Crohn's Disease

What is Crohn's Disease?

Crohn's disease is an autoimmune disease that causes chronic inflammation of the digestive or gastrointestinal (GI) tract. It causes the body's immune system to recognize the lining of the GI tract as something foreign to the body and mount an immune response against it. Crohn's disease can affect any part of the GI tract from the mouth to the anus but it most often affects the end of the small intestine (ileum) and the beginning of the colon.

The exact cause of Crohn's disease is unknown but genetics and a malfunctioning immune system likely play a role in getting it. Typically, the disease affects people between the ages of 15 and 35 but it can occur at any age.

Crohn's disease is an inflammatory bowel disease, like ulcerative colitis. But these diseases are not the same and should not be confused with each other.

What are the Symptoms of Crohn's Disease?

The most common symptoms of Crohn's disease include:

  • Abdominal pain and cramps
  • Persistent diarrhea
  • Urgent need to move bowels
  • Fatigue or low energy
  • Weight Loss
  • Fever

Other symptoms that you can have include mouth sores, skin problems, eye inflammation, and anal problems, such as tears (fissures) or fistulas. The symptoms you experience depends on which part of the GI tract is involved, which is why people with Crohn's disease can have different symptoms.

How is Crohn's Disease Diagnosed?

There is currently no single test that can be used to diagnose Crohn's disease, so you are likely to have a number of different types of tests.

If you think you may have Crohn's disease you should see your primary care doctor as soon as possible. They will start by asking questions about your symptoms, taking a medical history, and performing a physical exam. You may also have laboratory tests on your blood and stool, as well as x-rays of the upper and lower GI tract. A CT scan or MRI are other imaging tests that may be done.

After the initial testing is completed, your doctor may recommend an upper endoscopy or colonoscopy. These procedures allow the GI tract to be visually inspected and for any abnormal areas to be biopsied. Any tissue biopsy that is taken will be sent to a pathologist and viewed under a microscope to help confirm the diagnosis.

How is Crohn's Disease Treated?

There is currently no cure for Crohn's disease, so treatment is aimed at reducing flares and helping people live healthy lives. Treatment of Crohn's disease is usually multifaceted and often combines medications with diet and nutrition changes. Sometimes surgery is required to treat more severe episodes or complications that can occur from Crohn's disease. Since not everyone with Crohn's disease responds to treatment the same, you may find that you have to try a few different treatment options before you find the right one for you.

Medications for Crohn's disease suppress the immune system and prevent the body from attacking itself in order to improve your symptoms. Some medications are designed to stop disease flares and may be used for short periods of time. Other medications are used to prevent flares from occurring, so they are used for longer time periods. It is not uncommon for people to need to use more than one medication to control symptoms, especially if symptoms are more severe.

Some people may find that eating certain foods can lead to disease flare ups, so it is reasonable to avoid these foods. Dieticians can often help give healthy diet recommendations. Other lifestyle recommendations that can help reduce disease flares include getting regular exercise, not smoking, and avoiding nonsteroidal anti-inflammatories (such as ibuprofen, naproxen).

Surgery is often required to treat severe symptoms that are not improved by medicines or lifestyle changes, but it is not used as a first choice. Surgeries are used to remove the part of the colon that is affected by the disease or to open a blocked area of bowel. While surgery is often needed, it is important to know that it won't cure Crohn's disease.

What is the Prognosis of Crohn's Disease?

Crohn's is a chronic life-long disease that typically follows a pattern of disease flare ups followed by periods of remission. Because of this, lifelong treatment and monitoring is needed.

Having Crohn's disease increases your risk of getting colon cancer. This risk depends on how long you have had the disease and how much of your colon is affected. Based on your risk, your doctor is likely to recommend colon cancer screening earlier and more often than what is recommended for people without Crohn's disease.

Where Can You Get More Information About Crohn's Disease?

Crohn's and Colitis Foundation http://www.crohnscolitisfoundation.org/

National Institute of Diabetes and Digestive and Kidney Diseases https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease

American Society of Colon and Rectal Surgeons https://www.fascrs.org/patients/disease-condition/crohns-disease-expanded-version