapid development of that protein are present.The tests look for abnormal amounts of each and the results can help inform treatment options.
A virus that affects the skin or the nervous system, often causing blisters.
A condition that occurs when too much hair to grow on a woman’s face or body.
A disease caused by a fungus called Histoplasma. This fungus grows in soil and material contaminated with bat or bird droppings. Breathing the fungal spores can cause infection; it is not contagious between people.
HIV (short for human immunodeficiency virus) weakens the immune system by destroying important cells that fight disease and infection. A deficient immune system can’t protect from illness as it normally would. It is sometimes referred to as the AIDS virus.
Tests that measure the amount of certain proteins, called hormone receptors, in cancer tissue. Hormones can attach to these receptors. Having a lot of hormone receptors means that hormones can help the cancer grow.
Hormones (estrogen, progesterone, or both) are used to treat women after menopause to replace the hormones no longer produced by the ovaries.
A surgical operation for ulcerative colitis (UC) after removal of the bowel. An internal pouch is made from the ileum and attached to the anus. This means stools are passed through the anus in the usual way. Sometimes referred to as restorative proctocolectomy.
The network of cells, tissues and organs that work together to protect the body and defend it against infectious organisms (bacteria, viruses, etc.) and other harmful substances. Through a series of steps called the immune response, the immune system attacks these organisms and substances.
Suppression of the immune system and its ability to fight infection. Immunosuppression may be due to drugs or diseases.
Infections are caused by germs inside the body. Different types of infections include colds, sore throats, rashes, and cuts or wounds that become infected. How they are treated depends on what type of germ caused the infection.
A term to describe disease that can be transmitted through the environment, and can spread infection.
A natural process that the body normally uses to protect itself from harm, such as an injury or infection. Affected areas may become red, swollen and painful and feel hot or warm to the touch.
A type of breast cancer that begins in the breast ducts. The cancer cells spread from the ducts to the lymph vessels in the skin of the breast.
A disease characterized by inflammation, where the body’s immune system thinks its own cells are threats, attacking them as they would typically target external threats like foreign bacteria or a virus.
See PRINCIPAL INVESTIGATOR.
Ionizing radiation is made (or given off) by X-ray procedures, radioactive substances, rays that enter the Earth's atmosphere from outer space, as well as other sources. At high doses, ionizing radiation increases the chemical activity inside cells and can lead to health problems, such as cancer.
The colored portion of the eye containing a circular opening, the pupil, in its center.
A condition involving inflammation of the eye's iris. The iris is a part of the middle layer of the eye (uvea), so iritis is sometimes called anterior uveitis.
Yellowing of the skin and the whites of the eyes. It is caused by accumulation of bilirubin in the body when the liver is not working well.
The point of contact between elements of a skeleton whether movable or rigidly fixed together with the surrounding and supporting parts (as membranes, tendons or ligaments).
A rare childhood disease that makes the walls of the blood vessels in the body become inflamed; this disease can affect any type of blood vessel, including the arteries, veins and capillaries.
Kinesiologists are medical specialists who are leaders in the prevention and management of injury and chronic disease through movement. Using exercise, they are devoted to improving performance, health and overall quality of life.
An abnormal change in structure of an organ or body part due to injury or disease.
A hereditary cancer predisposition syndrome reported in 1969 by Drs. Frederick Li and Joseph Fraumeni from the National Cancer Institute.
The tough bands of tissue that serves to connect the articular extremities of bones or to support or keep an organ in place. Ligaments are usually composed of coarse bundles of dense white fibrous tissue parallel or closely interlaced – they are pliant and flexible, but not extensible.
The growth and spread of unhealthy cells in the liver. Also known as hepatocellular carcinoma.
A liver transplant is the process of replacing a diseased liver with a donated, healthy liver.
A reaction that looks like Lupus, defined as an inflammatory connective tissue disease often held to be an autoimmune disease. Occurring chiefly in women, Lupus is characterized by fever, skin rash and arthritis, often by acute hemolytic anemia, and by small hemorrhages in the skin and mucous membranes.
A lymph node is a rounded mass of lymphatic tissue surrounded by a capsule of connective tissue. Located in the lymphatic system, these nodes filter lymph (lymphatic fluid), and they store white blood cells. Lymph is a clear fluid that carries cells that help fight infections and other diseases. The lymphatic system is made up of the tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. Lymphatic vessels extend to all tissues of the body.
A cancer of a part of the immune system known as the lymph system.
An MRI is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of the body’s interior. These pictures can distinguish between normal and diseased tissue.
