Crohn's Disease: Symptoms, causes, diagnosis, and more (original) (raw)

Crohn’s disease is a chronic or long-term condition that causes inflammation in the digestive tract. Crohn’s disease can result in severe pain and other symptoms, but medication can help manage it.

Symptoms of Crohn’s disease can include abdominal pain and diarrhea, weight loss, and fatigue.

Although it typically starts in childhood or early adulthood, Crohn’s disease can develop at any age.

Having a supportive network of people who understand life with Crohn’s disease is important. Bezzy IBD is a free online community and app by Healthline Media, which you can download from the App Store for iPhone and iPad and Google Play for Android.

This article explains what Crohn’s disease is and how it manifests. It also examines its causes, diagnosis, complications, and treatments and offers some dietary tips.

Crohn’s disease is an autoimmune-mediated inflammatory condition. This means the immune system mistakenly attacks the body’s cells, thinking they are harmful when they are not.

Crohn’s can affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. Symptoms mainly involve the intestinal system, but in rare cases, they can also affect the skin, joints, bones, eyes, kidneys, and liver.

Types of Crohn’s disease

1. Ileocolitis: The most common type, this affects the end of the small intestine and the large intestine, or colon.
2. Ileitis: This only affects the ileum or small intestine.
3. Gastroduodenal Crohn’s disease: This affects the stomach and the duodenum, the beginning of the small intestine.
4. Jejunoileitis: This causes patches of inflammation in the jejunum and ileum. People may refer to this as small “bowel Crohn’s.”
5. Crohn’s (granulomatous) colitis: This affects only the colon.

Symptoms range from vomiting to rectal bleeding and depend to some extent on the type.

Symptoms of Crohn’s disease vary, depending on which part of the gut the condition affects. They often include:

• Pain: The pain level varies from person to person and depends on where the inflammation is in the gut. People tend to experience pain in the lower right side of the abdomen.
• Ulcers in the gut: These are raw areas that may bleed. If this happens, an individual may find blood in their stools.
• Mouth ulcers: These are common symptoms of Crohn’s disease.
• Diarrhea: This can range from mild to severe, and there may be mucus, blood, or pus. A person may also feel the urge to have a bowel movement but find that nothing comes out.
• Fatigue: People with Crohn’s disease often feel very tired.
• Fever: Crohn’s disease can cause a high body temperature and fever.
• Nausea and vomiting: Disturbances to the digestive system can lead to nausea and vomiting.
• Altered appetite: At times, a person may experience appetite loss.
• Weight loss: This can result from a loss of appetite.
• Anemia: A loss of blood can lead to anemia.
• Rectal bleeding and anal fissures: The skin of the anus becomes cracked, leading to pain and bleeding.

During a flare of Crohn’s disease symptoms, an individual may also develop:

• arthritis
• uveitis
• skin rash and inflammation
• bile duct inflammation
• delayed growth or sexual development in children

Symptoms in females

Crohn’s disease can have some specific symptoms in females, such as:

• irregular menstruation due to effects on hormone function
• iron deficiency, as Crohn’s affects the absorption of nutrients and can lead to intestinal bleeding
• pain during sex, if symptoms affect areas near the anus or vagina
• discomfort about sex, as Crohn’s can affect a person’s libido and body image, as well as cause pain and other types of discomfort

It is not clear what causes Crohn’s disease. Experts suggest that it may stem from an abnormal reaction of the immune system. However, they do not know whether this reaction causes the disease or results from it.

Factors that may increase the risk of inflammation include:

• genetic factors
• a person’s immune system
• environmental factors, such as smoking
• bacterial or viral infection

Is Crohn’s an autoimmune disease?

Crohn’s is an autoimmune condition – meaning that the immune system mistakenly attacks healthy cells. As the immune system interacts with different organisms, this may trigger inflammation and intestinal damage.

There are many theories about why Crohn’s develops, including genetic factors, problems with the gut microbiome, and environmental exposure.

A doctor will ask a person about their symptoms, such as abdominal pains. A physical examination can reveal other hallmark symptoms, such as a lump in the abdomen resulting from loops of inflamed bowels sticking together or perianal lesions.

How to test

The following tests may help in the diagnosis:

• stool and blood tests
• biopsy
• sigmoidoscopy, which involves using a sigmoidoscope, a short, flexible, tube-like tool to investigate the lower bowel
• colonoscopy, which involves using a flexible, tube-like tool, a colonoscope, to investigate the colon
• endoscopy, which involves inserting a long, thin, flexible tool called an endoscope down through the esophagus and into the stomach to investigate the upper part of the gut
• CT scan or MRI, which helps reveal changes in the bowel

While treatment can help manage Crohn’s disease, there is no cure. Research continues, and once scientists can identify the causes, it may be possible to find a cure.

Treatment for Crohn’s disease may involve medication, surgery, and nutritional supplements. The aim is to control inflammation, resolve nutritional problems, relieve symptoms, and reduce the occurrence of flares.

The course of treatment will depend on:

• where the inflammation occurs
• the severity of the issue
• any complications
• a person’s response to previous treatments

Some people go for long periods, even years, without experiencing any symptoms. These are periods of “remission.” However, symptoms usually flare up again.

