Everything you need to know about Crohn's disease, from causes to treatment options
By Michele Bloomquist
Doctors don't know much about the underlying causes of Crohn's disease, a condition marked by chronic digestive troubles. Still, the information that is currently available can help you learn to manage this often uncomfortable and unpleasant condition in order to live as close to the normal you knew before your diagnosis.
What Is Crohn's Disease?
Crohn's disease is an inflammation of the digestive (or gastrointestinal) tract, with painful symptoms such as constant stomach upset, bouts of diarrhea, and bowel obstructions. About 500,000 people in the United States are affected by Crohn's disease, and it's likely that many more suffer from it but haven't been diagnosed.
Crohn's affects men and women about equally, and it may run in families. About 20 percent of those with Crohn's have a close family member (a parent or sibling) with the same symptoms. Crohn's can occur at any age, but most people first experience symptoms between the ages of 15 and 35.
The Symptoms of Crohn's Disease
The most common symptoms of Crohn's disease are abdominal pain and diarrhea. Rectal bleeding, weight loss, arthritis, skin problems, anemia, and fever can also occur. The symptoms can come and go, and they can be worse in some people than in others.
What Causes Crohn's Disease?
Doctors and researchers aren't sure exactly what causes Crohn's. Some speculate that the disease is an autoimmune reaction to normal substances in the gut (like bacteria and food) that the immune system mistakes for foreign invaders and is compelled to "attack." Others believe that genetic abnormalities cause Crohn's. Another possible culprit is thought to be proteins produced by the immune system.
How Is Crohn's Disease Diagnosed?
There is no single medical test that is used to diagnose Crohn's. Instead, a number of tests are often used to detect symptoms: blood tests check for anemia and signs of infection, and stool samples can determine whether blood is present in the GI tract. X-rays of the upper and lower digestive tract can also help confirm a diagnosis of the condition, while a sigmoidoscopy or colonoscopy (procedures in which a small camera attached to a lighted scope is used to see inside the intestine) can show what's going on inside the bowel. In addition, a biopsy of bowel tissue allows doctors to examine the tissue on a cellular level.
Complications of Crohn's Disease
Crohn's is associated with an increased risk for other digestive problems, including bowel obstructions, fistulas (small ulcerlike sores inside the intestine or rectum), fissures (small cracks in the intestinal tract), and infections. Nutritional problems are also common because the inflamed digestive tract often cannot properly absorb nutrients from foods as they pass through it. This nutritional deficit can contribute to additional complications of Crohn's that seemingly have no connection to the digestive tract, including arthritis, skin problems, inflammation in the eyes or mouth, kidney stones, gallstones, and other diseases of the liver and biliary system. Some of these secondary health issues disappear on their own with proper treatment for Crohn's, while others must be treated separately.
How Is Crohn's Disease Treated?
Because Crohn's disease can differ so much from person to person, you and your medical professional may have to try several approaches to find what works best.
Lifestyle changes, medications, nutritional supplementation, and surgery are all options used to treat Crohn's disease.
Drug therapies may consist of anti-inflammatory drugs, cortisone or steroids, immune system suppressors, inflammation-response blockers, antibiotics, antidiarrhea medications, and fluid replacements. Remember, over-the-counter medications, herbs, and supplements are drugs too, so be sure to tell your health care providers about any that you use. That way, they can take steps to reduce the risk of dangerous drug interactions.
Nutritional supplementation may be necessary to offset the bowel's inability to absorb nutrients, especially in children and teens whose long-term growth and development are at risk without proper nutrition. While no specific foods have been implicated in causing Crohn's, some patients report that their symptoms improve when they avoid certain trigger foods. These may include spicy foods, dairy, alcohol, and whole grains.
Between two-thirds and three-quarters of people with Crohn's will have some surgical procedure related to its treatment. Surgery may be needed to relieve symptoms or to treat problems such as bowel obstructions, perforations, abscesses, or bleeding in the intestine. Even after surgery, symptoms can return in other parts of the bowel. Always weigh the decision to undergo surgery carefully with your doctor to determine whether it's the best option in your case.
Can Lifestyle Affect Crohn's?
Taking excellent care of your health is especially important when you have a chronic health condition like Crohn's. The basic habits of healthy living — eating a well-balanced diet, eating in moderation, getting regular exercise, and reducing sources of stress — are critical when you have Crohn's. Bad habits, like smoking and drinking excessively, will make matters worse.
A Future With Crohn's Disease
While Crohn's disease may never be completely cured, there are steps you can take to make living with this illness less painful, difficult, and disruptive to your daily life. Remember, the illness can come and go throughout your lifetime. When Crohn's disease flares up, be sure to take action quickly. Doing so will ensure that you'll be in control of Crohn's disease, not the other way around.