Crohn's disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 23, 2016
StartCrohn's disease

There are many diseases that affect the gastrointestinal tract of the body, and one of these is Crohn’s disease. This is a relatively common disease, affecting about five million people around the globe.

Contents

Definition & Facts

Crohn’s disease is the chronic inflammation of the bowels and digestive tract. It most often affects the end of the small intestines (also known as the ileum) and beginning of the colon, but is not necessarily limited to those regions. It can also skip over regions of the digestive tract leaving untouched, healthy, normal sections only to return farther along the intestines. This can create a patchwork of ulcers and inflammation along the tract. As a chronic illness, Crohn’s disease will have periods where it goes into remission and shows no symptoms and periods where it flares up in the patient.

Symptoms & Complaints

The most recognizable symptoms include:

In addition, it can cause a host of other complications in the body, depending on the seriousness of the symptoms. Loss of appetite is a frequent sign of those suffering from the disease, and consequently many patients experience noticeable weight loss due to this.

The irritation and inflammation in the bowels can also make it difficult to get sufficient nutrients to the body, which in younger children manifests as a lack of growth or failure to sustain growth. It’s fairly common for patients to have deficiencies in vitamin B-12, iron deficiency, calcium deficiency, and vitamin D deficiency. Intestinal blockage or ulcers are also possible, and inflammation can occur around the eyes, skin, liver, and joints in more severe cases.

Causes

There is no known cause for Crohn’s disease. For a time, diet and stress to the intestines were thought to be the causes. It’s now been shown that these can worsen the disease if not properly managed but that they do not cause it.

One line of thought is that a virus or foreign bacteria triggers the illness. While the body attacks the invading virus or bacteria, the immune system overreacts and starts to attack the healthy, normal bacteria of the intestine. This is what causes the severe inflammation along the intestinal tract.

Genetics is also another possibility in whether someone has a higher chance of contracting the disease; many who have it have a close relative who also has the disease. Finally, environment might play a role as well. Crohn’s disease is more common in developed, urban regions than in other areas around the world, and those areas that have diets higher in meats, fats, and dairy have a higher occurrence among the population.

Diagnosis & Tests

To properly diagnose Crohn’s disease can be difficult, especially since many of its symptoms are similar to ulcerative colitis, another gastrointestinal disease The biggest difference between the two is ulcerative colitis will always affect the colon and almost always involve the rectum, as well as having a continuous area of inflammation.

Crohn’s, as mentioned, generally affects only the beginning of the colon and the end of the ileum, but this is not always true. Consequently, the best test for diagnosing is a colonoscopy; this can visually show where in the intestines the inflammation is occurring. However, it is limited in its reach. Colonoscopies almost never go past the end of the small intestine, and sometimes Crohn’s disease will only affect a small portion of the digestive tract where the doctor cannot see.

Blood tests may be performed, which can show anemia or a deficiency in certain vitamins. Radiological tests are also used where the doctor has the patient swallow a fluoroscopic substance so that it travels along the digestive tract. This can show where the intestines might be shrinking due to inflammation, and is especially useful for areas where the colonoscopy cannot go. Even with these tests, however, a doctor may not be able to diagnose Crohn’s disease with full certainty.

Treatment & Therapy

Crohn’s disease has no cure but has become more manageable with recent medical advances and medications. Individuals with the illness are expected to live normal life-spans and with proper treatment can maintain a healthy weight. Anti-inflammatory drugs are the first line of treatment and can include corticosteroids. These may not work for everyone, however, and can also cause some negative side effects such as insomnia, night sweats, and high blood pressure among others.

Immunosuppressive drugs can also be used to help calm down the patient’s immune system. As the immune system is suppressed, the inflammation will naturally decrease and offer relief to the intestinal tract. Antibiotics are administered when infection along the intestines is a concern due to tears within the lining of the tract, but they are not generally used to treat Crohn’s disease itself.

Other medications are used to help treat the more obvious symptoms of the illness. Anti-diarrheal medicine helps to relieve mild diarrhea and helps to reduce the number of bowel movements during the day. Many patients will also take iron supplements, calcium supplements, and other vitamin supplements to help combat these deficiencies. If the illness is severe, feeding tubes are sometimes used to get nutrients into the body and give the intestinal tract a rest.

Prevention & Prophylaxis

If the disease is in remission, lifestyle changes can help prevent a relapse. Eating more fruits and vegetables while eating less fats and meats can help reduce the symptoms, and eating smaller meals more often can help as well. Sometimes, a certain type of food has been shown to trigger the disease, and eliminating these from a diet will also help.

Common problem food groups are fats, dairy, and fiber. Keeping track of foods being eaten will help identify which ones could be a problem. Smoking should be stopped, if the patient is a smoker. Reducing stress—whether through exercise, meditation, or other methods—is also highly recommended.