Crohn’s disease is a chronic condition that causes digestive tract inflammation. It produces abdominal symptoms and can result in other health problems, too.
Crohn’s disease and ulcerative colitis are the most common inflammatory bowel diseases (IBDs). But, while ulcerative colitis affects only the large intestine, Crohn’s disease causes inflammation throughout the entire digestive tract, the Centers for Disease Control and Prevention (CDC) explains.
Although Crohn’s disease most often affects the small intestine and the beginning of the large intestine, it can impact any part of your digestive tract. Sometimes it can cause symptoms that seem unrelated to your gastrointestinal (GI) system, like fatigue and skin problems.
Crohn’s disease it is not a rare disorder. About half a million Americans have the condition, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). What’s more, studies show the incidence of Crohn’s disease is increasing in the U.S. and some other parts of the world, although experts don’t understand why, the NIDDK notes.
What is Crohn’s disease caused by and who’s at risk?
Crohn’s disease occurs about equally in men and women. Although it can develop at any age, it’s more likely to first occur between the ages of 20 and 29. The specific cause of Crohn’s hasn’t been pinpointed yet, but it is not caused by eating a certain food or because of psychological stress, the NIDDK emphasizes.
Instead, researchers believe an autoimmune reaction — an abnormal immune system response that results in your own immune system attacking healthy cells — may trigger Crohn’s. This immune system response causes inflammation, the CDC explains, which results in Crohn’s disease symptoms.
Known factors that significantly raise the risk of developing Crohn’s disease include having a family member (most often a parent, brother, or sister) diagnosed with Crohn’s, or another IBD, and smoking, which doubles your risk of developing the disease. Taking nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin and ibuprofen, birth control pills, and antibiotics appears to slightly increase the chance of developing Crohn’s disease, as does eating a high-fat diet, according to the NIDDK.
Symptoms of Crohn’s disease
Crohn’s disease often begins slowly with a few symptoms and may become worse over months. Some people have periods of remission, when most of their symptoms disappear for weeks and even years, but then they return.
Symptoms can vary person to person and depend on what part of the GI tract is affected. According to the Crohn’s and Colitis Foundation, the most common signs of Crohn’s due to inflammation in the gastrointestinal tract include:
- Persistent diarrhea
- An urgent need to move your bowels
- Chronic constipation (which can lead to bowel obstruction)
- Rectal bleeding
- Abdominal cramps and pain
- A sensation of an incomplete bowel movement
The NIDDK points out Crohn’s can also cause these symptoms:
- Weight loss
- Nausea or loss of appetite
- Joint pain or redness
- Red, tender bumps under the skin
- Red or painful eyes
Diagnosing and treating Crohn’s disease
To diagnose Crohn’s disease, your doctor will discuss your symptoms and medical and family history, and a perform a physical exam to see if your abdomen is tender or swollen and if your liver or spleen is enlarged.
A series of diagnostic tests are usually ordered to rule out other conditions (such as diverticular disease, ulcerative colitis, and certain GI cancers) that can produce symptoms similar to those of Crohn’s disease.
Blood tests (to check for anemia and inflammation), stool tests, a colonoscopy, an upper GI endoscopy, and imaging of the abdomen with a CT (computed tomography) scan are the primary diagnostic tools your doctor will use to diagnose Crohn’s.
The good news is that treatment can relieve symptoms and control Crohn’s disease . Therapy, especially for mild-to-moderate Crohn’s, usually involves aminosalicylates, a type of anti-inflammatory specifically prescribed for the disease. Corticosteroids (steroids) are used to calm an overactive immune system and lessen inflammation in people with moderate-to-severe Crohn’s symptoms. Immunomodulators are additional medications often prescribed to reduce digestive tract inflammation; they can be very effective but may take weeks to months to relieve symptoms.
If Crohn’s disease symptoms are severe, your doctor will likely advise you to rest your GI tract for several days or weeks by following a prescribed nutrient-rich, liquid diet. In cases where symptoms are disabling, a feeding tube or IV nutrition may be used during a hospital stay or administered at home.
Despite medications and resting the GI tract, many people who have Crohn’s eventually need surgery due to complications, including internal bleeding, fistulas, and intestinal obstructions. The NIDDK emphasizes that although surgery cannot cure Crohn’s disease, it can greatly relieve symptoms and improve quality of life when other treatments have not been adequate.
April 27, 2021
Janet O’Dell, RN