Crohn’s Disease

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Crohn’s disease is a particular type of inflammatory bowel disease that occurs when your body’s immune system attacks your own cells. With the help of a physician, you can find treatment methods to address the diarrhea, abdominal pain, rashes and other symptoms commonly experienced by those with the disorder.

What Is Crohn's Disease?

Crohn’s disease is one of the two most common forms of inflammatory bowel disease, the other being ulcerative colitis. It’s an autoimmune disorder, which is another way of saying that it happens when your body’s immune system produces a response to your own cells. Your immune system is great at fighting off foreign invaders, but when it attacks your own tissue, it can cause serious problems.

It’s primarily characterized by abdominal pain and diarrhea, but there are other symptoms that sufferers can also experience, many of which can be every bit as difficult as the digestive ones.

There’s nothing new about Crohn’s – records of inflammatory bowel conditions go back to at least the 1600s – but in recent years there has been much greater awareness of it and a number of medical advances that have made meaningful differences for many patients.

Symptoms Of Crohn's Disease

Crohn’s disease can affect any part of the GI tract from the mouth to the anus, and it can occur in different areas of the digestive tract. Some of the more common symptoms of inflammation caused by Crohn’s disease include:

Severe diarrhea
Abdominal pain
Fever
Fatigue

Outside of the digestive system, other symptoms can include:

Anemia
Arthritis
Inflammation of the eye
Skin rashes

Patients may experience just a few or many of these symptoms, and they may be mild in some or severe in others. It’s important to note that they can change in each person over time, and some people may even go into periods of remission where they experience no symptoms at all.

Causes And Risk Factors

The exact causes of Crohn’s disease aren’t known, but it’s thought that variety of factors may play a role in your likelihood of developing the condition. Here are a few of the things that may influence your chances of getting it:

Age – Although you can get Crohn’s at any age, it’s usually diagnosed between the ages of 15 and 30.
Genetics – Crohn’s is more common in people who have an immediate relative who also has the disease.
Germs – There is some evidence to suggest that exposure to viruses or bacteria may help trigger the onset of the disease.
Ethnicity – People with Eastern European backgrounds, particularly Ashkenazi Jews, may be more likely to have Crohn’s. Recently, there’s also been an apparent increase in the number of African American’s coming down with the disease.
Location – It seems that people who live in urban environments are more likely to have Crohn’s than those in more rural settings, and those who live in northern climates are at greater risk than those in southern climates.

There are also a few things that we know do not cause Crohn’s disease. There doesn’t seem to be a difference between men and women when it comes to who gets the disease, and although factors like diet and stress can make your symptoms worse, they are not actually causes of Crohn’s in the first place.

Diagnosis

Because the symptoms of Crohn’s disease vary significantly from person to person and can also be similar to symptoms of other conditions, the disease is sometimes difficult to diagnose. Fortunately, doctors have a lot of tools at their disposal to help them identify what’s going wrong and develop a treatment path that makes sense for you. Here are some of the most common diagnostic procedures you’re likely to encounter when it comes to Crohn’s disease:

