Crohn's Disease

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What Is Crohn’s Disease?

Crohn’s disease is a long-term inflammatory bowel disease that causes inflammation in the digestive tract. It can affect any area from the mouth to the anus, although it most commonly affects the end of the small intestine and the beginning of the colon. Symptoms often alternate between active flares and periods of remission.

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What Causes Crohn’s Disease?

The exact cause is not fully understood. Crohn’s is thought to develop when an abnormal immune response causes ongoing inflammation in the digestive tract. Genetics, environmental factors and changes in the gut microbiome may all contribute. It is not caused by stress or by eating a particular food.

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Living With Crohn’s Disease

Urgency, pain and fatigue can affect work, education, relationships, travel and social activities. Planning toilet access, carrying supplies and scheduling rest around demanding activities may make some situations easier.

Tracking bowel movements, pain, bleeding, fatigue, food, medicines and symptoms outside the gut can help patients notice changes and prepare for medical appointments.

Types of Crohn’s Disease

Crohn’s may be classified according to the part of the digestive tract affected. Ileitis affects the end of the small intestine, while ileocolitis affects both this area and the colon. Crohn’s colitis affects only the colon.

Less common types include gastroduodenal Crohn’s, which affects the stomach and upper small intestine, and jejunoileitis, which affects areas of the small intestine. Some people also develop disease around the anus, including fistulas, abscesses or ulcers.

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How Is Crohn’s Disease Treated?

Treatment aims to reduce inflammation, control symptoms and maintain remission. Options may include short courses of corticosteroids, immunosuppressants, biologic medicines and targeted oral treatments.

The most suitable treatment depends on where the inflammation is located, how severe it is and which treatments have already been tried. Medicines can control Crohn’s but do not currently cure it.

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Surgery for Crohn’s Disease

Surgery may be needed to treat blockages, fistulas, abscesses, severe bleeding or inflammation that does not improve with medicine. It usually involves removing or repairing the affected part of the bowel.

Unlike surgery for ulcerative colitis, surgery does not cure Crohn’s disease because inflammation can later appear in another part of the digestive tract. Continued treatment and monitoring may still be needed.

Risks

Anyone can develop Crohn’s disease, although it often begins in adolescence or early adulthood. Having a parent or sibling with inflammatory bowel disease increases the likelihood of developing it.

Smoking also increases the risk of Crohn’s disease and may contribute to more severe illness. Genetics can influence susceptibility, but family history cannot predict with certainty who will develop the condition.

Long-term inflammation can cause narrowing of the intestine, known as a stricture, which may lead to a blockage. Crohn’s can also cause fistulas, abscesses, anal fissures, ulcers, bleeding and malnutrition.

People with Crohn’s affecting the colon may have an increased risk of colorectal cancer, particularly after living with the condition for many years. Regular monitoring can help identify inflammation and other changes early.

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Symptoms

Common symptoms include persistent diarrhea, abdominal pain, cramping, weight loss and fatigue. Some people also experience blood in the stool, an urgent need to use the toilet, nausea, vomiting, reduced appetite or fever.

Symptoms vary depending on the location and severity of inflammation. Children may also experience poor growth, delayed puberty or difficulty gaining weight.

Crohn’s can affect other areas of the body. Some people experience painful or swollen joints, mouth ulcers, eye redness, skin changes or problems involving the liver, bile ducts or kidneys.

These symptoms may occur during a bowel flare or develop separately. Fatigue, anemia, anxiety and low mood can also significantly affect daily life.

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Diagnosis

Diagnosis usually involves discussing symptoms and medical history, followed by blood and stool tests. These tests can look for inflammation, anemia and infection.

A colonoscopy or another form of endoscopy with biopsies is often needed. Imaging tests, such as MRI or CT scans, may also be used to examine areas of the small intestine and identify complications.