What You Need to Know About Crohn’s Disease

Crohn’s doesn’t have to disrupt your life.

A one-time bout of diarrhea might just be from a bad burrito, but if you frequently get diarrhea—sometimes so often you’re afraid to leave the house—you might have Crohn’s disease. Crohn’s disease is an autoimmune disease that attacks the lining of the digestive tract. It’s one of a number of conditions that comprise inflammatory bowel disease—the other is ulcerative colitis.

“Crohn’s disease is typically disruptive to people’s lives,” says Ernest DiGiovanni, DO, a gastroenterologist with Regional Medical Center Bayonet Point in Hudson, Florida. “It’s usually classified as mild-to-moderate or moderate-to-severe. A person can have excruciating pain or so many bowel movements a day that they can’t leave the house. It can be disruptive for sure.”

Causes and symptoms of Crohn’s
The cause of Crohn’s disease is unknown. “It may be genetic, it may be infectious,” says Dr. DiGiovanni. “Researchers have found some genes that are potentially associated with the condition, and between 15 and 20 percent of people with Crohn’s have a relative with Crohn’s.

A parasite or an infection may also be responsible for the condition. Surprisingly, it’s seen mostly in developed countries. “It mostly developed where we have good water purification,” says DiGiovanni. “There may be some types of worms or parasites that are protective.” 

The most common features of Crohn’s disease include abdominal pain, diarrhea, weight loss and fatigue. Depending on where in the body the Crohn’s affects, other symptoms could include:

  • Mouth sores
  • Eye inflammation
  • Problems of the anus including tears, ulcers, fistulas, infection and narrowing

Crohn’s versus colitis
Crohn’s disease and ulcerative colitis are both inflammatory bowel diseases, commonly abbreviated as IBD—not to be confused with irritable bowel syndrome (IBS). “IBS is a syndrome of exclusion characterized by alternating constipation and diarrhea,” says Dr. DiGiovanni, meaning that IBS is something that is diagnosed only when other likely diagnoses are ruled out.

Crohn’s and ulcerative colitis are similar but different, DiGiovanni says. “The main difference is what part of the body each affects,” he says. “Both affect the colon, but ulcerative colitis always affects the rectum—the most bottom part of the colon—and extends upward. In Crohn’s, the most common affected area is in the last part of the small intestine, but it can affect anywhere in the gastrointestinal tract, including the stomach and even the mouth.”

Between 1 million and 1.3 million Americans have IBD. Colitis is slightly more common overall, and is more common in men than women, while Crohn’s disease is more likely to affect women.

Treatment options
Crohn’s disease has no cure, but there are many treatment options. Medication is usually the first option, with surgery being considered if the medication doesn’t work. Most of the medications, including steroids and antibiotics, aim to reduce inflammation. Since Crohn’s is an autoimmune disease, immunotherapy drugs known as biologics can also help to reduce inflammation, but they can have severe side effects.. Some healthcare providers will start a patient with the strongest drugs (the top-down approach), while others will save those drugs until after other treatments have failed (the step-up approach).

If medication doesn’t help, the next option is surgery. One surgical option is removing part of the colon and then reattaching the two ends. If the surgeon cannot reattach the ends, an opening in the abdomen will be cut and waste will exit into a colostomy bag. Another option is opening blockages in the bowel called strictures.

Preventing flare-ups
It may seem logical that food would be a factor in digestive diseases, but that’s not the case with Crohn’s, according to DiGiovanni. “There isn’t really any kinds of dietary restrictions for people with Crohn’s,” he says. He notes, however, that many people with Crohn’s have vitamin deficiencies because the intestines don’t absorb nutrients as efficiently as in people without Crohn’s.

The number one prevention tip is to avoid or quit smoking. Smoking both raises the risk of developing Crohn’s and may make the condition more severe. “Smoking has been shown to be very detrimental,” says DiGiovanni. “The first thing you need to do is stop smoking.”

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