Crohn’s is a painful disease of the digestive tract. Classified as a chronic inflammatory bowel disease (IBD) it is characterized by inflammation of the GI tract, usually at the point where the small intestine joins the large intestine, the colon. Crohn’s is sometimes confused with ulcerative colitis, as both are IBDs, but they are not the same condition. Beyond the digestive system, Crohn’s can affect the eyes, skin, and joints. Crohn’s is not curable, but treatments can lengthen the spans of time between severe symptoms, and allow the patient to lead a basically normal life.

People with Crohn’s disease don’t usually have consistent, ongoing symptoms. The patient may have a period of severe symptoms followed by a remission that can last from weeks to even years. How a person reacts to Crohn’s depends on where in the GI the disease occurs, along with its severity. These are the general symptoms associated with Crohn’s disease:

– Chronic diarrhea that often contains blood or mucus
– Fever
– Abdominal pain and tenderness
– Abdominal cramping
– Weight loss
– Feeling of low appetite
– Fatigue
– Rectal bleeding

Complications from Crohn’s can lead to other symptoms. An abnormal passageway, called a fistula, can develop between organs or tissues, leading to leaking discharge around the rectum. Severe inflammation can create swelling and scar formation and lead to problems such as bowel perforation, fever, and abdominal distension. In these cases, Crohn’s can be life threatening.

The causes of Crohn’s are not directly attributable. The disease is not related to something the patient has done or eaten. At times, scientists have thought Crohn’s is an autoimmune disease, but research now suggests the immune system is not attacking the body itself (as in autoimmune conditions), but is attacking harmless virus, bacteria, or food in the gut. These attacks cause the inflammation and bowel injury. There seems to be a genetic influence, as roughly 20 percent of those with Crohn’s have a blood relative with an IBD.

As noted above, Crohn’s is often inherited. People primarily acquire Crohn’s disease before the age of 30, although it can occur in later years, as well. Approximately 700,000 people in the United States are affected by Crohn’s disease.

While both Crohn’s and ulcerative colitis are classified as IBDs, there are key differences.

Crohn’s
– Inflammation develops anywhere in the GI tract
– Most common at the end of the small intestine
– May appear in patches
– May extend through entire thickness of bowel wall

Ulcerative colitis
– Limited to the large intestine
– Occurs in the rectum and colon
– Appears in a continuous pattern
– Inflammation occurs in innermost lining of the intestine

Crohn’s is an inflammatory bowel disease (IBD), but it is not irritable bowel syndrome (IBS). IBS involves muscle contractions of the bowel and is not characterized by intestinal inflammation. Also, IBS is a disorder, not a disease.

At Vanguard Gastroenterology, we use a variety of tests and procedures to diagnose Crohn’s. We may perform colonoscopies or sigmoidoscopies to obtain bowel tissue for testing. An upper endoscopy allows us to look at the esophagus, stomach, and the beginning of the small intestine. We also use blood tests to check for high white blood cell counts (inflammation) and low red blood cell counts (anemia from blood loss). Stool samples allow us to rule out infection as the cause of the patient’s diarrhea. We may use CT scans or MRIs of the upper and lower GI tracts.

Although there is no cure for Crohn’s disease, at Vanguard Gastroenterology, we have a variety of treatment options that can allow patients to lead normal lives. The goals for treatment are to reduce inflammation, relieve symptoms such as diarrhea, and to eliminate any nutritional deficiencies caused by the disease. It’s important to note that medications or surgery don’t cure Crohn’s disease. We primarily treat Crohn’s disease with medications.

– Anti-inflammatories
– Corticosteroids
– Immune system modifiers
– Antibiotics
– Anti-diarrhea drugs
– Biologic therapies
– Surgery For Crohn’s Disease

Up to three-quarters of people with Crohn’s disease will eventually need surgery to treat the disease. Surgery usually will remove the diseased part of the bowel. However, Crohn’s can impact another portion in the future.

Surgical patients are not responding to medications, are having extreme difficulty with medication side effects, or have developed these complications:

Formation of a scar that is narrowing the bowelExcessive bleeding in the intestineA perforation in the bowel wallFormation of a fistulaFormation of an abscessA condition known as toxic megacolon, where the colon is severely stretched out and toxins begin to spread through the blood

Although Crohn’s is thought of as a chronic, lifelong condition, it is not considered generally life threatening. People can die from complications such as infection and the development of cancer, however.

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