Blood Tests – There is no single blood test that can directly tell whether or not you have Crohn’s disease, but there are a number of tests that can help a doctor better determine the nature of your condition. For example, simple blood tests can detect whether you have a deficiency in oxygen-carrying red blood cells or if you have an infection that may be causing problems. Other tests look for particular markers in your blood for inflammation, antibodies sometimes associated with IBD, vitamin deficiencies and more.
Stool Studies – Your doctor may test a stool sample to see if you have any irregularities in your stool, including blood or parasites.
Flexible Sigmoidoscopy – This is a procedure where your doctor will use a thin, lighted instrument to examine your rectum and sigmoid, which is the last part of your colon. This test may be performed in place of a full colonoscopy for patients who have significant inflammation.
Colonoscopy – A thin tube with a camera will be used to examine your colon for any signs of disease, and small tissue samples may be taken to further diagnose your condition.
Chromoendoscopy – As part of the colonoscopy procedure, your doctor may perform what’s called a chromoendoscopy. He or she will spray a dye into your colon that can identify variations in the lining of your intestine, highlighting polyps or areas that may be precancerous.
Biopsy – Also as part of the colonoscopy, your doctor may remove small amounts of tissue to test for diseases like cancer.
Upper Endoscopy – Here the doctor will use a flexible, lighted instrument to examine your upper gastrointestinal tract, including the esophagus, stomach and first part of your small intestine. This type of test is most common on patients who are experiencing nausea, vomiting, difficulty eating or pain in the upper abdomen.
Capsule Endoscopy – This is a procedure that may be performed if your doctor suspects Crohn’s disease related to your small intestine. The patient swallows a tiny capsule with a camera inside it (don’t worry – you’ll pass it as part of a normal bowel movement without any discomfort), and the images are used to develop a diagnosis.
Balloon-assisted Enteroscopy – In this procedure, the doctor uses an instrument to examine portions of your small bowel that are usually out of reach with other forms of examination.
X-rays – An x-ray of your abdomen may be helpful to rule out certain serious conditions like a perforated colon.
CT Scans – This imaging procedure can provide a detailed picture of your entire bowel and surrounding tissue. When particularly accurate images of the small bowel are needed, a type of CT scanning called CT enterography may be ordered.
MRIs – Magnetic Resonance Imaging is especially beneficial when it comes to examining organs and tissues around the anal area or in the small intestine. One benefit these offer over CT scanning is that there is no exposure to radiation.

Also note that some of these tests aren’t only used for the diagnosis of Crohn’s disease but also for ongoing monitoring of the condition, so don’t be surprised if you find yourself having to undergo some of these procedures at different points in your treatment path.

Keeping a diary of your symptoms can help your doctor better understand what you’re experiencing and may help in recommending the tests needed to diagnose your condition. Click here to download a diary to record your symptoms.

Treatment Options

Because the way that Crohn’s disease presents itself and progresses can vary considerably from person to person, there are a number of approaches that you and your doctor may want to consider. Most patients try a combination of approaches, including diet and lifestyle changes, medication and even surgery to address their condition.

Since there are so many different ways to treat the disease, you may find that there are some that work better for you than others. Try to be flexible in your approach, don’t expect to see immediate changes, and don’t get disheartened if certain things don’t make much of a difference. There’s usually more to try, and you may be surprised by what actually does work for you. Here are some of the most common options:

Diet Changes

For many people, a good place to start is by altering their diet and lifestyle. That’s because certain foods can contribute to digestive distress, and avoiding those foods can help prevent symptoms.

As just one example, many Crohn’s patients find that symptoms like diarrhea, abdominal pain and gas can be improved by eliminating dairy products. As many as 30 million Americans are lactose intolerant and are unable to properly digest the sugar in dairy products. That’s especially true among Asian, African American, and Native American populations. The use of specialty dairy products or supplements like Lactaid can dramatically improve their ability to digest and enjoy dairy.

Of course, dairy isn’t the only culprit. While everyone is affected differently, other foods that have been found to cause digestive problems for many include high-fat foods, spicy foods, alcohol, and caffeine. High fiber foods can also worsen symptoms for some. Keeping a food diary can be helpful in identifying foods that trigger your Crohn’s symptoms.

Multivitamins

Multivitamins may also play a role in your treatment. Those who suffer from Crohn’s disease often don’t absorb nutrients as well as they should, and that can be compounded by limited diets. Malnutrition can be a common side effect of Crohn’s disease.

Supplementing with vitamins and minerals can be a helpful way to ensure that your body is getting everything it needs – though you should always check with your doctor first. Remember, not every vitamin is right for every patient.

Quit Smoking

As if you needed another reason to quit smoking, it turns out that smoking can also aggravate inflammatory conditions like Crohn’s disease. We know that quitting isn’t easy, but there are more products, programs and support systems available than ever before to help you kick the habit.

