What is Crohn’s Disease?
Named after Dr. Burrill B. Crohn, who first described the disease in 1932 along with
colleagues Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer, Crohn’s disease belongs
to a group of conditions known as Inflammatory Bowel Diseases (IBD). Crohn’s disease
is a chronic inflammatory condition of the gastrointestinal tract.
When reading about inflammatory bowel diseases, it is important to know that Crohn’s
disease is not the same thing as ulcerative colitis, another type of IBD. The symptoms of
these two illnesses are quite similar, but the areas affected in the gastrointestinal tract (GI
tract) are different.
Crohn’s most commonly affects the end of the small bowel (the ileum) and the beginning
of the colon, but it may affect any part of the gastrointestinal (GI) tract, from the mouth
to the anus. Ulcerative colitis is limited to the colon, also called the large intestine.
Crohn’s disease can also affect the entire thickness of the bowel wall, while ulcerative
colitis only involves the innermost lining of the colon. Finally, in Crohn’s disease, the
inflammation of the intestine can “skip”-- leaving normal areas in between patches of
diseased intestine. In ulcerative colitis this does not occur.
Recognizing the Signs and Symptoms
Crohn’s disease can affect any part of the GI tract. While symptoms vary from patient to
patient and some may be more common than others, the tell-tale symptoms of Crohn’s
disease include:
Symptoms related to inflammation of the GI tract:
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Persistent Diarrhea
Rectal bleeding
Urgent need to move bowels
Abdominal cramps and pain
Sensation of incomplete evacuation
Constipation (can lead to bowel obstruction)
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General symptoms that may also be associated with IBD:
Fever
Loss of appetite
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Weight Loss
Fatigue
Night sweats
Loss of normal menstrual cycle
Even if you think you are showing signs of Crohn’s Disease symptoms, only proper
testing performed by your doctor can render a diagnosis.
People suffering from Crohn’s often experience loss of appetite and may lose weight as a
result. A feeling of low energy and fatigue is also common. Among younger children,
Crohn's may delay growth and development.
Crohn's is a chronic disease, so this means patients will likely experience periods when
the disease flares up and causes symptoms, followed by periods of remission when
patients may not notices symptoms at all.
In more severe cases, Crohn’s can lead to tears (fissures) in the lining of the anus, which
may cause pain and bleeding, especially during bowel movements. Inflammation may
also cause a fistula to develop. A fistula is a tunnel that leads from one loop of intestine
to another, or that connects the intestine to the bladder, vagina, or skin. This is a serious
condition that requires immediate medical attention.
The symptoms you or your loved one experience may depend on which part of the GI
tract is affected. Read more about the Types of Crohn's Disease and Associated
Symptoms.
What are the Causes of Crohn’s Disease? Who is Affected?
Crohn’s disease may affect as many as 700,000 Americans. Men and Women are equally
likely to be affected, and while the disease can occur at any age, Crohn's is more
prevalent among adolescents and young adults between the ages of 15 and 35.
The causes of Crohn’s Disease are not well understood. Diet and stress may aggravate
Crohn’s Disease, but they do not cause the disease on their own. Recent research suggests
hereditary, genetics, and/or environmental factors contribute to the development of
Crohn’s Disease.
The GI tract normally contains harmless bacteria, many of which aid in digestion. The
immune system usually attacks and kills foreign invaders, such as bacteria, viruses, fungi,
and other microorganisms. Under normal circumstances, the harmless bacteria in the
intestines are protected from such an attack. In people with IBD, these bacteria are
mistaken for harmful invaders and the immune system mounts a response. Cells travel
out of the blood to the intestines and produce inflammation (a normal immune system
response). However, the inflammation does not subside, leading to chronic inflammation,
ulceration, thickening of the intestinal wall, and eventually causing patient symptoms.
Crohn’s tends to run in families, so if you or a close relative have the disease, your family
members have a significantly increased chance of developing Crohn’s. Studies have
shown that 5% to 20% of affected individuals have a first – degree relative (parents,
child, or sibling) with one of the diseases. The risk is greater with Crohn’s disease than
ulcerative colitis. The risk is also substantially higher when both parents have IBD. The
disease is most common among people of eastern European backgrounds, including Jews
of European descent. In recent years, an increasing number of cases have been reported
among African American populations.
The environment in which you live also appears to play a role. Crohn’s is more common
in developed countries rather than undeveloped countries, in urban rather than rural areas,
and in northern rather than southern climates.
Crohn’s Diagnosis & Testing
Crohn’s disease is characterized by a range of signs and symptoms, so there is no single
test that can determine the diagnosis of Crohn's with certainty.
