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          Article medically reviewed by Cosimo Simeone — Written by Rohini Prasannan 

Introduction

Crohn’s disease is a type of illness that affects the digestive system, specifically the intestines. Therefore, it leads to ongoing inflammation, which means there is constant redness and swelling in the digestive tract. Furthermore, Crohn’s disease can make you have frequent loose stools (diarrhea) and pain in your stomach (stomach cramps). In addition to that, sometimes, it gets worse with more symptoms during these times, called flare-ups. 

How Common is Crohn’s disease?

Crohn’s disease affects many people globally, with China and the USA having the highest number of cases. Therefore about 4.9 million people worldwide are affected, with half a million of them in the US. However, both males and females of different age groups, including children, can suffer from this condition.

What are the chances of getting Crohn’s disease?

Crohn’s disease commonly occurs in younger individuals, often during their late teenage years, twenties, or early thirties. However, it is important to note that this condition can occur at any age, affecting both men and women equally. Furthermore, if you smoke cigarettes your chances of developing Crohn’s disease may be higher compared to those who do not smoke (1).

Types of Crohn’s disease

  • Ileocolitis: Inflammation of  the end of the small intestine (ileum) and part of the large intestine (colon).
  • Ileitis: Swelling and inflammation in one or more sections of the small intestine (or ileum).
  • Gastroduodenal: Inflammation of the esophagus, stomach and/or the first part of the small intestine (or duodenum).
  • Jejunoileitis: It is the inflammation of the upper half of the small intestine (or jejunum).

What are the main causes of Crohn’s disease?

The exact cause of Crohn’s disease is not known still. However, there are certain things that can make a person more likely to get it. Those cause are:

  • Autoimmune disease: Bacteria in the gastrointestinal tract can confuse the body’s immune system, causing it to mistakenly attack healthy cells. Subsequently this can lead to Crohn’s disease.
  • Genetics: Crohn’s disease can run in families. If any family member has Crohn’s, you may be at an increased risk of also having it. 
  • Smoking: Cigarette smoking doubles the risk of Crohn’s disease (2).

Crohn’s disease symptoms:

People who have Crohn’s disease can go through times when their symptoms are really bad, called flare-ups. Because of these, they might have a lot of pain and other uncomfortable symptoms. But then, there are also times when they have little or no symptoms at all, called remission. Remission can last for weeks, months, or even years. But, flare-ups can occur unpredictably, making it difficult to foresee when someone will experience worsening symptoms again (2). 

Symptoms of Crohn’s disease include:

  • Abdominal pain
  • Chronic diarrhea
  • Feeling of fullness
  • Fever
  • Loss of appetite
  • Weight loss
  • Abnormal skin tags
  • Anal fissures
  • Anal fistulas
  • Rectal bleeding

Crohn’s disease diagnosis:

Patients first go to the doctor because they have ongoing symptoms like diarrhea, stomach cramps, or losing weight without knowing why. The doctor has different ways and tools to figure out if you have Crohn’s disease (3). First of all the doctor will inquire about your symptoms, their duration, and family medical history. Then he will perform a physical examination composed of three parts: 

  • Checking for abdominal bloating 
  • Listening to abdominal sounds 
  • Tapping on the abdomen to check for tenderness and pain 

Also could be needed to do a blood test. In fact Doctor checks for increased levels of white blood cells, which can suggest inflammation or infection. The test also looks for a low count of red blood cells, which is known as anemia. Moreover, blood test can provide valuable information about the presence and severity of inflammation and anemia.

Imaging tests

Imaging tests are done to get a detailed look at your digestive tract and identify any signs of inflammation or complications.

  • Computed tomography (CT) scan: A CT scan takes pictures of the digestive tract. It helps the healthcare provider see how severe the inflammation in the intestines is.
  • Upper gastrointestinal (GI) endoscopy: An upper endoscopy is a procedure where a flexible tube with a camera is used to look inside your mouth, esophagus, stomach, and small intestine to check for any issues or abnormalities.
  • Upper gastrointestinal (GI) exam: X-ray images are used to observe the movement of barium liquid that is swallowed, as it travels through your digestive system, enabling the doctor to track its progress and identify any potential problems.

Further types of diagnosis:

Stool test, to check for the presence of bacteria or parasites to rule out infections that could be causing ongoing episodes of diarrhea. Also can be used the colonoscopy which a thin tube with a light and camera. This is inserted by your doctor to carefully examine the inside of your colon. In addition, a small tissue sample from the colon is also taken to analyze for any indications of inflammation or other abnormalities.

Management and treatment:

While there is no known cure for Crohn’s disease, there are treatments to reduce inflammations, control symptoms, and prevent complications, which includes: (4).

