Crohn’s disease is a chronic bowel disease that causes severe
inflammation of your digestive tract and affects your quality of life. It is
associated with abdominal pain and diarrhea and is characterized by alternating
phases of flare-ups and remissions. It is named after Dr. Burill B. Crohn who
in 1932 was the first to identify the disease.
More than 400,000 Americans suffer from Crohn’s. Exact numbers
are difficult to confirm due to a lack of standards in diagnosis, as well as
wrongly classified cases of the disease.
Crohn’s is included in a larger group of illnesses known as
inflammatory bowel diseases. It can appear anywhere along the gastrointestinal
tract, from the mouth to the anus. It is typically found in the distal small
bowel and colon. Crohn’s can also develop anywhere in the intestinal tract,
making it difficult to diagnose and treat.
Over time, ulcerations, or small sores, will develop and extend
through the layers of your intestinal tract. This can cause severe
complications such as:
- strictures, or intestinal narrowing
- fistulas, or abnormal tunneling between two
different sections of the gastrointestinal tract
- anal fissures, which are painful tears in the
skin around the anal area
- ulcers of the gastrointestinal tract
- malabsorption, not being able to absorb
nutrients, leading to weight loss
What Are the Symptoms of Crohn’s Disease?
Symptoms of Crohn’s vary depending on the severity of the disease
and the location of the inflammation. All people with Crohn’s experience severe
abdominal pain and cramping during a severe episode. Other symptoms can include:
- weight loss
- diarrhea, which may contain blood or mucus
Because Crohn’s affects the immune system, symptoms can also be
found outside your gastrointestinal tract and can include:
- skin rash
- sores inside your mouth
What Causes Crohn’s Disease?
The cause of Crohn’s disease is unknown. It’s an autoimmune
disorder in which a combination of genetics and environment cause your immune
system to attack your own intestinal cells.
Who Is at Risk for Crohn’s Disease?
Risk factors are difficult to prevent because they include
unchangeable factors such as age, family history, medical history, and
Crohn’s disease most often affects people between the ages of 15
Those with a family history of Crohn’s are at a significantly
higher risk of developing the disease.
History of Autoimmune Disorders
If other autoimmune disorders are present, such as rheumatoid
arthritis, you may have a higher risk for developing Crohn’s disease.
Although people of all races have the disease, Crohn’s is found
more often among people from Eastern Europe, and American Jews of European
How Is Crohn’s Disease Diagnosed?
Crohn’s disease is difficult to diagnose because the symptoms can
mimic many other conditions and diseases, such as:
- a parasitic infection
- diverticulitis, a common condition found in the
- celiac disease, a condition that damages the
- colon cancer
Another reason Crohn’s is difficult to diagnose is the lack of a specific
blood test to identify the disease.
Your doctor will consider a variety of factors in diagnosing
Crohn’s disease, including your medical history, a physical exam, and a variety
History and Physical Exam
Your doctor will begin by asking you for a detailed history of
your symptoms and about any family history of autoimmune disorders or bowel
This checks for any intestinal narrowing or obstruction, which
can be a medical emergency.
An ultrasound will rule out diseases in abdominal organs such as:
- gall bladder
CT Scan or MRI
These imaging methods are used to determine any complications of
the disease such as fistulas or abscesses.
This is the gold standard for diagnosing Crohn’s disease. A
colonoscopy enables your doctor to see the inside of your intestinal wall and to
remove a tissue sample for further examination.
How Is Crohn’s Disease Treated?
There is no known cure for Crohn’s disease. You and your doctor
can only prevent complications and control inflammation. Since the disease
alternates between periods of remission and flare-up, treatment focuses on
helping you to avoid or control an episode. Treatment varies based on the site
and severity of disease as well.
Some treatment options include medications, surgery, nutrition,
and stress management.
Many different medications are used to manage Crohn’s disease.
They may be used alone or in combinations.
Corticosteroids can be used to
control inflammation and control your immune system. Because of the side
effects of chronic steroid use, steroids are often prescribed short-term during
These anti-inflammatory drugs treat mild to moderate symptoms and help keep you
agents: These agents are prescribed to help you maintain remission by suppressing
your over-active immune system.
- Antibiotics: Antibiotics prevent and treat
infection or decrease the overgrowth of bacteria in your gastrointestinal
- Biological agents: Similar to drugs used in
chemotherapy, biological agents are given for more severe cases. These
medications may be given orally, intravenously, or by self-injection.
Depending on the location and severity of your condition, it may
be necessary to remove a diseased portion of your intestine. There are also
times when it is necessary to remove an ulceration or blockage in your
digestive tract. These treatments do not cure the disease. Crohn’s is a chronic
condition that often will reoccur later in life.
During surgery, every attempt is made to preserve as much
intestine length as possible to avoid further complications.
People with Crohn’s disease are often underweight because
intestinal inflammation interferes with the absorption of food. Nutritional
counseling and dietary supplements may be used.
Stress can increase the frequency and severity of flare-ups.
Stress management and emotional support are important to a successful treatment
Can a Crohn’s Flare-up Be Prevented?
Certain lifestyle changes can decrease the severity of a flare-up,
but there is no known way to eliminate flare-ups altogether. Measures you can
take to help prevent them include dietary changes, stress management, and
A low fiber diet can decrease bowel frequency and help reduce
diarrhea. Many people with Crohn’s find that diarrhea and flatulence improve by
limiting dairy, as well as gas-producing foods such as:
- raw fruits and juices
Dieticians often recommend six small, frequent meals per day
instead of three large ones.
Limiting stress and learning to manage it with exercise and
relaxation techniques can help decrease Crohn’s symptoms.
Recent studies have shown that even light smoking can increase
the intensity of flare-ups.
People with Crohn’s must take their medications exactly as
prescribed and follow their treatment plan in order to prevent complications
Crohn’s disease can be a lifelong challenge. Following your
doctor’s advice and sticking with your diet and treatment plan will greatly
improve your quality of life.