Crohn’s Disease

Overview

Crohn’s disease is a type of inflammatory bowel disease (IBD). The disease primarily involves the intestinal system, but it also has a variety of extraintestinal manifestations and can affect the skin, joints, bones, eyes, kidneys, and liver. Although Crohn’s disease typically starts in childhood or early adulthood, it can start at any age. As many as 780,000 Americans have the condition, according to the Crohn’s & Colitis Foundation of America (CCFA). 

Crohn’s disease most commonly occurs in the small intestine and the colon. It can affect any part of your gastrointestinal (GI) tract, from the mouth to the anus. It can involve some parts of the GI tract and skip other parts. The range of severity for Crohn’s is mild to debilitating. Symptoms vary and can change over time. In severe cases, the disease can lead to life-threatening flares and complications.

Causes

Although there are many theories about what causes Crohn’s disease, none of them have been proven. There is a benefit, though, in understanding the possible causes of Crohn’s disease and how they interact with one another. Doing so can help one better understand the symptoms, diagnosis, and treatment of Crohn’s disease. Scientists believe that Crohn’s disease is caused by a combination of these factors:

• Immune system problems
• Genetics
• Environmental factors

Symptoms

The Crohn’s disease symptoms often develop gradually. Certain symptoms may also become worse over time. Although it’s possible, it’s rare for symptoms to develop suddenly and dramatically. The earliest symptoms of Crohn’s disease can include:

• Diarrhea
• Abdominal cramps
• Blood in your stool
• Fever
• Fatigue
• Loss of appetite
• Weight loss
• Feeling as if your bowels aren’t empty after a bowel movement
• Feeling a frequent need for bowel movements

It’s sometimes possible to mistake these symptoms for those of another condition, such as food poisoning, an upset stomach, or an allergy. The symptoms may become more severe as the disease progresses. More troublesome symptoms may include:

• A perianal fistula, which causes pain and drainage near your anus
• Ulcers that may occur anywhere from the mouth to the anus
• Inflammation of the joints and skin
• Shortness of breath or decreased ability to exercise due to anemia

Diagnosis

No single test result is enough for your doctor to diagnose Crohn’s disease. They will begin by eliminating other possible causes of your symptoms.

Your doctor may use several types of tests to make a diagnosis:

• Blood tests can help your doctor look for certain indicators of potential problems, such as anemia and inflammation.
• A stool test can help your doctor detect blood in your GI tract.
• Your doctor may request an endoscopy to get a better image of the inside of your upper gastrointestinal tract.
• Your doctor may request a colonoscopy to examine the large bowel.
• Imaging tests like CT scans and MRI scans give your doctor more detail than an average X-ray. Both tests allow your doctor to see specific areas of your tissues and organs.
• Your doctor will likely have a tissue sample, or biopsy, taken during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.

Treatment

Crohn’s disease treatment may involve medication, surgery, and nutritional supplements. The aim is to control inflammation, resolve nutritional problems, and relieve symptoms.

There is no known cure for Crohn’s disease, but some treatments can help by reducing the number of times a person experiences recurrences. Crohn’s disease treatment will depend on:

• Where the inflammation occurs
• The severity of the condition
• Complications
• A person’s response to previous treatment for recurring symptoms

Several types of medications are available to treat Crohn’s. Antidiarrheal and anti-inflammatory drugs are commonly used. More advanced options include biologics, which uses the body’s immune system to treat the disease. After a Crohn’s diagnosis, your doctor will likely suggest making an appointment with a registered dietitian. A dietitian will help you understand how food may affect your symptoms and how your diet may help you.

Some people can have long periods, even years, without any symptoms. Experts refer to this as remission. However, there will usually be recurrences. As periods of remission vary greatly, it can be hard to know how effective treatment has been. It is impossible to predict how long a period of remission is going to be.

When To See A Doctor

Your doctor can help guide you in finding the right medications, alternative treatments, and lifestyle measures that can help. If you’re having gastrointestinal symptoms, speak with your doctor to determine the cause and potential solutions.

Summary 

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that affects the gastrointestinal (GI) tract, most commonly the small intestine and colon. It can also impact other areas like the skin, joints, and eyes. The disease typically begins in childhood or early adulthood, although it can occur at any age, affecting around 780,000 Americans according to the Crohn’s & Colitis Foundation. It has a prevalence rate of about 5% in the U.S. population. The severity of Crohn’s disease ranges from mild to debilitating, with symptoms including diarrhea (affecting up to 90% of patients), abdominal cramps, blood in stool, fatigue, and weight loss. In severe cases, Crohn’s can lead to life-threatening complications such as perianal fistulas and ulcers, which occur in up to 30% of patients.

 The exact cause of Crohn’s disease remains unknown, but it’s believed to result from a combination of immune system issues, genetics (with a 10-15% familial incidence), and environmental factors, including diet and smoking, which may increase the risk by two to four times. Diagnosis is complex and involves eliminating other conditions through tests such as blood work, stool tests, endoscopies, colonoscopies, and imaging studies. A biopsy may also be taken to examine intestinal tissue, and it’s estimated that 50% of patients require surgery at some point in their lives due to complications.

 Treatment focuses on controlling inflammation, managing symptoms, and addressing nutritional deficiencies. While there is no cure, medications like anti-inflammatory drugs, biologics, and antidiarrheal agents can help reduce the frequency of flare-ups, with biologics showing a response rate of 40-60% in patients. Surgery and nutritional adjustments may also be necessary in some cases. A registered dietitian can assist in creating a diet plan that reduces symptoms, as nutritional support is critical, given that up to 85% of Crohn’s patients experience malnutrition at some point.

 Although people with Crohn’s may experience periods of remission, where symptoms subside for extended periods, recurrences are common, occurring in approximately 70% of patients within 10 years of diagnosis, making long-term management essential. If gastrointestinal symptoms arise, it’s crucial to consult a doctor for appropriate diagnosis and treatment options.

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about Crohn’s Disease or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.