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Crohn’s Disease

Definition

colon_ARTCrohn’s disease is a severe, chronic inflammatory bowel disease. It causes inflammation, ulcers , and bleeding in the digestive tract. It usually affects the end portion of the small intestine called the ileum. However, any part of the digestive tract can be affected, from the mouth to the anus.

Crohn’s disease causes inflammation in the small intestine, but it can affect any part of the digestive tract, from the mouth to the anus. The inflammation can cause pain and diarrhea. Crohn’s disease can be difficult to diagnose because its symptoms are similar to many other intestinal disorders such as irritable bowel syndrome (IBS) and ulcerative colitis. It affects men and women equally, and many people with Crohn’s disease also have a blood relative with some form of inflammatory bowel disorder, most often a brother or sister and sometimes, a parent or child.

Causes

The cause of Crohn’s disease is not known. Inflammatory bowel diseases , such as ulcerative colitis and Crohn’s disease, seem to run in some families. Some researchers think that it is due to a reaction to a virus or bacteria. The immune system overreacts and causes damage to the intestines.

Symptoms

Symptoms include:

  • Diarrhea
  • Abdominal cramps and pain
  • Rectal bleeding
  • Weight loss
  • Fatigue, weakness
  • Nausea
  • Fever
  • Mouth sores
  • Sores, abscesses in the anal area

Diagnosis

You will be asked about your symptoms and medical history.  A physical exam will be done.

Your bodily fluids, tissues, and waste products may need to be tested. This can be done with:

  • Blood tests
  • Biopsy
  • Stool tests

Pictures of your bodily structures may need to be taken. This can be done with:

  • Barium swallow
  • Barium enema x-ray

Your rectum and colon may need to be examined. This can be done with:

  • Flexible sigmoidoscopy
  • Colonoscopy

Treatment

Treatment may include:

Dietary Changes

Your doctor may advise that you avoid foods that trigger symptoms. These foods are different for each person. They may include:

  • Dairy foods due to lactose intolerance
  • Highly seasoned foods
  • High-fiber foods

Medications

There are many types of medications that are used to treat Crohn’s disease. Examples of these medications include:

  • Aminosalicylate medications such as sulfasalazine, mesalamine, and olsalazine
  • Anti-inflammatory medications such as prednisone, methylprednisolone, and budesonide
  • Immune modifiers such as azathioprine, 6-mercaptopurine, and methotrexate
  • TNF inhibitors such as infliximab, adalimumab, and certolizumab
  • Antibiotic medications such as metronidazole, ampicillin, and ciprofloxacin

Surgery

Very severe Crohn’s may not improve with medications. You may be advised to have the diseased section of your intestine removed. The two remaining healthier ends of the intestine are then joined together. You are still at high risk for the disease returning.

Surgery may also be done if you have an obstruction or fistulas.

Untreated Crohn’s disease may lead to:

  • Fistulas—Abnormal connections between the intestine and other organs or tissues, such as the bladder, vagina, or skin
  • Intestinal obstruction
  • Arthritis
  • Eye inflammation
  • Liver disease
  • Kidney stones
  • Gallstones
  • Skin rashes
  • Osteoporosis