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Crohn's Disease

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Crohn's Disease

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Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain, and weight loss.

Medically reviewed by

Dr. Jagdish Singh

Published At June 14, 2019
Reviewed AtApril 25, 2024

What Is Crohn's Disease?

Crohn’s disease, otherwise called ileitis or enteritis, causes inflammation of the digestive tract (anywhere from the mouth to the anus) and is a type of inflammatory bowel disease (IBD). It causes inflammation of different parts of the digestive tract for different people, but the ileum (lower part of the small intestine) is the most commonly affected. It is a painful and debilitating condition that can also lead to life-threatening complications. This condition cannot be treated, but many therapies help manage the signs and symptoms and help people affected by this disease live almost normal lives.

What Are the Types of Crohn’s Disease?

Based on the location, the six types of this disease are:

  • Gastroduodenal Crohn’s Disease - Affects the stomach and duodenum.

  • Jejunoileitis - Affects the jejunum, which is the second portion of the intestine.

  • Ileitis - Affects the ileum, the last part of the intestine.

  • Ileocolitis - Affects the ileum and colon.

  • Crohn’s Colitis - Affects only the colon.

  • Perianal Disease - Causes fistula, deep infections, sores, and ulcers around the anus.

What Are the Stages of Crohn’s Disease?

  • Crohn's disease progresses from mild to moderate to severe. While diarrhea or stomach pain is possible in those with mild to moderate Crohn's disease, no other symptoms or consequences will occur.

  • In addition to other symptoms and problems, diarrhea and abdominal pain are possible in people with moderate to severe anti-diarrheal medications, which are meant for those with mild to moderate disease but do not alleviate symptoms.

  • When Crohn's disease reaches its severe stage, its symptoms disrupt everyday life. Pain and discomfort and frequent restroom breaks are needed. At this point, inflammation is common, and there's a chance that the tissues could get permanently damaged.

What Are the Signs and Symptoms of Crohn’s Disease?

Depending on the severity of the disease, the signs and symptoms can vary from mild to debilitating.

Early Symptoms:

  • Abdominal pain.

  • Abdominal cramps.

  • Diarrhea.

  • Blood in stools.

  • Fever.

  • Fatigue.

  • Mouth sores.

  • Weight loss.

  • Loss of appetite.

  • Frequent urges to empty bowel.

  • The feeling of incomplete defecation.

Severe Symptoms:

  • Drainage near or around the anus (perianal fistula).

  • Joints inflammation.

  • Inflammation of the skin.

  • Peptic ulcers.

  • Shortness of breath.

  • Inflammation of the liver or bile ducts.

  • Late sexual development in kids.

What Are the Symptoms of Crohn’s Disease Seen in Females?

In addition to the symptoms mentioned above, this disease can cause the following symptoms in females:

What Causes Crohn’s Disease?

The exact cause of this disease is still not known, but some factors affect the severity of the symptoms. Some of the factors that seem to play a role in causing this disease are:

  • The immune system.

  • Genetics.

  • Environmental factors.

What Are the Risk Factors for Crohn’s Disease?

Factors that increase the severity of this disease are:

  • Smoking.

  • People younger than 30 years.

  • Involvement of the rectum.

  • Duration of the disease.

  • Intestinal infections.

  • Use nonsteroidal anti-inflammatory medicines (NSAIDs) like Ibuprofen, Diclofenac, and Naproxen.

  • Living in urban areas.

What Are the Possible Complications of Crohn’s Disease?

Some of the local complications are:

  • Bowel obstruction - Scar formation might narrow the intestinal passage, preventing the flow of digestive contents.

  • Ulcers - Open sores anywhere from the mouth to the anus.

  • Fistulas - In severe cases, the ulcers can extend through the intestinal wall, leading to fistulas, which are connections between the skin or other organs and the intestines.

  • Anal fissure - A tear in the tissue that lines the anus.

  • Colon cancer - Inflammation of the intestine might lead to colon cancer.

  • Malnutrition - The inability to eat properly might lead to malnutrition.

  • Malabsorption - This can affect the ability of the small intestine to absorb nutrients from food.

Systemic complications include:

  • Arthritis.

