Everything You Need to Know About Crohn's Disease
Crohn’s disease falls under the umbrella of inflammatory bowel diseases (IBD) alongside ulcerative colitis. This condition irritates the digestive track and can cause swelling – which can lead to uncomfortable symptoms in the short-term and potential damage over the long-term. Crohn’s disease is a lifelong disease with no cure.
About 500,000 people in the United States are currently estimated to have Crohn’s disease – with research pointing to an upward trend in the total number of people over the last ten years. The exact cause of this trend is unclear (1).
Living with Crohn’s disease can be stressful and overwhelming, but arming yourself with disease information and facts can help you understand how best to manage your condition and live an active life. If you or a loved one has been diagnosed with Crohn’s disease, learn more about how to navigate best the uncertainty and the treatment options available to help you:
What is Crohn’s Disease?
Crohn’s disease is a condition that causes chronic inflammation in the gastrointestinal (GI) tract. The condition can affect any part of the GI tract, but it most commonly occurs at the beginning of the colon or the end of the small bowel (ileum). The inflammation does not always affect the entire intestine – leaving some areas normal between patches of diseased intestine.
There are several different types of Crohn’s disease based on which part of the intestine is affected. If you have Crohn’s disease, it is essential to understand which type you have. The different types include (2):
- Ileocolitis. The end of the small intestine and the large intestine. Ileocolitis is the most common form of Crohn’s disease.
- Ileitis. Crohn’s that only affects the ileum.
- Gastroduodenal Crohn’s disease. The stomach and the duodenum (beginning of small intestine).
- Jejunoileitis. Patchy areas of inflammation in the jejunum (upper half of the small intestine).
- Crohn’s Colitis. Affecting just the colon.
What Are the Symptoms of Crohn’s Disease?
Symptoms of Crohn’s disease can be unpredictable and difficult to manage. People can experience periods when symptoms are severe, called flare-ups, followed by periods of no or very mild symptoms, called remission. Symptoms of Crohn’s disease include (3):
- Abdominal pain
- Chronic diarrhea
- Fever
- Feeling unexplainably full
- Loss of appetite
- Rectal bleeding
- Anal fissures or fistulas
- Weight loss
- Abnormal skin tags
People with severe forms of Crohn’s may also experience the following symptoms:
- Inflammation of the joints, eyes or skin
- Kidney stones
- Inflammation in the liver or bile ducts
- Anemia (iron deficiency)
- In children, delayed growth or sexual development
What Are the Risk Factors and Causes for Crohn’s Disease?
The cause of Crohn’s disease is not known. Previously, researchers believed diet and stress could be the cause, but these are now established as condition aggravators, not the cause (4). Certain factors as associated with an increased risk for developing the condition. These include (3):
- Genes. Specific gene mutations are linked to Crohn’s disease, so the disease tends to run in families. Having an immediate family member, such as a parent or sibling, with Crohn’s may mean you face an increased risk.
- Autoimmune disease. Bacteria in the digestive tract can trigger the body’s immune system to attack healthy cells.
- Smoking. Smoking cigarettes has been linked to a doubled risk for Crohn’s disease.
- Age. The onset of Crohn’s disease can happen at any age, but the condition is most likely to show up in adolescents and young adults. Most people with Crohn’s disease are diagnosed before they are 30 years old.
Complications of Crohn’s Disease
Crohn’s disease can cause one or more of the following complications in people with the condition (4):
- Bowel obstruction. Because Crohn’s disease can alter the intestinal wall, scarring and narrowing of tissue in parts of the bowel can occur. This can block the flow of digestive contents and may require surgery to correct.
- Ulcers. Chronic Crohn’s-related inflammation can lead to ulcers (open sores) in the digestive tract.
- Fistulas. Fistulas occur when ulcers extend completely through the intestinal wall – creating an abnormal connection between body parts such as intestine and nearby organs.
- Malnutrition. Fistulas can cause food to bypass the bowel area required for proper nutrient absorption.
- Colon cancer. Condition is associated with an increased risk for colon cancer.
- Blood clots. An increased risk for blood clots in the veins and arteries near the intestines. People with IBD, including Crohn’s disease, are also more likely to have certain other severe health conditions, including cardiovascular disease, arthritis, liver disease, kidney disease or respiratory diseases (5).
What Treatments Are Available for Crohn’s Disease?
Although there is no cure for Crohn’s disease, there are several different treatment methods available for managing the condition. The right treatment varies by person and can depend on what symptoms they have and how severe they are. Ultimately, treatment goals focus on managing symptoms, maintain remission and address any complications that arise over time.
Medications for Crohn’s Disease
Depending on the severity of your symptoms, your doctor may prescribe any one of the following classes of medications to help manage your Crohn’s disease (3):
- Antibiotics
- Biologic medications
- Antidiarrheals
- Corticosteroids
- Immunomodulators
Diet and Nutrition Tips for Crohn’s Disease
Managing diet and nutrition is a critical component of any Crohn’s disease management plan. Your doctor will help you work through the specifics of your dietary recommendations for your case.
When you are not experiencing symptoms or are otherwise in remission, your diet should be diverse and rich in nutrients. Healthy foods and nutrients to focus on include:
- Protein. Fish, eggs, lean meats, tofu and nuts.
- Fruits and vegetables. Focus on fruits and vegetables of different colors to get the full range of available nutrients.
- Foods high in calcium. Yogurt, kefir, milk and collard greens
- Probiotic foods. Yogurt, sauerkraut, tempeh and miso. In general, people with Crohn’s disease should avoid certain foods during flare-ups as they trigger inflammation. These trigger foods include (6):
- Insoluble fiber foods. Raw green vegetables, fruits with skin, nuts and whole-grain are difficult to digest.
- Lactose. Sugar found in dairy products, including cheese, milk and yogurt.
- Sugary foods. Candy, juice and foods containing insoluble sugars, including alcohol sugars.
- High-fat foods. Margarine, butter, coconut, cream, fried foods or anything greasy.
- Spicy foods.
- Alcohol and caffeinated drinks. Liquor, wine, beer, soda and coffee.
Surgery for Crohn’s Disease
Medications and diet can help improve symptoms of Crohn’s disease, but ultimately about 70% of people living with the condition end up needing some form of surgery. Surgery is used to preserve portions of the GI tract, help control symptoms when medications are no longer effectively doing so and if a fistula, fissure of obstruction forms (2).
Although surgery can provide relief from symptoms in the immediate term, surgical procedures usually do not offer a permanent fix for these issues. About one-third of people with Crohn’s disease who have surgery experience symptoms again within three years, while 60% experience recurrence within 10 years.
Outlook: Living with Crohn’s Disease
Living with Crohn’s disease can be challenging at times. Symptom flare-ups are unpredictable and can interrupt your ability to live daily life. The good news is that your healthcare provider can help you work through steps to talk to keep the disease under control. Your overall quality of life can be maintained with the right treatment, lifestyle adjustments and symptom monitoring.