Malignant is the description of a type of tumor that can invade and destroy tissues and spread to other parts of the body.
When cancer cells spread (metastasize) from one part of the body to another where they can grow into new tumors.
An approach based on the belief that the body can be stimulated to heal itself.
Chemical (such as dopamine, acetylcholine, or norepinephrine) which transmits or relays information or signals from one nerve cell (neuron) to other nerve cells or muscle cells.
A lymph node is a rounded mass of lymphatic tissue surrounded by a capsule of connective tissue. Located in the lymphatic system, these nodes filter lymph (lymphatic fluid), and they store white blood cells. Lymph is a clear fluid that carries cells that help fight infections and other diseases. The lymphatic system is made up of the tissues and organs that produce, store and carry white blood cells that fight infections and other diseases. Lymphatic vessels extend to all tissues of the body.
A small mass of rounded or irregular shape.
See OBSERVATIONAL MODEL and OBSERVATIONAL STUDY
The general design and strategy as to identifying and following up with participants during observational research studies. Types of observational study models include cohort, case-control, case-only, case-crossover, ecologic or community studies and family-based.
A research study whereby patients identified as belonging to study groups are assessed for biomedical or health outcomes. Patients may receive diagnostic, therapeutic, or other types of treatments, but the investigator does not assign participants to specific interventions (as in an interventional study).
A doctor who specializes in treating patients with cancer.
A medical doctor specializing in the branch of medical science dealing with the anatomy, functions and diseases of the eye.
A licensed professional who examines the eyes (using suitable instruments or appliances) for defects in vision and eye disorders in order to prescribe corrective lenses or other appropriate treatment.
The bones of a person with osteoporosis are weak and more likely to break. Anyone can develop osteoporosis; however, it is common in older women.
In biology, “overexpression” means to make too many copies of a protein or other substance. Overexpression of certain proteins or other substances can play a role in cancer development.
A rare form of breast cancer that begins in the breast ducts and spreads to the skin of the nipple and areola. The affected skin may appear to be crusted, scaly, red, or oozing.
A condition that occurs when all layers of the uvea are inflamed.
People with this condition have a mutation in the STK11 (also called LKB1) tumor suppressor gene.
The processes (in a living organism) of absorption, distribution (in the body), metabolism (process by which the body breaks down and converts medication into active chemical substances to treat a disease), and excretion of a drug or vaccine (usually via feces, urine and even respiration).
An inactive pill, liquid, or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the treatment's effectiveness.
The study method whereby an inactive substance (the placebo) is given to one group of patients while another group receives the drug being tested. The results are then compared to see if the test treatment is more effective than the placebo in treating the condition.
Inflammation of the ileal pouch (an artificial rectum surgically created out of ileal gastrointestinal tissue in patients who have undergone a colectomy).
In drug and medical product/device development, a study that is classified as “preclinical” means it is at the stage of research where it has yet to be cleared for testing in humans and is still being tested in animals to gather important feasibility, and drug safety data.
The clinical trial doctor - a highly qualified physician who carries out the research and interacts with the patients. All clinical trial doctors also have additional training in clinical trials and research.
Progesterone is a hormone made by the body that plays a role in the menstrual cycle and pregnancy. The hormone progesterone can also be made in the laboratory. It is used for birth control and as a treatment for menstrual disorders, infertility, symptoms of menopause, and other conditions.
A protein found inside the cells of the female reproductive tissue, some other types of tissue, as well as some cancer cells. The hormone progesterone will bind (attaches) to the receptors inside the cells and may cause the cells to grow.
The probable outcome or course of a disease; can also refer to the chance of recovery or recurrence.
A Protocol is the study plan on which the clinical trial is based. All plans are carefully designed to safeguard the volunteers, as well as answer specific research questions. A protocol describes who may participate in the clinical trial, the schedule of tests, procedures, medications, and regular follow-ups by the principal investigator and team to monitor the health and safety of research study participants, and effectiveness of the treatment.
Thick, yellowish-white fluid formed at the site of inflammation during infection.
A treatment that uses high-energy particles or waves to destroy cancer cells.
A clinical trial method in which the subjects are randomly distributed into groups which are either given the test drug or which serve as the control group.
Often expressed in terms of a number that confirms that the act of randomization – subjects being assigned by chance into separate groups that are then used to compare different treatments—has occurred. The number is indicative of the total number of times this process has successfully taken place. There is often a total number of randomized subjects that is the goal for a study to meet in order to be considered complete.
In a clinical trial protocol the rationale is the reason why a clinical trial is being conducted.
