Crohn's Disease

Crohn’s Disease is a chronic disorder causing inflammation of the digestive tract. It can involve any area of the GI tract from the mouth to the anus, but most commonly affects the small bowel and/or the colon. It is named after Dr. Burrill B. Crohn, who in 1932 along with his colleagues, published a landmark paper describing the disease. Crohn’s Disease and Ulcerative Colitis are the two primary disease categories making up inflammatory bowel disease (IBD).

What Causes Crohn’s Disease?

Although it is not yet known what causes the disease, it appears to be a complex interaction of factors: genetic component, immune system malfunction, and perhaps environmental factors. Research has shown that the IBD patient’s immune system is haywire. Once it is turned on, it won’t turn off at the right time. As a result, inflammation damages the intestine and causes the symptoms.

Types Of Crohn’s Disease And It’s Associated Symptoms:

  • Ileocolitis: Most common form of Crohn’s. Affects the ileum and colon causing pain to the right lower abdomen including cramping. May have significant weight loss.
  • Ileitis: Affects the ileum. Same symptoms as ileocolitis. Complications may include fistulas or inflammatory abscesses in the right lower abdomen.
  • Gastroduodenal Crohn’s Disease: Affects the stomach and duodenum (first part of the small intestine). Symptoms include abdominal pain, cramps, weight loss, and nausea. Vomiting may indicate obstruction.
  • Jejunoileltis: Patchy areas of inflammation in the jejunum (upper half of the intestine). Symptoms include abdominal pain and cramps following meals as well as diarrhea. Fistulas may form.
  • Crohn’s (granulomatous) Colitis: Affects the colon only. Symptoms include diarrhea, rectal bleeding, and disease around the anus (Abscess fistulas, ulcers), skin lesions, and abdominal pain are more common in this form of Crohn’s.

What Medications Are Used To Treat Crohn’s?

Because there is no cure for Crohn’s Disease, the goal of therapy is to suppress the inflammatory response in order to allow the intestines to heal, and relieve the symptoms associated with it (fever, diarrhea, and abdominal pain). Once the symptoms are under control (induce remission), medical therapy is used to decrease the frequency of flares (maintaining remission).

Drugs currently used to treat Crohn’s Disease are:

  • Aminosalicylates (5-ASA)
  • Corticosteroids
  • Immune modifiers
  • Antibiotics
  • Biologic therapies: Infliximab - For moderate to severe disease

What Is The Role Of Surgery In Crohn’s Disease?

Two thirds to three-quarters of all patients will require surgery at some point in their lives, due to intestinal obstruction, repair a fistula or fissure, or abscess. The surgery may allow for many symptom-free years, however, it is not considered a cure for the disease. The overall goal of surgery is to conserve bowel and return the patient to the best possible quality of life.

How Common Is Crohn’s?

As many as one million Americans have IBD, evenly split between Crohn’s Disease and Ulcerative Colitis. Crohn’s Disease may occur at any age, but usually presents at adolescence or in the young adult, between the ages of 15 and 35. There is also another peak at the 70 or older age group. 10% or 100,000 are youngsters less than 18 years of age.

What Are The Symptoms Of Crohn’s Disease?

  • Persistent diarrhea (loose, watery, or frequent bowel movements)
  • Crampy abdominal pain
  • Fever
  • Rectal bleeding
  • Loss of appetite, weight loss also may occur
  • Tears (fissures) in the lining of the anus, with pain and bleeding with bowel movements
  • Fistula formation - From the intestines to the bladder, vagina, or skin These symptoms range from mild to severe and episodes are followed by times of remission, a time when the symptoms disappear or decrease and good health returns.

Complications of Crohn’s Disease:

  • Most common complication is intestinal obstruction due to narrowed lumen. Medications may relieve it, but most require surgery
  • Sores or ulcers (aphthous ulcers) in the intestinal tract
  • Fistulas (deep ulcers) may tunnel into the bladder, vagina, or skin.
  • Malnutrition or nutritional deficiencies (B-12)

STOP SMOKING! Smoking can prevent remissions in Crohn’s Disease and make it more active! It’s also important to maintain a healthy diet. People with Crohn’s have reduced appetite and require increased caloric intake because it is a chronic disease.