Unlike ulcerative colitis, which only affects the inner layer of the digestive tract, Crohn’s disease commonly involves all layers of the intestinal wall. Crohn’s disease and ulcerative colitis are collectively called inflammatory bowel disease (IBD).
Symptoms of Crohn's Disease
The symptoms of Crohn’s disease include:- Abdominal pain and cramps
- Bloody stool
- Diarrhea
- Fever
- Loss of appetite
- Mucus in the stool
- Ulceration of the digestive tract
Causes of Crohn's Disease
There are theories about the cause of Crohn's disease, and IBD in general, but IBD is an idiopathic disease (a disease with unknown cause). Crohn's disease does tend to run in families, especially in those of Jewish descent (Ashkenazi Jews in particular), although most people with IBD don't have a family history of the disease.One theory about the cause of IBD is that it could be an allergic response, largely based on the fact that IBD is an autoimmune disease. Environmental factors have also been implicated, but there is no consensus in the medical community as to exactly which factors might influence the onset of IBD.
The true cause of IBD could still be any combination of these, or even a causative agent that is yet undiscovered.
How Crohn's Disease is Diagnosed
A physician might first suspect Crohn's disease based on a history of symptoms such as pain, diarrhea, unintended weight loss, and blood in the stool. One or more different diagnostic tools can help to make a diagnosis of Crohn's disease.Colonoscopy may be used to look inside the colon to see if inflammation is present, or an upper endoscopy may be done if disease in the upper digestive tract is suspected. Several other tests such as x-rays, barium enema, upper gastrointestinal series, and sigmoidoscopy may also be helpful.
Blood tests are also commonly done to provide helpful information about the status of IBD, especially red blood cell and white blood cell counts. Other blood tests can measure electrolyte levels, such as sodium and potassium, to determine if they are depleted from persistent diarrhea.
Treatment for Crohn's Disease
Medication: A variety of medications may be used to treat Crohn's disease. Medications typically fall into two categories: Maintenance drugs, which are taken continuously to prevent flare-ups, and fast-acting drugs, which are taken to stop a flare-up.Medications frequently used to treat Crohn's disease include: Azulfidine (sulfasalazine); Asacol and Pentasa (mesalamine); Imuran (azathioprine); Purinethol (6-MP, mercaptopurine); cyclosporine; Rheumatrex (methotrexate); Remicade (infliximab); Humira (adalimumab); and corticosteroids (such as prednisone and Entocort EC (budesonide)).
Surgery: Surgery is also used as a treatment for Crohn's disease. Approximately 70% of people with Crohn's disease will have surgery in the first 10 years after diagnosis. Of those, half will have more surgery in the next 3 to 4 years. Resection, where a diseased section of intestine is removed, is the most common type of surgery. Surgery is not a cure for Crohn's disease.
Alternative Therapies for Crohn's Disease
Alternative and complementary treatments are popular with people who have IBD. Many of these types of treatments have not been rigorously studied, nor have they been shown to be ineffective, but a few have some future promise for treating Crohn's disease.Omega-3 fatty acids have had mixed results as a treatment for Crohn's disease, but they are considered a healthy addition to anyone's diet.
Boswellia (frankincense) has been studied for use in IBD, but it is currently not approved to treat any condition.
Slippery elm has been found to have antioxidant effects, but further study is needed to determine if it is helpful for use in IBD.
Bromelain has shown promise in animal studies, but there are no studies on humans yet.
Forms of Crohn's Disease
Different terms are used to describe Crohn's disease, depending on what part of the digestive tract is affected.The most common form of Crohn's disease is ileocolits, which affects the ileum (lower end of the small intestine) and the colon (large intestine). Ileitis, also known as fistulizing or perforating Crohn's disease, affects only the ileum. Gastroduodenal Crohn's disease affects the stomach and duodenum (first part of the small intestine). Jejunoileitis is characterized by intermittent areas of inflammation in the jejunum (middle section of the small intestine). Crohn's colitis, sometimes called granulomatous colitis, affects only the colon and is sometimes confused with ulcerative colitis.
Colorectal and Small Bowel Cancer
For people with Crohn's disease, there are several factors that seem to affect the risk of developing colorectal cancer. These risks include:- a young age at diagnosis
- 8 to 10 years of active disease
- incidence of strictures
- history of primary sclerosing cholangitis
Related Problems
Extra-intestinalSeveral complications are associated with Crohn's disease, and those that manifest outside the colon are called extra-intestinal complications. Extra-intestinal complications include arthritis, delayed growth in children, eye diseases, gallstones, skin conditions, and mouth ulcers. Most of these complications will worsen when the Crohn's disease is flaring and improve when it is in remission.
Intestinal
Some of the potential local (intestinal) complications of Crohn's disease include abscesses; bowel obstruction; bowel perforation; colorectal cancer; fissures; fistulas; toxic megacolon; and worsening of symptoms during menstruation.
