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Crohn’s disease
Its obviously (A). And I am not a doctor 
16 The answer is A Medicine
Crohn’s disease (choice A) is an inflammatory autoimmune condition with a significant genetic predilection;
however, the course of the disease varies greatly from patient to patient. In many cases, attacks go into remission
only to recur again years later; in other cases, the disease is consistent and persistent. The inflammation
causes bowel cells to secrete large volumes of water with more salt than can be resorbed; consequently, it causes
diarrhea. In mild cases, this may only be annoying but in severe cases patients may have dozens of bowel
movements per day, interfering with daily activities and sleep. The inflammation also may cause thickening
and scarring of the mucosa, which in turn causes cramping and pain. Again, the pain can vary from a minor
annoyance to almost being intolerable. In addition, the inflammation can lead to ulceration and bleeding,
which can induce a microcytic anemia, as in the case described, or less commonly it may interfere with vitamin
B12 absorption in the terminus of the ilium and induce pernicious anemia, a macrocytic event. The pain
and cramping inhibits appetite, causing weight loss. In some cases, the ulceration can be so severe that fistulas
are formed and organs adjacent to the colon become affected, causing a host of potential secondary problems.
The inflammation is often localized in the ilium (about 50% of the time) or at the junction of the ilium
and the colon (about 30% of the time), and in the body of the colon about 20% of the time, but it can occur
at any place, varying from the mouth the rectum. In some patients, the affected area is a continuum, whereas
in others it develops simultaneously in different areas, creating a patchwork effect. Ulceration can even
happen outside the gastrointestinal system as, for example, in the mouth, skin, liver, joints, or eyes. What triggers
the condition is unknown, but there appears to be a strong genetic component; approximately 20% of
Crohn’s disease patients have a first-degree relative who also is affected. The onset of the disease can start at
any age but most typically appears between the ages of 15 and 35 years. It affects men and women to an equal
extent, and Caucasians are at greater risk than other ethic groups.
Ulcerative colitis (choice B) is the other inflammatory gastrointestinal disease. Unlike Crohn’s disease
ulcerative colitis causes inflammation only in the colon or rectum, almost always only involves the superficial
layer of the inner lining of the bowel, and the inflammation generally is diffuse and uniform rather than
concentrated in some areas and pitted and nonhomogeneous. However, some relation must exist between the
two diseases since having first-degree relatives with ulcerative colitis is a risk factor for developing Crohn disease.
Irritable bowl syndrome (choice C) is not a disease per se but a description of a group of functional disturbances
that may cause symptoms such as bloating, flatulence, diarrhea and/or constipation, and mucus in
the feces. Unlike Crohn disease or ulcerative colitis, the syndrome very rarely causes inflammation or any type
of tissue damage. Irritable bowl syndrome is very common; approximately 20% of adults in the United States
Після сільської школи хай ідуть на хвельдшера чи ветеринара.
