In this section, you or a loved one can find out more about medical treatments and practical information about Crohn's disease. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step toward becoming an active decision-maker in your care plan.
Crohn's disease is an inflammatory bowel disease that causes inflammation and ulcers in your digestive tract. Crohn's disease (CD) is a long-term (chronic) disease that causes all or part of the bowel (gastrointestinal [GI] tract), where food is digested in the body, to become severely inflamed (red and swollen). Crohn's disease causes sores (ulcers) in the bowel. It is one of the two most common conditions associated with inflammatory bowel disease, the other being ulcerative colitis (UC).
These two conditions should not be confused with irritable bowel syndrome (IBS—also called spastic colon or nervous colitis), which is a disorder that affects the muscle contractions of the colon. Irritable bowel syndrome does not involve intestinal inflammation and is a much less serious disease than CD or UC. But the symptoms are very similar, which often leads to misdiagnosis.
Scientists do not yet know what causes Crohn's disease(CD). They suspect that CD inflammation may be caused by a combination of an overactive immune system, environmental factors, the microbiome (bacteria in the colon), and a person's own genetics. It is not clear what is the direct cause of the inflammation or what causes some people's immune systems to "go into overdrive" trying to protect the body. One way the immune system tries to protect the body is through inflammation, and the immune systems of people with CD seem to produce over-reactive, poorly controlled inflammation in the GI tract. Scientists believe that once the CD patient's immune system is "turned on," it does not know how to properly "turn off." As a result, inflammation damages the bowel and causes CD symptoms. This failure of the immune system to "turn off" is why the main goal of medical therapy for CD is to help patients regulate their immune system.
While the causes of CD are not known, there's agreement about what doesn't cause CD. Scientists no longer believe that diet and stress can cause CD. However, stress, certain foods or inadequate nutrition may aggravate symptoms, so easing stress and maintaining a proper diet and good nutrition can really help reduce the frequency and severity of CD symptoms.
Scientists suspect that genes may play a role. It is not yet completely understood how or why certain genes or changes in genes are associated with CD, but it is a major focus of current research. People who have a parent, sibling or child with CD have a much higher risk of developing it themselves.
Normally, the immune cells protect the body from infection. In people with CD, however, the immune system mistakes food, non-harmful bacteria and other things that are supposed to be in the bowel for substances that pose a threat. In response, it attacks the bowel lining and produces chronic inflammation. This inflammatory reaction continues without proper control, which then damages the bowel wall. When the bowel wall is damaged, CD symptoms occur, such as diarrhea and abdominal pain.
Risk factors are personal characteristics that are known to be associated with a greater likelihood of having a disease or condition. But these risk factors, such as age or where you live, do not necessarily cause CD. Also, absence of a risk factor may not mean protection from CD.
Risk factors may include:
The severity of Crohn's disease (CD) symptoms can differ widely from person to person and depends on many factors including how much of the colon is affected. The digestive system is the part of the body that is affected most directly, but complications can potentially affect other parts of the body as well.
In addition to inflammation and ulcers in the bowel, CD can cause problems in other parts of the body, such as arthritis, inflammation of the eyes or skin, clubbing of the fingernails, kidney stones, gallstones and, occasionally, inflammation of the bile ducts. People with long-standing CD may also develop osteoporosis, a condition that causes bones to become weak and brittle.
People with CD suffer a wide range of symptoms, most of them mild to moderate, depending on which part of the colon is affected. The disease is usually relapsing and remitting, which means that there can be periods of disease flare (active disease) and remission (temporary end to the medical signs and symptoms).
Common symptoms include:
Crohn's disease affects all the layers of the bowel wall – causing inflammation and swelling, as well as ulcers . In turn, this irritation may lead to bleeding. It also prevents the bowel from absorbing nutrients from food.
If you have CD, you may experience any or all of the following symptoms:
A sudden change or worsening of pain may indicate a complication (see below), so you should speak to your healthcare provider immediately if one is suspected.
Unexplained weight loss
Failure to grow (in children)
Loss of appetite
The symptoms can be exhausting and may also reduce your appetite. Diarrhea, cramping, and pain can even become worse when you eat because of the increased intestinal activity afterwards. But Crohn's disease is not the same in everyone. The severity of symptoms varies depending on the level of immune system activity and which areas of the bowel are affected. And symptoms may change over time.
Call a doctor right away if you have been diagnosed with CD and you have one or more of the following symptoms, because your condition may have worsened:
Fever over 101°F (38.3°C) or shaking chills
Lightheadedness, passing out or rapid heart rate
Stools that are almost always bloody
Severe dehydration, such as passing little or no urine for 12 or more hours
Severe belly pain or severe pain and bloating
Evidence of pus draining from the area around the anus, or pain and swelling in the anal area
Not passing any stools or gas
For most people, regardless of having Crohn's disease (CD) or not, exercise, healthy eating and good sleep habits are recommended. A healthy lifestyle can lead to enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.
While diet is not thought to cause CD, people experiencing symptoms of the disease often find some foods aggravating. It may be helpful to keep (and regularly review) a food diary to better understand how your body is reacting to various foods. Many people find soft, bland foods make them feel better than spicy ones. Several small meals may work better than two or three large ones. If you are lactose intolerant, you may want to avoid dairy products.
In addition, chronic diseases like CD tend to increase the body's energy needs. Since CD can cause a loss of appetite, staying nourished make take extra effort. In general, it's best to maintain a high-quality, well-balanced diet with ample fluids. Working with a registered dietitian may be beneficial.
Even light exercise, especially when done regularly, can help reduce stress, improve mood and normalize bowel function.
Vitamins and probiotics
As long as their own doctors agree, people with Crohn's disease (CD) may benefit from vitamin supplementation as well as introduction of "good" bacteria into the intestine.
People with CD may want to manage stress by using methods that focus on the connection between emotions, the body and individual health. Examples include tai chi, biofeedback, hypnosis, yoga and meditation.
The goals of medical treatment for Crohn's disease (CD) are :
Absence of symptoms (achieving remission)
Preventing flares of disease (maintaining remission)
Improving personal quality of life
Healing the gut
Medications: The goal of treating CD is to decrease or stop the inflammation. The type of medication that is prescribed depends on the severity of the disease. Common medications that can decrease inflammation are corticosteroids , immunomodulators and drugs known as biologics, which target specific pathways believed to be involved in the disease.
Other medications may include:
Surgery is usually used an option after medical treatment fails. While no one wants to have an operation, sometimes it's the only way to control symptoms when medication is no longer effective.
Surgery options for Crohn's disease: Surgical options for CD vary and depend on the amount of inflammation in the bowel. If surgery is an option, talk to your doctor about what surgery is right for you.
Surgeries often used in CD are:
Source: Crohn's & Colitis foundation of America - www.ccfa.org