  • Skin problems like erythema nodosum, skin tags, and pyoderma gangrenosum.

  • Bone loss.

  • Iron and vitamin B12 deficiency.

  • Eye problems like uveitis and scleritis.

  • Kidney problems like kidney stones and fistulas.

  • Liver problems.

  • Gallstones.

  • Pancreatitis.

  • Delayed puberty.

How to Diagnose Crohn’s Disease?

As there is no specific test to diagnose this condition, your doctor will try to eliminate all other conditions that cause similar symptoms with the help of the following tests:

  • Blood test - To look for anemia and inflammation.

  • Fecal occult blood test - To detect blood in the digestive tract.

  • Endoscopy - To diagnose any possible cause in the upper digestive tract.

  • Colonoscopy - To examine the large intestine.

  • CT (computed tomography) or MRI (magnetic resonance imaging) scan.

  • Biopsy - The doctor might take a tissue sample during endoscopy or colonoscopy.

What Is the Treatment for Crohn’s Disease?

Currently, there is no cure for this disease. Treatment aims at reducing the inflammation that triggers all the signs and symptoms. Managing symptoms helps reduce the incidence of complications and recurrence. The treatment options include:

Medications:

  • Corticosteroids - Prednisone and Budesonide.

  • Aminosalicylates - Sulfasalazine.

  • Immunosuppressant drugs - Azathioprine, Mercaptopurine, Infliximab, Methotrexate, Natalizumab, and Ustekinumab.

  • Antibiotics - Metronidazole and Ciprofloaxacin.

  • Anti-diarrheal medicines - Psyllium powder, Methylcellulose, and Loperamide.

  • Painkillers - Paracetamol, Ibuprofen, and Naproxen.

  • Iron supplements.

  • Vitamin B12 injections.

  • Calcium supplements.

  • Vitamin D supplements.

Lifestyle Changes:

  • Avoid foods and drinks that aggravate your symptoms.

  • Avoid smoking.

  • Manage stress.

  • Exercise regularly.

  • Perform breathing and relaxation exercises.

Alternative Medicine:

  • Probiotics.

  • Herbal supplements.

  • Nutritional supplements.

  • Acupuncture.

  • Fish oil.

  • Prebiotics.

Surgery:

If the other treatment options do not help relieve the symptoms, your doctor might recommend surgery. Surgery is performed to close fistulas, drain abscesses, and remove the damaged portion of the gastrointestinal tract.

What Food to Eat and Not to Eat with Crohn’s Disease?

Food to Avoid:

  • Alcoholic beverages.

  • Caffeinated drinks.

  • Sugary beverages.

  • Whole grain bread.

  • Brown rice.

  • Dairy products with added fibers.

  • Fatty foods like coconut, nuts, and poppy seeds.

  • Raw fruits and fruit juice with pulps.

  • High-protein food items like fried eggs, beans, peas, etc.

  • Sweets.

  • Vegetables like broccoli, cabbage, cauliflower, greens, corn, onions, peppers, beets, and parsnips.

Foods to Include:

  • Decaffeinated drinks.

  • Low-fiber bread.

  • White rice.

  • Dairy products if they do not worsen your symptoms.

  • Fats that can be included are ghee, butter, oils, and mayonnaise.

  • Peeled fruits like bananas and pulp-free juices.

  • Proteins like fish, hard-boiled eggs, soy products, and poultry.

  • Vegetables like asparagus, seedless vegetables, eggplant, potatoes, and pumpkin.

Conclusion

As such, Crohn’s disease is not fatal or life-threatening. But, it can lead to complications that can be fatal. Complications like severe infections and colorectal cancer can lead to death. It is better to seek medical help in the initial stages to prevent the worsening of the condition.

Frequently Asked Questions

1.

Is Crohn's Disease a Condition To Be Worried About?

Yes, Crohn's disease is a condition to be worried about. This condition can be both debilitating and painful in the affected individuals. This condition might lead to life-threatening complications. One prominent reason to worry about Crohn's disease is that it has no complete cure. The signs and symptoms might also last for a long period of time.

2.

What Are the Types of Crohn's Disease?

