Gastrointestinal | Crohn’s disease

Crohn’s disease is a chronic condition that causes inflammation affecting any part of the digestive tract.

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Overview

Crohn’s disease is an inflammatory bowel disease that can affect any region along the full gastrointestinal tract (i.e., from mouth to anus). It is an autoimmune disease where the body’s immune system innately attacks its own healthy cells. Inflammation and/or the development of ulcers can manifest at any region of the gastrointestinal tract, but do not necessarily affect all regions. Types of Crohn’s disease and certain areas of the gastrointestinal tracts affected can include:

 

  • Ileocolitis – affects the end of the small intestine leading to the large intestine
  • Ileitis – affects the last section of the small intestine called the ileum
  • Gastroduodenal Crohn’s disease – affects the stomach and beginning of the small intestine called the duodenum
  • Jejunoileitis – affects the upper parts of the small intestines called the jejunum
  • Granulomatous colitis – affects the large intestine

 

The exact cause of the Crohn’s disease is relatively unknown, but there do exist increased risks for individuals who:

 

  • Have a family history of inflammatory bowel disease
  • Are Jewish, White, or of European descent
  • Smoke
  • Live in high pollution areas
  • Use oral contraception
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Are in their late teens to 30 years old

 

Crohn’s disease is a chronic condition that can be treated but not cured. Individuals with Crohn’s disease often experience periods of time with active disease (i.e., present symptoms), but also experience periods of time with decreased disease activity (i.e., present little or no symptoms). Symptoms of Crohn’s disease can include:

 

  • Diarrhea
  • Stomach cramping
  • Abdominal pain
  • Weight loss
  • Malnutrition
  • Anemia
  • Nausea
  • Vomiting
  • Rectal bleeding
  • Skin lesions

Crohn’s disease is not contagious, meaning that it is not transmissible from one individual to another. Research suggests that the disease is linked to genetic heredity, where about 20 percent of people with Crohn’s disease have had at least one close relative also with an inflammatory bowel disease.

While there is no proven way to predict the development of Crohn’s disease or to prevent the disease, a healthy lifestyle can help improve the immune system’s response to disease.

The best way for individuals to manage Crohn’s disease is to reduce symptoms and prevent flare-ups by practicing healthy lifestyle habits, which include:

  • Not smoking
  • Avoiding fatty food
  • Eating anti-inflammatory foods
  • Taking medications as prescribed
  • Avoiding stress
  • Exercising

 

Crohn’s disease not only affects the individual’s physical condition, but also can affect the individual’s emotional wellbeing. Mental health professionals may recommend behavioral or psychological methods to help patients better manage symptoms and disease.

There exists no single, definitive test to diagnose Crohn’s disease. However, there are a variety of tests and procedures that are available to collectively assist in diagnosing Crohn’s disease, including:

  • Blood tests to check for anemia and infection
  • Stool tests to detect bacteria and inflammation
  • Imaging tests to view the inside of the digestive tract
  • Endoscopy procedures to view the upper and/or lower digestive tracts
  • Colonoscopy procedures to view the large intestines
  • Biopsies taken during endoscopy or colonoscopy

 

Physicians will use results from testing along with a patient’s symptoms to develop a treatment plan that may include a combination of medications, nutritional supplements and/or surgery.

  • Medications used to treat Crohn’s disease include:
  • Aminosalicylates (e.g., balsalazide, mesalamine)
  • Steroids (e.g., prednisone, budesonide, methylprednisolone)
  • Antibiotics
  • Antidiarrheal drugs 
  • Fluid replacement
  • Biologics (e.g., infliximab, adalimumab, certolizumab pegol)

 

About 50 percent of individuals with Crohn’s disease will require surgery during the first 10 years of the disease, and up to 75 percent of individuals with Crohn’s disease will require surgery at some time during their lives. For those individuals who develop an abscess, obstruction or perforation, as well as those who cannot be successfully treated with medications, often require surgery to remove the diseased section of the digestive tract. The removal of a diseased section may encourage disease remission, but is not a cure for the disease, and disease relapse is common.