What is Crohn’s Disease?
Crohn’s disease is a chronic disease that causes inflammation and irritation in your digestive tract. Most commonly, Crohn’s affects your small intestine and the beginning of your large intestine. However, the disease can affect any part of your digestive tract.How Common is Crohn’s Disease?
Researchers estimate that more than half a million people in the United States have Crohn’s disease.1 Studies show that, over time, Crohn’s disease has become more common in the United States and other parts of the world.1,2 Experts do not know the reason for this increase.Who is More Likely to Develop Crohn’s Disease?
Crohn’s disease can develop in people of any age and is more likely to develop in people- between the ages of 20 and 292
- who have a family member, most often a sibling or parent, with IBD
- who smoke cigarettes
What Are The Complications of Crohn’s disease?
Complications of Crohn’s disease can include the following:- Intestinal obstruction. Crohn’s disease can thicken the wall of your intestines. Over time, the thickened areas of your intestines can narrow, which can block your intestines. A partial or complete intestinal obstruction, also called a bowel blockage, can block the movement of food or stool through your intestines.
- Fistulas. In Crohn’s disease, inflammation can go through the wall of your intestines and create tunnels, or fistulas. Fistulas are abnormal passages between two organs, or between an organ and the outside of your body. Fistulas may become infected.
- Abscesses. Inflammation that goes through the wall of your intestines can also lead to abscesses. Abscesses are painful, swollen, pus-filled pockets of infection.
- Anal fissures. Anal fissures are small tears in your anus that may cause itching, pain, or bleeding.
- Ulcers. Inflammation anywhere along your digestive tract can lead to ulcers or open sores in your mouth, intestines, anus, or perineum.
- Malnutrition. Malnutrition develops when your body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function.
- Inflammation in other areas of your body. You may have inflammation in your joints, eyes, and skin.
What Are the Symptoms of Crohn’s Disease?
The most common symptoms of Crohn’s disease areOther symptoms include- anemia
- eye redness or pain
- feeling tired
- fever
- joint pain or soreness
- nausea or loss of appetite
- skin changes that involve red, tender bumps under the skin
Some research suggests that stress, including the stress of living with Crohn’s disease, can make symptoms worse. Also, some people may find that certain foods can trigger or worsen their symptoms.
What Causes Crohn’s Disease?
Doctors aren’t sure what causes Crohn’s disease. Experts think the following factors may play a role in causing Crohn’s disease.Autoimmune Reaction
One cause of Crohn’s disease may be an autoimmune reaction—when your immune system attacks healthy cells in your body. Experts think bacteria in your digestive tract can mistakenly trigger your immune system. This immune system response causes inflammation, leading to symptoms of Crohn’s disease.Genes
Crohn’s disease sometimes runs in families. Research has shown that if you have a parent or sibling with Crohn’s disease, you may be more likely to develop the disease. Experts continue to study the link between genes and Crohn’s disease.Other Factors
Some studies suggest that other factors may increase your chance of developing Crohn’s disease:- Smoking may double your chance of developing Crohn’s disease.3
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen4 antibiotics,5 and birth-control pills5 may slightly increase the chance of developing Crohn’s disease.
- A high-fat diet may also slightly increase your chance of getting Crohn’s disease.6
How Do Doctors Diagnose Crohn’s Disease?
Doctors typically use a combination of tests to diagnose Crohn’s disease. Your doctor will also ask you about your medical history—including medicines you are taking—and your family history and will perform a physical exam.Physical Exam
During a physical exam, a doctor most often- checks for bloating in your abdomen
- listens to sounds within your abdomen using a stethoscope
- taps on your abdomen to check for tenderness and pain and to see if your liver or spleen is abnormal or enlarged
Diagnostic Tests
Your doctor may use the following tests to help diagnose Crohn’s disease:- lab tests
- intestinal endoscopy
- upper gastrointestinal (GI) series
- computed tomography (CT) scan
How Do Doctors Treat Crohn’s Disease?
Doctors treat Crohn’s disease with medicines, bowel rest, and surgery.No single treatment works for everyone with Crohn’s disease. The goals of treatment are to decrease the inflammation in your intestines, to prevent flare-ups of your symptoms, and to keep you in remission.
Medicines
Many people with Crohn’s disease need medicines. Which medicines your doctor prescribes will depend on your symptoms.Although no medicine cures Crohn’s disease, many can reduce symptoms.
Aminosalicylates. These medicines contain 5-aminosalicylic acid (5-ASA), which helps control inflammation. Doctors use aminosalicylates to treat people newly diagnosed with Crohn’s disease who have mild symptoms.
Corticosteroids. Corticosteroids, also known as steroids, help reduce the activity of your immune system and decrease inflammation. Doctors prescribe corticosteroids for people with moderate to severe symptoms.