There are five major types of Crohn's disease, and they are as follows:
- Ileocolitis, which is the most common type of Crohn's disease.
- Ileitis.
- Gastroduodenal Crohn's Disease.
- Jejunoileitis.
- Crohn's granulomatous colitis.

3.

What Are the Symptoms of a Crohn's Attack?

The following are the various symptoms that can be seen in a patient who is affected by Crohn's disease:
- Diarrhea.
- Fever.
- Fatigue.
- Abdominal pain is cramping in character.
- Blood in your stool.
- Mouth sores.
- Loss of appetite.
- Loss of weight.
- Pain and drainage in and around the anus, which is primarily due to inflammation.

4.

What Is the Normal Life Expectancy of a Person With Crohn's Disease?

The diagnosis of Crohn's disease in most patients is typically made between 15 and 35. The condition is not usually noted to shorten life expectancy. Thus, most people who are affected by Crohn's disease enjoy good and rewarding lives.

5.

Can Crohn's Go Away by Its Own?

No, in most people, Crohn's disease does not go away on its own. Treatment is usually the only way to prevent Crohn's from getting into remission. If this condition is not treated, it will probably get aggravated and lead to serious complications.

6.

Can Crohn's Disease Be Treated?

There is no cure for Crohn's disease to date. There is also no single mode of treatment that works on all affected individuals with Crohn's. Primary medical treatment aims to decrease the inflammation rate that triggers the affected individual's signs and symptoms. It is also known to improve the long-term prognosis rate by limiting the incidence of complications.

7.

What Foods Should Be Avoided in Crohn's Disease?

The following are the foods that should be avoided in a patient who is diagnosed to have Crohn's disease:
- Alcoholic beverages.
- Butter.
- Mayonnaise.
- Margarine.
- Carbonated beverages such as soda.
- Coffee
- Tea.
- Chocolate.
- Corn.
- Dairy products, especially if the patient is noted to be lactose intolerant.
- Fatty foods, such as french fries.

8.

What Happens if Crohn's Disease Is Left Untreated?

If Crohn's disease is left untreated in patients, in addition to the pain they experience, they might also have bleeding and changes in their bowel movement. They might have difficulty in absorbing nutrition. This can often lead to malnourishment, anemia, and crippling fatigue. In untreated Crohn's disease cases, the lesion might spread throughout the intestinal tract, leading to severe symptoms and a bad prognosis.

9.

Does Crohn's Disease Cause Bloating Symptoms?

Ulcerative Colitis and Crohn's Disease are the two primary types of inflammatory bowel diseases (IBD). Both conditions can frequently make the affected individual feel bloated and gassy.

10.

Is Crohn's Disease a Rare Condition?

Yes, Crohn's disease is considered to be a very rare condition. This condition's incidence is noted to be an approximate number of about 500 confirmed cases only in the United States of America.

11.

Does Crohn's Get Aggravated With Age?

Yes, Crohn's disease can get aggravated with age. Adults diagnosed with these conditions after the age of 50 are more likely to get remissions of their symptoms.

12.

Can Crohn's Disease Affect My Eyes?

Yes, Crohn's disease can affect your eyes. Usually, inflammatory bowel diseases are commonly associated with digestive symptoms only. However, an approximate of up to 10 percent of people with Crohn's disease may also experience irritation and inflammatory symptoms in one or both eyes. Crohn's related eye disorders can be severely painful. In rare cases, they may even result in vision loss.

13.

What Foods Can I Eat if I Have Crohn's Disease?

The following are the foods that you can eat when you have Crohn's disease:
- Oat bran.
- Beans.
- Barley.
- Nuts.
- Whole grains.
- Lean meats.
- Fish.
- Eggs.
- Nuts.
- Tofu.

14.

How Do I Gain Weight With Crohn's Disease?

Exercise can help in boosting your appetite. Being active aids in strengthening bones and muscles, both of which are usually noted to be weakened by Crohn's disease. Building muscle can significantly help you in gaining weight.

15.

Why Does Crohn's Make Me Fatigue?

When you have Crohn's disease, there are chances that you might also have intestinal bleeding. This can cause anemia since Crohn's might also make it difficult for your intestine to intake in iron and other nutrients. So, you have decreased blood levels to carry oxygen to the rest of your body, which makes you feel fatigued.