Reduce Stress

Many also believe that stress can aggravate your symptoms. Finding ways to reduce stress, such as meditating and adhering to a regular exercise routine, is also often recommended. An added bonus is that, alongside whatever benefit they provide your digestion, these practices will help you live a healthier, happier life overall. (Learn tips for reducing stress in our ‘Coping With A Bowel Condition’ section.)

Medications

If you’ve watched any television recently, you’ve probably seen lots of commercials for new drugs aimed at inflammatory disorders like Crohn’s. That’s not just marketing at work – it’s science, too. That’s because there really is a whole range of pharmaceuticals available to help treat the condition, including a number of options that have only been introduced in the past 10 years or so.

Anti-inflammatory and immunosuppressant drugs are often the first treatment prescribed, and they have a good track record of helping sufferers. Here are some of the most common types of drugs your physician may recommend:

Immunosuppressants work on your immune system by reducing your body’s production of chemicals that promote inflammation. These medicines are often beneficial to those living with bowel disorders because those inflammatory chemicals can damage the lining of your digestive tract. By suppressing them, you may be reducing a direct source of irritation.
Biologics are a relatively new type of therapy, but they’ve also been found to be very effective for many. The way they work is by neutralizing the activity of certain proteins that can produce inflammation. They’re typically administered either by injections that you can do yourself – and we promise it doesn’t hurt! – or by intravenous infusion that can be performed in your doctor’s office.
Anti-diarrheal medications are also commonly used to help bulk up stools.
Pain killers like ibuprofen, naproxen sodium, and diclofenac may be used to deal with mild discomfort.

Keep in mind that some of these medications can actually aggravate your symptoms. Painkillers, for example, have been known to cause digestive issues. You’ll want to monitor your response to them closely to see if they’re making things worse.

Surgery

For some patients, medications, diet, and lifestyle changes simply aren’t enough to prevent their Crohn’s from progressing. After a time, the disease can create complications like a fistula that require more direct action. In these cases, a surgeon may remove a damaged section of your bowel and connect the healthy portions together.

For some patients, this actually eliminates symptoms entirely – though they may return later, sometimes years down the road. Some patients may also benefit from a second procedure, usually performed around 10 years after the first.

Talking With Your Doctor

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If you suspect you may have Crohn’s disease, talk to your doctor about your concerns. He or she may refer you to a specialist to investigate your symptoms and to perform the necessary tests to determine if you do in fact have the condition.

Your doctor will want to hear about all your symptoms, any changes in medication you’ve made and any stressful life changes that may have recently happened. Be sure to write down all your questions before your visit so that you don’t forget them during your appointment.

To make sure you don’t overlook anything important during your consultation, take a couple of minutes to write down the following information so you can be certain that you’ll review it in person:

Your symptoms – List anything that you believe may be a symptom of your condition, including how severe it is and how long you’ve been experiencing it. Even things that don’t seem like they’re obviously related to Crohn’s disease are worth taking note of, because the disease can affect many biological systems, including your skin, eyes, joints and more.
Your medications – List all of the medications you’re taking. This doesn’t only include prescriptions; be sure to include any vitamins or supplements you’re taking, too.
Questions for the doctor – It’s easy to get flustered during an appointment, so writing out the following questions is a good way to ensure that you don’t forget to ask them:
- What could be causing these symptoms?
- What tests do I need to take?
- Is this a temporary condition or something that may last a while? If so, how long does it usually last?
- Are there things I can do on my own to help improve my condition? Diet, exercise, or behavioral changes that might make a difference?
- What treatment options are available to me?
- With medications and other therapies, are there side effects?
- What results do these treatments usually produce?

Crohn’s disease can be a difficult condition to live with, but by talking to your doctor and finding treatment, it can be managed. And if you need help finding a specialist near you, try our doctor finder!