Crohn’s Disease 101: Everything You Need to Know
Medically Reviewed by Carolin Schneider, MD
Crohn’s disease, also known as regional ileitis or ileitis terminalis, is an inflammatory bowel disease (IBD) that can affect any part of your gastrointestinal tract. It causes various symptoms, including abdominal pain, diarrhea, vomiting and weight loss. According to the Crohn’s & Colitis Foundation, Crohn’s disease may affect as many as 800,000 Americans.
While the cause of this chronic condition is unknown, it has been shown that smoking is related to the development of Crohn’s disease. The symptoms of Crohn’s may vary, depending on where in the gastrointestinal tract the inflammation occurs and how severe it is. This makes Crohn’s disease challenging to diagnose.
To find the correct diagnosis, your healthcare provider may analyze blood or stool samples and perform a colonoscopy. Even though there’s no surgical or pharmaceutical cure for Crohn’s disease, various treatment options are available to keep symptoms under control.
Causes and Symptoms of Crohn’s Disease
Although the exact cause of Crohn’s disease is unknown, doctors believe that it has both genetic and environmental links. Your family’s medical history may provide an indicator of whether you’re at risk, as several genes that demonstrate a higher risk level have been identified. Smokers are also a high-risk group for developing Crohn’s, and people of all genders are equally at risk.
Moreover, researchers have found that people with Crohn’s have a different gut microbiota — the types of microorganisms living in your gastrointestinal tract — composition than those without the condition. Therefore, it’s estimated that Crohn’s disease is caused by the interplay of genes and environment. Most people will develop the condition as young adults between the ages of 15 and 30, but cases in elderly people have also been diagnosed. Many Crohn’s patients experience symptoms for months or years before they are diagnosed.
Primary symptoms of this condition include:
- Abdominal pain
- Chronic diarrhea
However, Crohn’s patients might also experience other symptoms, such as:
- Gas and bloating
- Blood-clotting problems
- Pain when defecating
- Rectal bleeding
- Blood in stools
- Drastic weight loss
Crohn’s disease may also cause issues in other parts of the body than the intestine. Patients with Crohn’s disease can also develop:
- Joint disorders
- Swollen eyes
- Kidney stones
- Liver disease
- Inflamed gums
- Neurological issues that include seizures, strokes, myopathy, peripheral neuropathy and headaches
Crohn’s disease patients will experience periods of flare-ups, which involve symptoms becoming active, and periods of remission in which inflammation calms down and there are fewer or no symptoms.
Complications of Crohn’s disease include:
- Higher risk for colorectal cancer
- Intestinal infection
- Anal fissures
Diagnosing Crohn’s Disease
Crohn’s disease can be challenging to diagnose. For this reason, people are frequently misdiagnosed with other conditions that may cause similar symptoms.
If you suspect that you have Crohn’s disease or another condition involving your gastrointestinal system, you should monitor your symptoms so your doctor has an accurate representation of your medical history. Also, it’s helpful to document what you eat each day to see how different foods change your symptoms.
Your family history is also helpful in making the right diagnosis. Based on your health history, a doctor will conduct a series of tests to diagnose your condition and prescribe the most effective treatment:
- Physical Examination: Depending on your symptoms, the doctor may examine you to determine any abnormalities that include rashes, joint swelling, masses in your abdominal area and ulcers in your mouth. These office tests are preliminary and cannot conclusively diagnose Crohn’s disease. Depending on your symptoms, you will likely need additional followup tests.
- Blood test: A blood test can help diagnose anemia that results from blood loss and vitamin B12 deficiency. Many people with Crohn’s develop anemia because their bodies are unable to absorb nutrients effectively due to the inflammation in their gastrointestinal systems. A blood test can also measure the C-reactive protein that indicates the level of inflammation in a person’s body.
- Stool test: A stool examination can help your doctor rule out gastroenteritis caused by bacteria and can also help them measure the level of intestinal inflammation present.
- Colonoscopy: A colonoscopy is the most effective test for diagnosing Crohn’s disease because the doctor has a direct view of your colon and small intestine. While conducting a colonoscopy, a gastroenterologist will perform a biopsy to diagnose Crohn’s disease. An accurate diagnosis can help you manage and control your symptoms.
Treatments for Crohn’s Disease
Even though there’s no cure for Crohn’s disease, various treatments are available to help you manage symptoms, control flare-ups and prolong remission periods. Doctors typically use a combination of medication, lifestyle changes, diet plans and surgical procedures to keep symptoms under control so patients can live healthy lives. In very severe cases, surgeries can be performed to remove a part of the intestine and limit inflammation.
Medications and treatment methods are designed to extend periods of remission for as long as possible. Commonly prescribed medicines include steroids and anti-inflammatory drugs. For the most part, Crohn’s medications treat acute outbreaks and infections. Doctors recommend against using medicines for an extended period because side effects might occur. Steroids are drugs that reduce swelling and suppress the immune system. They have several adverse side effects, including swelling in the face, acne, insomnia, shaking, mood swings, increased appetite and weight gain. Immunoregulatory drugs are frequently prescribed with steroids. These drugs help prolong remission periods of Crohn’s disease.
It’s helpful to monitor your dietary and fluid intake to track whether certain foods or drinks are causing flares. Knowing what causes problems can help you keep your symptoms under control. Even though no “Crohn’s diet” exists, you may need to make adjustments to your eating habits to keep your condition under control.
Consume an ideal amount of calories, minerals, vitamins and protein; Crohn’s disease can put you at risk for severe weight loss and malnutrition. You should also moderate your fluid intake. Drink lots of water in small amounts to prevent problems related to dehydration. If you have trouble digesting lactose, then you should refrain from drinking milk and eating other dairy products. Instead of eating large meals, it’s advisable to consume smaller meals throughout the day.
Some lifestyle modifications can also help you manage Crohn’s symptoms and flares. Talk to your doctor about whether you should be taking additional nutritional supplements. Some doctors may advise you to take iron, calcium, vitamin D or vitamin B-12. Ensure that you talk to a doctor before taking supplements; these medications can interfere with your digestive tract. Only a doctor can determine what vitamins are best for you.
It’s also recommended that people with Crohn’s disease try to maintain healthy sleeping patterns. Getting enough sleep can keep you healthy, strong and energetic. Avoid smoking as much as possible. Exercise can help Crohn’s patients overcome fatigue.
Surgery may become necessary if the condition causes you to develop a blockage in your intestine. Surgery is also necessary for treating bowel obstructions, fistulas and abscesses. A bowel resection is a type of surgery that involves the removal of part of your intestine. The purpose of this procedure is to drain abscesses and remove an intestinal blockage. These surgeries may alleviate some of the symptoms and complications you experience due to Crohn’s, but it’s important to remember that no surgery can cure the condition or prolong periods of remission.