Crohn’s Disease

Overview

Crohn’s disease is a condition that causes inflammation (swelling) of the digestive tract. Crohn’s disease can lead to a number of complications, including ileitis, which is inflammation affects the ileum (lower third of the small intestine). There is no cure for Crohn’s disease, but gastroenterologists can help manage the symptoms and reduce your pain. If not properly managed, Crohn’s disease can lead to debilitating pain and even life-threatening complications.

Crohn’s disease causes 

Experts don’t know the exact cause of Crohn’s disease. Previously, they believed that diet and stress could cause the condition. Today, experts know that diet and stress can aggravate Crohn’s disease but cannot actually cause it. They do believe that a compromised immune system that is fighting a virus or bacterium, as well as hereditary factors, can play a role in the development of Crohn’s disease.

Crohn’s disease risk factors

Risk factors for developing Crohn’s disease include:

• Being of Eastern European (Ashkenazi) Jewish descent
• Being under age 30
• Having a parent, sibling or child with Crohn’s disease
• Living in an industrialized country
• Living in an urban area
• Regularly taking non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil, Motrin or Aleve
• Smoking cigarettes

Crohn’s disease symptoms

Signs and symptoms of Crohn’s disease can range in intensity from mild to severe, and usually come on gradually. There may be periods of time when you don’t experience any symptoms, which is known as being in remission.

Symptoms of Crohn’s disease can include: 

• Abdominal pain and cramping
• Bloody stool
• Decreased appetite
• Delayed growth or sexual maturation (in children)
• Diarrhea
• Fever
• Fatigue
• Inflammation (swelling) of the skin, eyes and joints
• Inflammation of the liver or bile ducts
• Mouth sores
• Pain or drainage from the anus
• Unintended weight loss

Crohn’s disease diagnosis

There is no single test to diagnose Crohn’s disease. Your gastroenterologist may use one or more of the following diagnostic tools to diagnose your condition:

Physical examination. Your doctor will perform a complete physical exam, and ask you questions about your health history in general and your Crohn’s disease symptoms specifically.

Blood tests. Your doctor can use a blood test to check for infection or to rule out other conditions that can cause similar symptoms.

Colonoscopy. Your doctor uses this procedure to closely analyze your entire colon and ileum, and to take a biopsy (small tissue sample) for lab analysis, if needed.

Imaging tests. A computerized tomography (CT) or magnetic resonance imaging (MRI) scan can check your bowel for irregularities.

Capsule endoscopy. In this procedure, you’ll swallow a capsule that has a camera in it. While in the digestive tract, the camera takes detailed images of your small intestine. The camera automatically transmits these images to a special monitor, where your doctor can analyze them for signs of Crohn’s disease or other conditions.

Crohn’s disease treatment

Because there’s no cure for the condition, the goal of treatment for Crohn’s disease is to reduce inflammation that triggers your symptoms. The location and severity of your Crohn’s disease, your overall health and other factors will help determine your course of treatment.

Anti-inflammatory medications. Your specialist may prescribe an anti-inflammatory medication – such as corticosteroids or oral 5-aminosalicylates – to help reduce your swelling and associated symptoms.

Immunosuppressants. Your specialist may prescribe one or a combination of immune system suppressing medications. These medications work by reducing your body’s overactive immune response that causes the inflammation and symptoms.

Antibiotics. If you have an infection with your Crohn’s disease, your specialist will prescribe an antibiotic medication to clear up the infection.

Other medications. Your gastroenterologist may prescribe one or more other medications – such as anti-diarrhea medicine, pain reducing medicine, iron supplement, calcium and vitamin D supplement or vitamin B-12  injections, to help address other symptoms you face.

Specialized diet. In cases of severe Crohn’s disease, you may need to receive a specialized diet via feeding tube or intravenous (IV) line. Receiving nutrition in one of these ways can help improve your overall health and give your bowel time to rest and heal. Another dietary modification that your specialist may recommend is a low residue or low-fiber diet, which can help reduce your risk of developing blockages in your bowel.

Surgery. If more conservative treatment options are not effective in reducing your Crohn’s symptoms, your specialist may recommend you undergo surgery. In fact, almost half of people with Crohn’s will need to undergo at least one surgery. In surgery, your specialist removes the damaged portion of the digestive tract and reconnects the healthy sections. In almost all cases, surgery is a temporary fix and those who have undergone surgery will suffer another Crohn’s flare-up some time later.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a gastroenterologist for more specialized treatment.