Medication

There are many medications for Crohn’s disease, including:

• Aminosalicylates: These are anti-inflammatory drugs and include balsalazide (Colazal) and mesalamine (Lialda). A doctor may prescribe these for a person with a new diagnosis and mild symptoms.
• Steroids: These may include oral steroids, such as prednisone (Rayos) and budesonide (Entocort), or intravenous steroids, such as methylprednisolone (Solu-Medrol). They are for short-term use only, as they can have severe adverse effects.
• Antibiotics: These can be useful during Crohn’s flare-ups if a person has an abscess or fistula.
• Antidiarrheal drugs and fluid replacements: When the inflammation subsides, diarrhea usually becomes less severe. However, someone may still need something to address diarrhea and abdominal pain.

Biologics

Biologics are a type of drug that scientists have developed from living organisms. Biologics reduce the body’s immune response by targeting proteins that lead to inflammation. They appear to help people with Crohn’s disease.

Below are some examples:

Examples of biologics for Crohn’s disease include:

• infliximab (Remicade)
• adalimumab (Humira)
• certolizumab pegol (Cimzia)

Surgery

Some people with Crohn’s disease may eventually need surgery. This can relieve symptoms that have not responded to medication. It may also help address complications, such as an abscess, perforation, blockage, and bleeding.

A person may need a colectomy, in which a surgeon removes the whole colon or large intestine. This procedure may also involve making a small opening in the front of the abdominal wall and bringing the tip of the end of the small intestine into this opening, forming a stoma, through which feces exits the body.

Natural treatment

There is no cure for Crohn’s disease. People can help manage their symptoms using natural treatments complementary to prescription medications.

Some natural approaches to Crohn’s disease symptoms include:

• Dietary changes: During a flare-up, a person can avoid high fiber foods, dairy, sugar, high fat foods, and spicy foods. Between flare-ups, individuals can aim to drink more water, eat small meals, boil or steam food instead of frying it, and keep a food diary to track the effects of different foods.
• Behavioral changes: Quitting smoking, if it applies, meditation, mindfulness, and exercise may all help.
• Essential oils: Some essential oils, such as patchouli and peppermint, may help reduce inflammation.

IBDs, such as Crohn’s disease, are common in children and adolescents. Crohn’s disease affects children and adults in similar ways. Typical symptoms include:

• unexplained weight loss
• bloody diarrhea
• abdominal pain

If symptoms are severe and frequent, the risk of complications is higher. A person with any of the following complications may need surgery:

• internal bleeding

• abscesses

• a stricture, which involves part of the gut narrowing, causing a buildup of scar tissue and a partial or complete blockage of the intestine

• a perforation, a small hole in the wall of the gut, which can lead to leakage, infections, and abscesses

• fistulas, which involves a channel forming between two parts of the gut

• a persistent iron deficiency

• food absorption problems

• a slightly higher risk of bowel cancer

Can Crohn’s disease be fatal?

Typically, Crohn’s disease is not life threatening, but it can cause fatal complications, such as colorectal cancer or severe infections.

Experts determine whether Crohn’s disease constitutes a disability on a case-by-case basis. This is because each person with the condition has a different experience.

Individuals with Crohn’s disease could qualify for disability insurance if it prevents them from working. Many people with IBD have to go through a series of appeals before the authorities approve their disability claims.

Crohn’s disease and ulcerative colitis are both types of IBD but are different conditions.

Crohn’s disease can affect any part of the digestive tract, including the esophagus, stomach, small intestine, and large intestine, called the colon. Ulcerative colitis, on the other hand, only affects the colon.

There is currently no cure for Crohn’s disease, but treatments and various care strategies can help manage it.

Still, the disease is likely to affect quality of life. Life expectancy may also be slightly lower for a person with Crohn’s disease because it increases the risk of developing other diseases, such as cancer, liver problems, biliary tract complications, and genitourinary tract infections.

Some people with Crohn’s need surgery and possibly more than one procedure over time.

Here are some questions people often ask about Crohn’s disease.

Can you live a ‘normal’ life with Crohn’s?

While Crohn’s flares can affect day-to-day life, treatments such as diet changes, medications, and surgical interventions can all help support the quality of life in people with Crohn’s disease.

How does a person get Crohn’s disease?

Experts do not know precisely why Crohn’s disease occurs. However, research suggests an inappropriate immune response due to genetic and environmental factors.

A person with certain genetic features may develop Crohn’s due to exposure to drugs, toxins, infections, and intestinal microbes.

What are the early warning signs of Crohn’s disease?

• diarrhea
• weight loss
• fatigue
• abdominal cramping and pain

Which foods trigger Crohn’s disease symptoms?

Foods that may worsen symptoms are alcohol, carbonated drinks, and high fiber foods, such as popcorn, nuts, and vegetable skins. Eating a large meal can also trigger symptoms.

Crohn’s disease is a chronic, or long-term, condition that causes inflammation in the digestive tract. It can be painful, reduce quality of life, and cause complications that can be fatal.

A person with Crohn’s disease can manage the symptoms with medication, stress reduction, and other approaches. Some people will also require surgery.