Crohn's Disease

Crohn’s disease, also called regional enteritis or ileitis, is a lifelong form of inflammatory bowel disease (IBD). The condition inflames and irritates the digestive tract — specifically the small and large intestines. Crohn’s disease can cause diarrhea and stomach cramps. It’s common to experience periodic disease flare-ups.

Causes

Autoimmune disease

Bacteria in the digestive tract may cause the body’s immune system to attack your healthy cells.

Genes

Inflammatory bowel disease (IBD) often runs in families. If you have a parent, sibling or other family member with Crohn’s, you may be at an increased risk of also having it. There are several specific mutations (changes) to your genes that can predispose people to developing Crohn’s disease.

Smoking

Cigarette smoking could as much as double your risk of Crohn’s disease.

Types

Ileocolitis

Inflammation occurs in the small intestine and part of the large intestine, or colon. Ileocolitis is the most common type of Crohn’s disease.

Ileitis

Swelling and inflammation develop in the small intestine (ileum).

Gastroduodenal

Inflammation and irritation affect the stomach and the top of the small intestine (the duodenum). Jejunoileitis: Patchy areas of inflammation develop in the upper half of the small intestine (called the jejunum).

Symptoms

  • Abdominal pain.

  • Chronic diarrhea.

  • A feeling of fullness.

  • Fever.

  • A loss of your appetite.

  • Weight loss.

  • Abnormal skin tags (usually on your buttocks).

  • Anal fissures.

  • Anal fistulas.

  • Rectal bleeding.

Diagnosis

  • Blood test: A blood test checks for high numbers of white blood cells that may indicate inflammation or infection. The test also checks for low red blood cell count, or anemia. Approximately one in three people with Crohn’s disease have anemia.

  • Stool test: This test looks at a sample of your stool to check for bacteria or parasites. It can rule out infections that cause chronic diarrhea.

  • Colonoscopy: During a colonoscopy, your doctor uses an endoscope (thin tube with an attached light and camera) to examine the inside of your colon. Your doctor may take a tissue sample (biopsy) from the colon to test for signs of inflammation.

  • Computed tomography (CT) scan: A CT scan creates images of the digestive tract. It tells your healthcare provider how severe the intestinal inflammation is.

  • Upper gastrointestinal (GI) endoscopy: Your doctor threads a long, thin tube called an endoscope through your mouth and into your throat. An attached camera allows your doctor to see inside. During an upper endoscopy, your doctor may also take tissue samples.

  • Upper gastrointestinal (GI) exam: X-ray images used during an upper GI exam allow your doctor to watch as a swallowed barium liquid moves through your digestive tract.

Treatment

  • Antibiotics: Antibiotics can prevent or treat infections. Severe infections can lead to abscesses (pockets of pus). Or they can cause fistulas (openings or tunnels that connect two organs that don’t normally connect).

  • Antidiarrheal medication: Prescription medications like loperamide (Imodium A-D®) can stop severe diarrhea.

  • Biologics: These medications include monoclonal antibodies to suppress the immune response.

  • Bowel rest: To give your intestines a chance to heal, your provider may recommend going without food or drink for several days or longer. To get the nutrition you need, you may receive intravenous (parenteral) nutrition. Only drink a prescribed liquid or have a feeding tube during this time.

  • Corticosteroids: Cortisone, prednisone and other corticosteroids ease inflammation brought on by autoimmune disease.

  • Immunomodulators: These drugs calm inflammation by suppressing an overactive immune system. They include azathioprine and cyclosporine.

  • Surgery: Surgery won’t cure Crohn’s disease, but it can treat complications. You may need surgery to correct intestinal perforations (holes), blockages or bleeding.

Complications

  • Abscesses: Infected pus-filled pockets form in the digestive tract or abdomen.

  • Anal fissures: Small tears in the anus (anal fissures) can cause pain, itching and bleeding.

  • Bowel obstructions: Scar tissue from inflammation, fistulas or a narrowed intestine can block the bowel partially or completely. Waste matter and gases build up. A blockage in the small bowel or large bowel requires surgery.

  • Colon cancer: Crohn’s disease in the large intestine increases the risk of colon cancer.

  • Fistulas: IBD can cause abnormal tunnel-like openings, called fistulas, to form in the intestinal walls. These fistulas sometimes become infected.

  • Malnutrition: Chronic diarrhea can make it hard for your body to absorb nutrients. One common problem in people with Crohn’s disease is a lack of iron. Too little iron can lead to anemia (low red blood cell count) when your organs can’t get enough oxygen.

  • Ulcers: Open sores called ulcers can form in your mouth, stomach or rectum.

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