Crohn’s Disease

Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract, part of a group of conditions known as inflammatory bowel diseases (IBD).

Chron’s disease can affect any part of the gastrointestinal tract (also called the GI tract) from the mouth to the anus.

Most commonly, Chron’s disease affects the end of the small intestine and the beginning of the colon. This disease can result in swelling, pain and frequent and urgent bowel movements, significantly impacting daily life.

Managing Crohn’s disease is a lifelong commitment that extends beyond medical treatment. This may include dietary changes, stress management and regular exercise. Many patients find support groups beneficial for sharing experiences and strategies.

Risk factors

There are several factors that can increase a person’s risk of Chron’s disease.

• Age: Most commonly diagnosed in people between the ages of 15 and 35.
• Family history: Having a close relative with Crohn’s disease increases your risk.
• Smoking: Tobacco use is a significant risk factor and can also worsen the disease.
• Diet: High-fat and refined foods may increase susceptibility, though evidence is not conclusive.
• Nonsteroidal anti-inflammatory medications (NSAIDs): Use of NSAIDs, such as ibuprofen and aspirin, may aggravate or trigger disease symptoms.
• Environmental factors: Exposure to industrial pollutants and changes in lifestyle in developed countries.
• Infections: Certain bacterial and viral infections might trigger the onset of Crohn’s disease.
• Immune system: Abnormal immune responses might attack the GI tract, triggering inflammation.

Symptoms

Pain usually occurs around or beneath the navel — often in the lower right part of the abdomen — and seems to worsen after meals.

Other symptoms include:

• Persistent diarrhea: Frequent, loose and watery bowel movements, often leading to dehydration and nutrient loss
• Abdominal pain and cramping: Sharp or dull pain in the lower abdomen, usually intensified after meals
• Blood in stool: Presence of bright red or dark blood, indicating inflammation or bleeding in the GI tract
• Fatigue: Chronic tiredness and weakness, often unrelated to physical activity or rest, due to inflammation and nutrient malabsorption
• Weight loss: Unintentional loss of weight due to decreased appetite, malabsorption of nutrients, or increased energy expenditure.
• Loss of appetite: Reduced desire to eat, often because of nausea, pain, or fear of food worsening symptoms
• Fever: Elevated body temperature caused by ongoing inflammation or infection
• Mouth sores: Painful ulcers in the mouth, also known as aphthous stomatitis, linked to inflammation and immune response
• Bowel obstruction: Partial or complete blockage of the intestines causing severe pain, bloating and inability to pass gas or stool
• Rectal bleeding: Passage of fresh blood from the rectum often accompanied by pain, due to anal fissures or severe inflammation
• Constipation (bowel obstruction): Difficulty in passing stool or infrequent bowel movements caused by narrowing of the intestines
• Night sweats: Episodes of heavy sweating during sleep, commonly due to systemic inflammation and fever
• Nutrient deficiencies: Lack of essential vitamins and minerals resulting from poor absorption in the inflamed intestines

Flare-ups and chronic symptoms

Chron’s disease often has periods of worsening and of dormancy.

Even when the symptoms are dormant, the disease doesn’t go away.

Flare-ups can be short or long, mild or severe. In severe cases, a fistula or pathway opens between the intestinal walls or even between the intestine and the skin, vagina or bladder.

Screenings and diagnosis

Crohn’s disease can be difficult to diagnose because the symptoms are similar to many other diseases and conditions, including ulcerative colitis.

Diagnosis of Crohn’s disease often involves a combination of tests and procedures. These can include blood tests to look for signs of inflammation or anemia, stool tests to rule out other conditions and imaging tests such as X-rays, MRI or CT scans. Endoscopic procedures like colonoscopy and upper endoscopy may also be conducted to visualize the GI tract and take biopsy samples.

Treatment options

While there is no cure for Crohn’s disease, various treatments can help manage the symptoms and maintain remission.

Common treatments include anti-inflammatory drugs, immunosuppressants and biologics. Your health care provider will tailor a treatment plan to your specific needs, taking into account the severity of your condition and your overall health.

Surgical care and procedures

In cases where medication and lifestyle changes are not enough, surgery might be necessary.

Surgical options can include resection of affected parts of the intestines, strictureplasty to widen narrowed parts of the intestines, or the creation of an ostomy.

Surgical intervention is typically considered a last resort but can provide significant relief and improve quality of life.

Managing medication

Consistency in taking prescribed medications is crucial for managing Crohn’s disease. Regular follow-ups with your health care provider are important to adjust dosages and medications as needed. It’s also essential to report any side effects or new symptoms promptly, so adjustments can be made to your treatment plan.

Potential complications

Unchecked, Crohn’s disease can lead to several complications such as intestinal obstruction, abscesses, fistulas and malnutrition.

Regular monitoring and a comprehensive treatment plan can minimize these risks.

Chronic inflammation can also increase the risk of colorectal cancer, making regular screenings important.

Recovery and rehabilitation

If you have surgery for Chron’s disease, recovery may include physical therapy and gradual reintroduction of regular activities to ease back into daily life.

By actively participating in your treatment plan, seeking regular medical advice and making necessary lifestyle adjustments, many individuals with Crohn’s disease lead full, active lives.

If you have concerns or symptoms of Crohn’s disease, consult your health care provider for a thorough evaluation and personalized care plan.