16.

What Is the Best Mode of Treatment for Crohn’s Disease?

There is currently no cure for Crohn's disease, and there is no single modality of treatment that uniformly works for everyone. Medical treatment's primary goal is to reduce the inflammation that tends to be the main trigger of the person's signs and symptoms. It aims to enhance long-term survival by limiting complications.

17.

Can I Live a Normal Life if I Have Crohn's?

Various studies have proven that people with Crohn's disease more frequently have the same life expectancy as normal people. It is essential to remember and understand that most people affected by Crohn's disease lead full, happy, and productive lives.

18.

Can Yoghurt Relieve Crohn's Disease?

Live-cultured yogurt is usually noted to be a great food to eat when a person is diagnosed with Crohn's disease. The probiotics in this form of yogurt can significantly aid with the recovery of the inflamed intestine. But the patient might need to avoid yogurt if he or she usually has trouble digesting dairy proteins.

19.

Can Crohn's Disease be a Permanent Disability?

Yes, the department of social security considers the individuals belonging to the category of severe Crohn's disease to be having a significant impairment. They also consider that this disease process can prevent the individual from performing substantial routine work. Thus, Crohn's disease is considered to be a permanent disability.

20.

What Factors Can Aggravate Crohn's?

The following are the factors that can aggravate Crohn's disease:
- Intake of food that is noted to be a trigger to an acute flare-up reaction.
- Infections, more frequently, the common cold.
- Cigarette smoking.
- Anti-inflammatory drugs like Aspirin and Ibuprofen.

21.

Can a Person With Crohn's Eat Chocolate?

No, a person who is diagnosed to have Crohn's disease should avoid the intake of chocolate. This is because chocolate has been listed as an essential trigger of Crohn's disease since they have a certain amount of caffeine.

22.

Does Crohn's Give Me a Bad Odour?

Inflammatory conditions such as Crohn's disease and ulcerative colitis can lead to the development of redness and ulceration. These lesions are more frequently easily identifiable and are also noted to have a characteristic odor. Thus, Crohn's disease can give some patients a bad odor.

23.

Is Crohn's Disease an Autoimmune Disease?

Yes, Crohn's disease is an inflammatory of the gastrointestinal tract that is usually noted to sustain for a long period of time. It is an autoimmune disorder, where a person's own immune system mistakenly attacks the healthy tissue in his or her body.

24.

What Can Help in Relieving Crohn's Pain?

In patients who have mild pain, the doctor usually recommends Acetaminophen. Other common pain relievers, such as Ibuprofen and Naproxen sodium, are contraindicated. These drugs are more likely to aggravate your symptoms and can make your disease progress to a worse stage as well.

25.

How Are You Diagnosed With Crohn's?

There is no single diagnostic test that is specific for Crohn's disease. The primary diagnostic tools are the history and physical examination. If the patient shows signs or symptoms of Crohn's disease, his or her doctor might use various diagnostic tests to confirm the diagnosis. The commonly used tools are blood tests, stool tests, imaging tests such as magnetic resonance imaging (MRI), colonoscopy, sigmoidoscopy, and tissue biopsies.

26.

Does Crohn's Increase Bowel Movements?

For most people who are affected with this condition, there are presence bouts of very loose, and watery stools are infrequent. Diarrhea and other associated symptoms can often interfere with regular life.

27.

Does Crohn's Affect the Digestive System?

Yes, Crohn's disease affects the digestive system. This condition typically affects the deeper layers of the digestive epithelium. It is usually noted as "skip lesions" between healthy regions of epithelium. Crohn's disease frequently involves the regions of the small intestine, the colon, or both. Internal tissues may usually develop shallow, crater-like areas or deeper sores. This lesion has been typically termed as the cobblestone pattern.

28.

What Is Crohn's Diarrhea?

For people who are diagnosed with inflammatory bowel diseases (IBD) such as Crohn's disease, ulcerative colitis, or microscopic colitis, diarrhea is a normal routine in them. It is usually one of the most frequently seen symptoms. The diarrhea is often noted to have been mixed with blood, or mucus and pus.
Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology

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