Crohn's Disease

Definition

Crohn 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.

Small Intestine

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Causes

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

Risk Factors

People of Jewish heritage are more likely to get Crohn disease. Your risk may also be increased if you have family members with inflammatory bowel disease or other autoimmune diseases.

Symptoms

Symptoms include:

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

Complications of untreated Crohn disease may lead to:

• Fistulas—abnormal connections between the intestine and other organs or tissues, such as the bladder, vagina, or skin
• Intestinal obstruction
• Liver disease
• Bowel perforation
• Bleeding
• Kidney stones
• Gallstones
• Osteoporosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. If you are diagnosed with Crohn disease, testing can be used to monitor the disease and assess complications.

Tests may include:

• Blood tests
• Stool tests

Imaging tests evaluate the intestines and surrounding structures. These may include:

• Upper gastrointestinal series
• Lower gastrointestinal series
• Flexible sigmoidoscopy
• Colonoscopy
• CT scan
• MRI scan
• Ultrasound
• X-ray

A biopsy may be taken during some of the these tests. A biopsy is a sample of the intestinal tissue that can be examined under a microscope.

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 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 (6MP), and methotrexate
• TNF inhibitors such as infliximab, adalimumab, and certolizumab
• Antibiotics such as metronidazole, ampicillin, and ciprofloxacin

Surgery

Very severe Crohn 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.

Prevention

Women may be able to reduce their risk of Crohn disease through exercise. Talk to your doctor about an exercise program that is best for you.