In most cases, doctors do not prescribe corticosteroids for long-term use.
Immunomodulators. These medicines reduce immune system activity, resulting in less inflammation in your digestive tract. Immunomodulators can take several weeks to 3 months to start working.
Doctors most often prescribe immunomodulators like cyclosporine only if you have severe Crohn’s disease because of the medicine’s serious side effects. Talk with your doctor about the risks and benefits of cyclosporine.
For a list of all side effects related to each medication, click here.
Biologic therapies. These medicines target proteins made by the immune system. Neutralizing these proteins decreases inflammation in the intestines. Biologic therapies work to help you go into remission, especially if you do not respond to other medicines.
Other medicines. Other medicines doctors prescribe for symptoms or complications may include
- acetaminophen for mild pain. You should avoid using ibuprofen, naproxen, and aspirin because these medicines can make your symptoms worse.
- antibiotics to prevent or treat complications that involve infection, such as abscesses and fistulas.
- loperamide to help slow or stop severe diarrhea. In most cases, people only take this medicine for short periods of time because it can increase the chance of developing a megacolon.
Bowel rest
If your Crohn’s disease symptoms are severe, you may need to rest your bowel for a few days to several weeks. Bowel rest involves drinking only certain liquids or not eating or drinking anything. During bowel rest, your doctor may- ask you to drink a liquid that contains nutrients
- give you a liquid that contains nutrients through a feeding tube inserted into your stomach or small intestine
- give you intravenous (IV) nutrition through a special tube inserted into a vein in your arm
Surgery
Even with medicines, many people will need surgery to treat their Crohn’s disease. One study found that nearly 60 percent of people had surgery within 20 years of having Crohn’s disease.7 Although surgery will not cure Crohn’s disease, it can treat complications and improve symptoms. Doctors most often recommend surgery to treat- fistulas
- bleeding that is life-threatening
- intestinal obstructions
- side effects from medicines when they threaten your health
- symptoms when medicines do not improve your condition
Small bowel resection. Small bowel resection is surgery to remove part of your small intestine. When you have an intestinal obstruction or severe Crohn’s disease in your small intestine, a surgeon may need to remove that section of your intestine.
Subtotal colectomy. A subtotal colectomy, also called a large bowel resection, is surgery to remove part of your large intestine. When you have an intestinal obstruction, a fistula, or severe Crohn’s disease in your large intestine, a surgeon may need to remove that section of the intestine.
Proctocolectomy and ileostomy. A proctocolectomy is a surgery to remove your entire colon and rectum. An ileostomy is a stoma, or opening in your abdomen, that a surgeon creates from a part of your ileum. The surgeon brings the end of your ileum through an opening in your abdomen and attaches it to your skin, creating an opening outside your body. The stoma is about three-quarters of an inch to a little less than 2 inches wide and is most often located in the lower part of your abdomen, just below the beltline.
A removable external collection pouch, called an ostomy pouch or ostomy appliance, connects to the stoma and collects stool outside your body. The stool passes through the stoma instead of passing through your anus. The stoma has no muscle, so it cannot control the flow of stool, and the flow occurs whenever occurs.
If you have this type of surgery, you will have the ileostomy for the rest of your life.
How Do Doctors Treat the Complications of Crohn’s Disease?
Your doctor may recommend treatments for the following complications of Crohn’s disease:- Intestinal obstruction. A complete intestinal obstruction is life-threatening. If you have a complete obstruction, you will need medical attention right away. Doctors often treat complete intestinal obstruction with surgery.
- Fistulas. How your doctor treats fistulas will depend on what type of fistulas you have and how severe they are. For some people, fistulas heal with medicine and diet changes, whereas other people will need to have surgery.
- Abscesses. Doctors prescribe antibiotics and drain abscesses. A doctor may drain an abscess with a needle inserted through your skin or with surgery.
- Anal fissures. Most anal fissures heal with medical treatment, including ointments, warm baths, and diet changes.
- Ulcers. In most cases, the treatment for Crohn’s disease will also treat your ulcers.
- Malnutrition. You may need IV fluids or feeding tubes to replace lost nutrients and fluids.
- Inflammation in other areas of your body. Your doctor can treat inflammation by changing your medicines or prescribing new medicines.
How Can My Diet Help the Symptoms of Crohn’s Disease?
Changing your diet can help reduce symptoms. Your doctor may recommend that you make changes to your diet such as- avoiding carbonated, or “fizzy,” drinks
- avoiding popcorn, vegetable skins, nuts, and other high-fiber foods
- drinking more liquids
- eating smaller meals more often
- keeping a food diary to help identify foods that cause problems
Your doctor may recommend nutritional supplements and vitamins if you do not absorb enough nutrients. For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
References
“Digestive Diseases—Crohn’s Disease was originally published by the National Institute of Diabetes and Digestive and Kidney Diseases.”
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