Crohn’s disease is a chronic disorder of the gastrointestinal (GI) tract. It is one of the disorders in the group called Inflammatory Bowel Diseases (IBD). It causes inflammation of the tissue of the GI tract and can impact any area from the mouth to the anus. It is most commonly found in the last part of the small intestine, (known as the ileum) and at the beginning of the colon. The inflammation can extend through the entire wall of the GI tract. Crohn’s Disease is not limited to the digestive tract. It can involve the skin and create arthritic changes in joints as well.
It is one disorder in the group called inflammatory bowel diseases (IBD). Crohn’s has its own unique set of symptoms and causes. Ulcerative Colitis is another common IBD condition.
About 1.4 million Americans have either Crohn’s Disease or Ulcerative Colitis. Crohn’s Disease can occur at any age; though it is most commonly diagnosed between ages 15-30 but may also be found in the 50-80 age group. Males and females are equally affected.
No direct inheritable gene has been found, yet there appears to be a genetic connection because the disease often runs in families. The risk of developing the disease is between 5.2-22.5% if a first-degree relative (parent, sibling, or child) has the disease.
The cause of Crohn’s Disease is unknown at this point. Researchers are working hard to determine a cause. We do know that nothing YOU did made you develop Crohn’s Disease. The disorder involves the body’s immune system acting inappropriately. Usually, the immune system works to protect the body from infection. An abnormal response may be related to the genes a person has, and/or something in the environment that causes the immune system to be activated when it does not need to be. Ultimately, the immune system is “turned on” and ready to fight. This can cause inflammation and damage to the lining of the GI tract, leading to symptoms. Most often Crohn’s disease affects the ileum (the lower part of the small intestine, but it can involve the entire length of the colon including the rectum and anus.
Symptoms can range from mild to severe. Again, Crohn’s Disease can affect any portion of the GI tract from mouth to anus. Symptoms depend on what portion of the GI tract is affected. If your stomach and small intestine are affected, your symptoms may be different from someone else who has the disease in their colon. Sometimes, it takes many years of symptoms before the disease is diagnosed. People can go through periods of “flares” when symptoms get worse due to active disease and inflammation; and “remission” when symptoms improve.
In addition to affecting the GI tract, Crohn’s Disease can cause problems outside the GI tract such as:
There is no one test or exam finding to diagnose Crohn’s Disease. It is determined based on a combination of findings. Typically, some, or all of the below will be used:
There is no cure at this point for Crohn’s Disease. Medicines are used to treat symptoms and to decrease inflammation so the tissue of the GI tract can heal. The goal of treatment is to “induce remission,” meaning getting symptoms and inflammation under control. After remission is achieved, the goal is to “maintain remission”.
Good nutrition is key as nutritional deficiencies are possible because of poor absorption, chronic diarrhea, decreased appetite, and increased energy needs of the body because of the chronic disease.
Crohn’s is a lifelong condition. Working together with your provider can help to achieve optimum long-term health.
We provide comprehensive evaluation and management for our Crohn’s & Colitis patients
Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract. The most common areas it affects are the ileum, the lower portion of the small intestine, and the colon. Granulomatous ileitis and regional ileitis are other names for this disease. It is one of two disorders grouped in the condition called inflammatory bowel disease. The other disorder is Ulcerative Colitis. Crohn’s disease causes inflammation of the entire thickness of the bowel wall. The cause of Crohn’s is not known, but it is aggravated by bacterial infections and inflammation. Crohn’s affects women slightly more often than men and appears to run in some families. About 1 to 5 per 10,000 individuals have Crohn’s disease. The most commonly affected individuals are between the ages of 15 and 25 years.
Detection of Crohn’s is by a flexible sigmoidoscopy, a procedure where a lighted flexible instrument is inserted into the rectum to view the lower portion of the colon and rectum. Tissue samples are taken from the colon and sent for microscopic examination. Alternative detection methods are colonoscopy, a procedure similar to a flexible sigmoidoscopy but with a longer instrument, or barium enema x-ray. This is a lifelong condition in most individuals, but the disease course varies. Many individuals will not have symptoms after the first couple of attacks. Others will have recurrent symptoms. The majority of individuals with Crohn’s can carry on a normal life but can expect a shorter total life expectancy. Medications can control the symptoms. This condition often requires surgery.
Abdominal pain and chronic diarrhea are the most common symptoms of Crohn’s disease. The abdominal pain is usually right-sided or around the navel. Eating may make the pain worse. The diarrhea can sometimes be bloody. It also can be severe enough to cause malnutrition. Other symptoms include fatigue, weight loss, loss of appetite, and fever. Symptoms are not limited to the gastrointestinal tract. About 20% of individuals will have joint pains. Others will have skin lesions.
Complications of Crohn’s are many and varied. Bowel obstructions (blockages) are common. Fistulas and fissures in and around the anus and rectum can form. A fistula is an abnormal passage between two parts of the intestine or the intestine and the skin, bladder, or vagina. A fistula between two portions of the bowel allows food to bypass certain areas of the bowel and causes malabsorption. A fistula between the intestine and the skin, bladder, or vagina causes continuous drainage of bowel contents onto the skin or into the bladder or vagina. This can cause infections. Fissures are cracks in the skin. Infections can be a complication of both of these conditions.
Additional Handout – Crohn’s Disease- National Digestive Diseases Information Clearinghouse
The Crohn’s and Colitis Foundation of America is a non-profit, volunteer-driven organization dedicated to finding the cure for Crohn’s disease and Ulcerative Colitis.
The goal of treatment is to relieve symptoms, control the inflammation, and prevent complications. No treatment is necessary if there are no symptoms present. Mild symptoms of diarrhea are controlled with antidiarrheal agents and dietary fiber. If symptoms are more severe, anti-inflammatory drugs such as sulfasalazine and corticosteroids are given. If infections are present from fistulas and fissures, antibiotics such as metronidazole may be effective. Pain relievers and a hot water bottle can provide relief from abdominal pain and cramping. If malnutrition is present, vitamin and mineral supplements are needed.
About 70% of individuals with Crohn’s disease will require surgery for the disease at some point in their life. During surgery, a portion of the bowel is removed. An ileostomy, with a plastic pouch to collect stool, is generally done. The surgery is often done to control the complications.
The DOs
The DON’Ts
Derived from Patient Teaching Guide, © Mosby, Inc. All Rights Reserved.
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