Published on Jun 14, 2019 - 5 min read
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain, and weight loss
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, which 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 lead an almost normal life.
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, which is the last part of the intestine.
Ileocolitis - Affect the ileum and colon.
Crohn’s Colitis - Affects only the colon.
Perianal Disease - Causes fistula, deep infections, sores, and ulcers around the anus.
Depending on the severity of the disease, the signs and symptoms can vary from mild to debilitating.
Blood in stools.
Loss of appetite.
Frequent urges to empty bowel.
Feeling of incomplete defecation.
Drainage near or around the anus (perianal fistula).
Inflammation of the skin.
Shortness of breath.
Inflammation of liver or bile ducts.
Late sexual development in kids.
In addition to the symptoms mentioned above, this disease can cause the following symptoms in females:
Pain during sex (dyspareunia).
The exact cause of this disease is still not known, but some factors seem to affect the severity of the symptoms. Some of the factors that seem to play a role in causing this disease are:
The immune system.
Factors that increase the severity of this disease are:
People younger than 30 years.
Involvement of the rectum.
Duration of the disease.
Use of nonsteroidal anti-inflammatory medicines (NSAIDs) like Ibuprofen, Diclofenac, and Naproxen.
Living in urban areas.
Some of the local complications are:
Bowel obstruction - Scar formation might narrow the intestinal passage, leading to obstruction to flow of digestive contents.
Ulcers - Open sores anywhere from the mouth to 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 - Inability to eat properly might lead to malnutrition.
Malabsorption - Can affect the ability of the small intestine to absorb nutrients from food.
Systemic complications include:
Skin problems like erythema nodosum, skin tags, and pyoderma gangrenosum.
Iron and vitamin B12 deficiency.
Eye problems like uveitis and scleritis.
Kidney problems like kidney stones and fistulas.
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 or MRI scan.
Biopsy - The doctor might take a tissue sample during endoscopy or colonoscopy.
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:
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.
Vitamin B12 injections.
Vitamin D supplements.
Avoid foods and drinks that aggravate your symptoms.
Perform breathing and relaxation exercises.
If the other treatment options do not help in relieving the symptoms, your doctor might recommend surgery. Surgery is done to close fistulas, drain abscesses, and to remove the damaged portion of the gastrointestinal tract.
Food to avoid:
Whole grain bread.
Dairy products with added fibers.
Fatty food like coconut, nuts, and poppy seeds.
Raw fruits and fruit juice with pulps.
High-protein food items like fried eggs, beans, peas, etc.
Vegetables like broccoli, cabbage, cauliflower, greens, corns, onions, peppers, beets, and parsnips.
Foods to include:
Dairy products if it does not worsen your symptoms.
Fats that can be included are ghee, butter, oils, and mayonnaise.
Peeled fruits like banana and pulp-free juices.
Proteins like fish, hard-boiled egg, soy products, and poultry.
Vegetables like asparagus, seedless vegetables, eggplant, potato, and pumpkin.
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.
If your symptoms are severe even after taking medicines and implementing lifestyle changes, it is best to consult a gastroenterologist online through phone or video consultation.
Query: Hello doctor, My 6 year old daughter was born with tyrosinemia type 1. She had diarrhea and bloody stools for 10 days, a month back. She was tested for many things, and everything came back normal, except her calprotectin level was 1250 while she had loose and bloody stools. She was admitted and h... Read Full »
Query: Hello doctor, I have Crohn's disease. Two years back, I was fine. I had gone through extreme stress early that year and after that, I had a flare-up. I lost 9 kg in a month. Then, the doctors detected ulcers in my ileum I was diagnosed with Crohn's. I was out of work for 14 months. Assuming that it... Read Full »
Query: Hi doctor, I have Crohn’s disease. I would like to know how long it takes for the affected area of the small bowel to end up causing scarring (scar tissue). Do you feel if I have a lower number CRP on regular blood tests, that it should not lead to scarring, thickening or narrowing of the bowel? I... Read Full »
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