What is Crohn’s Disease?
Crohn’s disease is a chronic disorder that causes inflammation of the intestinal tract. It can involve any part of the digestive tract from the mouth to the anus, although it usually involves the small intestine and/or colon. Crohn’s disease is marked by an abnormal response of the body’s immune system. The condition begins with small microscopic nests of inflammation which persist and smolder. The lining of the digestive tract can then become ulcerated and thickened. Eventually the bowel may become narrowed or obstructed.
It is still not completely clear what causes Crohn’s disease but studies point to a genetic link as well as a defect in the body’s immune response. There may also be an environmental component. Men and women seem to be equally affected. The disease can occur at any age but it is primarily a disease of young people, occurring most frequently between 15 and 35.
Symptoms of Crohn’s Disease
The primary symptoms of Crohn’s disease are persistent watery diarrhea, crampy abdominal pain, fever and occasionally rectal bleeding. Many patients will also develop a decreased appetite, weight loss and fatigue. Some patients will develop fistulas (small tunnels that lead from one part of the intestine to another, or to the bladder, vagina or skin). Crohn’s disease can also affect the joints, eyes, skin and liver. Symptoms can range from mild to severe, and patients can experience periods of remission.
Diagnosis of Crohn’s Disease
There is no single specific test to evaluate for Crohn’s disease. The physician will evaluate your symptoms and medical history. He/she will order blood work, stool studies and possibly x-rays. Most likely your doctor will want to perform a colonoscopy to directly visualize the lining of bowel. This is a simple out-patient procedure to examine your colon using a flexible fiber-optic scope. The exam is done under sedation and is quite painless. The doctor will take biopsies of your colon and small intestine for a pathologist to evaluate. The diagnosis of Crohn’s may take some time because it is such a complex illness.
Treatment of Crohn’s Disease
There is no cure for Crohn’s disease. However, there are effective medical treatments used to suppress the inflammatory process. There are several types of medications used to treat Crohn’s. Anti-inflammatory drugs, such as Asacol, Colazal and Pentasa, are used to treat mild to moderate symptoms and to prevent relapse. Corticosteriods, such as Prednisone, are used to treat more severe cases; in general these should not be used as maintenance medications. There are several immune suppressing medications such as Imuran and 6-MP that can be highly effective at suppressing the immune response, controlling symptoms and preventing relapse. Recently,exciting new biologic therapies (Remicade) have been approved for the use in Crohn’s patients.
Occasionally severe attacks of Crohn’s may require hospitalization, bowel rest and intravenous antibiotics. Most Crohn’s patients will require surgery at some point in their lives. Surgery is not considered a cure for Crohn’s as it is with ulcerative colitis, frequently the disease will recur at the resection site.
Maintaining proper nutrition is important in the management of Crohn’s disease. While there is no evidence that any certain foods contribute to the disease, avoiding some may reduce your symptoms. Avoiding raw vegetables, high-fiber and spicy foods and eating a more bland, soft diet may cause less abdominal distress. Most doctors recommend a healthy, well-balanced diet containing a variety of foods. Emotional stress can worsen almost any chronic illness. It is important to learn to deal with your emotional stressors in a healthy manner. There are support groups in most communities for people with Inflammatory Bowel Disease (IBD); you can find a list on the website link below.