Reactive arthritis is a type of arthritis, or joint inflammation that occurs as a “reaction” to an infection somewhere else in the body.
The last part of the colon.
Recurrence means cancer that has recurred or come back. This usually happens after a period of time during which the cancer could not be detected. The cancer recur in the same place as the original (primary) tumor or to another place in the body.
A period free of active disease with few or no symptoms.
Carefully planned studies (also called a clinical trial or clinical study) that observe or treat patients in order to develop or discover new treatments or medications. Researchers want to see how well a drug works, how it can be used safely, and learn how to prevent, screen for, better diagnose and treat health issues
When the retina has been lifted or pulled from its normal position. It can occur at any age, but is more likely in people over age 40.
Any of various synthetic or naturally occurring analogs of vitamin A.
A form of arthritis that causes pain, swelling, stiffness and loss of function in the joints. It can affect any joint but is common in the wrist and fingers.
A disease involving inflammation, usually in the lungs, skin or lymph nodes. Sarcoidosis starts as tiny, grain-like lumps, called granulomas and can affect any organ in the body.
A type of breast imaging test used to detect cancer cells in the breasts of some individuals who have already had abnormal mammograms or who have dense breast tissue. This is not used for screening or in place of a mammogram.
The first visit to the site of a clinical trial, that evaluates whether the person can participate or not. The volunteer meets the specialist and study coordinator, reviews the informed consent form, undergoes a physical exam and tests, reviews their medical history, etc. If they qualify, a baseline visit is scheduled.
A hormone, such as estrogen or testosterone, affecting sexual development or reproduction.
A narrow, elongated channel in the body that allows the escape of fluid.
The backbone. Vertebrae are any of the bony or cartilaginous segments that make up the spinal column.
A means of describing or classifying cancer based on the extent of the cancer in the body.
To destroy microorganisms which adhere to surfaces, usually by bringing objects to a high temperature with steam, dry heat, or boiling liquid.
Its the sensation of dfficulty in moving a joint or apparant loss of range of motion of a joint.
The investigative methods found in the protocol that are used in a clinical trial.
see PLACEBO
A doctor who manages the treatment of cancer by excision (surgery).
A tubular gland of the skin that excretes perspiration.
Abnormal enlargement of a body part, typically due to an accumulation of fluid.
A sexually transmitted disease that can affect the genital area, lips, mouth, or anus of both men and women. Syphilis can be transmitted from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.
A group of cells that work together to carry out a specific function.
Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii. The infection can cause damage to the brain, eyes, and other organs.
Traditional Chinese medicine is based on the belief that disease is caused by problems with the flow of energy in the body. Herbal remedies as well as other procedures such as acupuncture and massage are used to restore the flow of energy in the body.
The act of transfusing donated blood, blood products or other fluid into the circulatory system of a person or animal.
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
Can also be called a neoplasm. A tumor is an abnormal mass of tissue that occurs when cells divide more than healthy cells or do not die when they are supposed to. Tumors can be benign ( non cancerous), or malignant (cancerous).
Diabetes means a person’s blood sugar (glucose) level is too high. Type 2 diabetes, the more common type, means the body does not make or use the hormone insulin properly. Insulin helps glucose get into the cells to give them energy. Without insulin, too much glucose stays in the blood, and over time this can lead to serious problems of the heart, eyes, kidneys, nerves, and gums and teeth.
An ulcer is an area of tissue erosion (loss of surface tissue), for example, of the lining of the gastrointestinal (GI) tract or skin. Due to the erosion, an ulcer is concave like a crater and depressed below the level of the surrounding tissue.
A procedure that uses high-energy sound waves to look at tissues and organs inside the body. These sound waves make echoes that form images of the tissues and organs on a computer screen (sonogram). Ultrasound can be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures.
Inflammation of the uvea, the pigmented, vascular structure in the eye consisting of the iris, ciliary body, and choroid.
A substance that is usually injected into a person or animal to protect against a particular disease.
The amount of a virus(such as hepatitis B or hepatitis C virus) in the blood.
An extremely small living thing that causes a disease and that spreads from one person or animal to another. It can only reproduce itself by taking over a cell in the body of its host.
A disease associated with chronic inflammation of melanocytes (specialized cells that produce a pigment called melanin). Melanin gives skin, hair, and eyes their color.
A disease spread by infected mosquitoes. Although many infected people experience no symptoms, the infection may be associated with fever, headache, body aches, skin rash, and swollen lymph glands. These symptoms can last a few days to several weeks, and usually go away on their own. If West Nile virus enters the brain, it can be life-threatening.

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