What is Crohn’s Disease?
Crohn’s diseases is a type of inflammatory bowel disease in which parts of the gastrointestinal tract (usually the end of the small intestine, called the ileum, and the beginning of the large intestine) become swollen and ulcerated. Crohn’s disease is a chronic condition that can flare up at any time, although smoking, infections, and hormonal changes may make you more prone to experiencing symptoms.
What causes Crohn’s Disease?
Doctors do not know what causes Crohn’s disease. It was once thought that it could be brought on by diet and/or stress, but we now know that while these factors may exacerbate the condition, they don’t cause Crohn’s disease. Some scientists believe that Crohn’s disease is caused by a malfunctioning immune system. The gastrointestinal tract is full of harmless bacteria that aid in digestion; these doctors hypothesize that in people with Crohn’s disease, the immune system responds to these bacteria as though they are harmful, resulting in chronic inflammation. There is also a hereditary component to Crohn’s disease, as it runs in families.
Who is at risk?
Less than 1% of Americans suffer from Crohn’s disease, and most estimates put that number at closer to 0.25%. It is most frequently diagnosed in teenagers and adults between the ages of 20 and 35. Men and women are equally susceptible to Crohn’s disease. Studies have shown that 5% to 20% of people with Crohn’s disease have a parent, child, or sibling with some type of irritable bowel disease. It is more prevalent among Caucasians, particularly those of Ashkenazi (Eastern European Jewish) descent. The most important controllable risk factor is smoking. Tobacco smokers are twice as likely to develop Crohn’s disease.
Signs and Symptoms
Symptoms of Crohn’s disease are frequently related to inflammation of the gastrointestinal tract. Crohn’s disease, ulcerative colitis, and other inflammatory bowel diseases have similar symptoms. These include diarrhea, cramping, abdominal pain, blood in the stool, and mouth sores. The pain and cramping can reduce appetite, and weight loss is another indicator of Crohn’s disease. These symptoms can develop slowly or come on suddenly, and may be mild, moderate, or severe.
Symptoms of Crohn’s Disease:
- Abdominal cramps and pain
- Bowel blockages
- Anal fissures (tears) resulting in bloody stool
- Weight loss
- Mouth sores
Crohn’s disease often goes undiagnosed for years, because it can affect different parts of the intestine and the symptoms often develop gradually. Doctors need to look at the inside of the intestine to diagnose Crohn’s disease. There are several tests that may be performed, including a colonoscopy with a biopsy, in which your tissue will be analyzed for granulomas. This helps avoid a misdiagnosis as ulcerative colitis, which doesn’t cause granulomas. You may also have a CT scan or CT enterography to take a closer look at the bowels. Abdominal X-rays, an upper gastrointestinal series (UTI), or MRI may also be performed
Diagnostic Tests for Crohn’s Disease:
- Imaging (CT scan, MRI, X-rays, etc.)
- Balloon endoscopy
- Capsule endoscopy
- Upper Gastrointestinal Series
- Standard blood tests
- Fecal occult blood test
There is no cure for Crohn’s disease, but a variety of treatment options can manage and control the illness. The first line of defense is medication. There are a wide variety of drug therapies available for people with Crohn’s disease. Anti-inflammatories and corticosteroids can reduce the swelling, and are especially effective in the short term. Immune system suppressants can also reduce inflammation. Antibiotics are sometimes subscribed, as well.
Patients may be given other medications to help relieve signs and symptoms of Crohn’s disease. Among them are anti-diarrhea medications, laxatives, NSAIDs, and vitamin supplements. Your doctor may recommend changes to your diet, as some foods may exacerbate symptoms. Crohn’s disease also reduces your appetite, so patients may want to focus on eating healthier, more nutritious foods.
About 70% of people with Crohn’s disease will eventually require surgery. Surgery can close fistulas and repair abscesses. Two common types of surgeries are bowel resectioning, in which the diseased part of the intestine is removed and the healthy ends are reattached and strictureplasty to widen a narrowed segment of the intestine. Surgery is generally necessary when medications are no longer working. It can relieve symptoms for many years, but approximately 30% of patients who have surgery will experience recurrence of symptoms within 3 years. About 60% will have symptoms recur within 10 years.