Crohn’s disease symptoms are often similar to other conditions, including bacterial
infection. To diagnose you with Crohn’s, doctors need to evaluate a combination of
information and begin to exclude other potential causes of your symptoms. This process
can take some time. Should you or a loved one experience symptoms, be sure to see your
doctor as soon as possible.
Early Tests and Exams
First, your doctor will conduct a standard physical exam of your body and interview you
to learn more about your general health, diet, family history, and environment. Bring a
record of your symptoms.
Early steps in the diagnostic process can include laboratory tests of blood and stool
matter, as well as X-rays of the upper and lower GI tract including the use of Barium, a
chemical that helps doctors see more details of your GI tract by increasing contrast of the
X-Ray image.
Endoscopy and Biopsy
Your doctor may recommend an endoscopy, which is the use of medical instruments to
visually examine the interior of your colon with a small camera mounted to the end of a
lighted tube. There are two types of endoscopic examinations: a colonoscopy and an
upper endoscopy.
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Colonoscopy involves insertion of a flexible tube through the opening of the anus and
allows for the examination of the colon, the lowest part of the large intestine.
Upper Endoscopy involves the insertion of a flexible tube through the opening of the
mouth, down the esophagus, into the stomach, and as far as the duodenum, the first
part of the small intestine.
In addition to a visual examination, doctors will often wish to obtain a biopsy of the
colon or other affected areas by removing a small piece of tissue. Biopsied tissues are
then analyzed in pathology to determine the presence of disease.
While endoscopy and biopsy may sound invasive, modern medical technology and
techniques have made these procedures virtually painless and easily accomplished during
an outpatient visit.
Crohn’s Treatment Options
A combination of treatment options can help you stay in control of your disease and help
you to lead a full and rewarding life. Remember that there is no standard treatment that
will work for all patients. Each patient’s situation is different and treatment must be
followed for each circumstance.
Treatment for Crohn’s and other IBD varieties can include the use of medication,
alterations in diet and nutrition, and sometimes surgical procedures to repair or remove
affected portions of your GI tract.
Medication
Medication treating Crohn’s disease is designed to suppress your immune system’s
abnormal inflammatory response that is causing your symptoms. Suppressing
inflammation not only offers relief from common symptoms like fever, diarrhea, and
pain, it also allows your intestinal tissues to heal.
In addition to controlling and suppressing symptoms (inducing remission), medication
can also be used to decrease the frequency of symptom flare ups (maintaining remission).
With proper treatment over time, periods of remission can be extended and periods of
symptom flare ups can be reduced.
Several types of medication are being used to treat Crohn's disease today. Read more
about Crohn’s disease Medication.
Diet & Nutrition
While Crohn’s Disease may not be the result of bad reactions to specific foods, paying
special attention to your diet may help reduce symptoms, replace lost nutrients, and
promote healing.
For people diagnosed with Crohn’s disease, it is essential to maintain good nutrition
because Crohn’s often reduces your appetite while increasing your body’s energy needs.
Additionally, common Crohn’s symptoms like diarrhea can reduce your body’s ability to
absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.
Many people who experience Crohn's disease flare ups find that soft, bland foods cause
less discomfort than spicy or high-fiber foods. While your diet can remain flexible and
should include a variety of foods from all food groups, your doctor will likely
recommend restricting your intake of dairy if you are found to be lactose-intolerant.
Surgery
Even with proper medication and diet, as many as two-thirds to three-quarters of people
with Crohn's disease will require surgery at some point during their lives. While surgery
does not cure Crohn's disease, it can conserve portions of your GI tract and return you to
the best possible quality of life.
Surgery becomes necessary when medications can no longer control symptoms, or if you
develop a fistula, fissure, or intestinal obstruction. Surgery often involves removal of the
diseased segment of bowel (resection), the two ends of healthy bowel are then joined
together (anastomosis). While these procedures may cause your symptoms to disappear
for many years, Crohn’s frequently recurs later in life.
Key things to know about Surgery:
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About 70% of people with Crohn’s disease eventually require surgery.
Different types of procedures may be performed depending on the reason, severity of
illness, and location of the disease.
Unlike ulcerative colitis, surgery does not cure Crohn’s disease.
Approximately 30% of patients who have surgery for Crohn’s disease experience
recurrence of their symptoms within three years and up to 60% will have recurrence
within ten years.
Retrieved from: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/
http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohnsdiagnosis-testing.html
http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohnstreatment-options.html
Revised: 2013