  • Medicine: Doctors may prescribe medications for symptomatic relief, decrease the inflammation and control infection. They include antibiotics, antidiarrheal medications, biologics, corticosteroids and immunomodulators
  • Bowel rest: Avoid eating or drinking for a specific period of time. During this time, you might receive special liquid nutrition through a tube or directly into your veins. This way, you can still get the nutrients your body needs while your intestines get better.
  • Surgery: While surgery cannot cure Crohn’s disease, it can help with certain problems caused by the disease. If you have holes, blockages, or bleeding in your intestines due to Crohn’s disease, surgery may be recommended. The surgery aims to treat these complications and improve your condition.

Crohn’s disease diet:

Changing what you eat can be helpful in reducing symptoms of your condition. Your doctor may suggest making certain adjustments to your diet, such as:

  • Avoid carbonated drinks
  • Avoid popcorn, vegetable skins, nuts, and other high-fiber foods
  • Drink more liquids
  • Eat smaller meals more often
  • Keep a food diary to help identify foods that cause problems

To book an appointment with a clinical nutritionist please visit https://mundushealth.com/make-appointments/ 

What are the complications of Crohn’s disease?

Certainly, Crohn’s disease can sometimes lead to severe complications, including:

  • Bowel Obstruction: The inflammation and scarring in the intestines can cause narrowing of the bowel, leading to blockages.
  • Fistulas: Abnormal connections can form between different parts of the intestine or between the intestine and other organs
  • Abscesses: Pockets of pus can develop in the affected areas of the intestine or surrounding tissues.
  • Ulcers: Deep sores or ulcers can form in the lining of the digestive tract, causing pain and bleeding.
  • Nutritional Deficiencies: The inflammation and impaired absorption in the intestines can result in malnutrition and deficiencies
  • Anal fissures: Small tears in the anus which can cause pain, itching and bleeding.
  • Colon cancer: Crohn’s disease in the large intestine increases the risk of colon cancer.

How can I prevent Crohn’s disease?

The exact preventive methods are not known yet. But adopting certain healthy lifestyle changes can help ease symptoms and reduce the frequency of flare-ups. These changes include:

  • Follow health diet
  • Adequate hydration
  • Limit alcohol intake
  • Stop smoking.
  • Exercise regularly.
  • Manage stress.

Living with Crohn’s disease

Certainly, the prognosis can vary depending on several factors, including severity, extent of inflammation, response to treatment, and overall health. Moreover Crohn’s disease is a chronic condition, and currently, there is no known cure. However, with appropriate management and treatment, many individuals with Crohn’s disease can lead productive and fulfilling lives (4). Some key points regarding the prognosis of Crohn’s disease include:

  • Disease Control: The aim of treatment is to make the disease go away or stay quiet for a long time. This means having very few or no symptoms. By using medicines and making healthy lifestyle changes, many people can have long periods without any problems from the disease.
  • Flare-Ups and Disease Course: Crohn’s disease comes and goes in waves. People have times when they feel sick (flare-ups) and times when they feel better (remission). Flare-ups vary between individuals. Taking care of oneself and following treatment can lessen the frequency and severity of flare-ups.
  • Complications: Crohn’s disease can lead to complications like strictures, fistulas, abscesses, and nutritional deficiencies. Early detection, monitoring, and proper treatment can prevent or manage these complications effectively.
  • Quality of Life: Living with Crohn’s disease can be tough. But many people lead happy lives by taking care of symptoms, getting the right medical help, and lifestyle changes. Furthermore having support from doctors, support groups, and loved ones can also make life better.

When should you call a doctor?

  • Severe Symptoms: Like severe abdominal pain, persistent diarrhea, rectal bleeding, or significant weight loss. 
  • Flare-ups: If you notice an increase in the frequency or severity of your Crohn’s disease symptoms.
  • Medication Side Effects: If you are experiencing side effects from your Crohn’s disease medications.
  • New Symptoms: If you develop new symptoms or complications related to your Crohn’s disease.
  • Worsening Condition: If your overall condition worsens, it is crucial to seek medical attention.
  • Concerns or Questions: If you have any concerns, and questions about your condition, treatment, or lifestyle adjustments.

To know more about the Crohn’s disease visit https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease 

Conclusions:

In conclusion, while it is unfortunate that there is currently no permanent cure for Crohn’s disease. It is crucial to emphasize the importance of taking charge of one’s flare-ups and keep the condition under control. Stay informed, have regular check-ups, and learn about the disease to make informed choices that align with personal goals and values. 

Crohn’s disease is a challenge but it should not restrict one’s life. Effective treatment and lifestyle changes can help manage symptoms, so that individuals with the disease can lead a fulfilling life. Certainly, by prioritizing self-care and maintaining a positive mindset. Furthermore, by working with healthcare providers and taking an active role, they can live a symptom-controlled and complication-free life. 

References

  1. Baumgart, D. C., & Sandborn, W. J. (2012). Crohn’s disease. Lancet (London, England), 380(9853), 1590–1605.
  2. Petagna, L., Antonelli, A., Ganini, C., Bellato, V., Campanelli, M., Divizia, A., Efrati, C., Franceschilli, M., Guida, A. M., Ingallinella, S., Montagnese, F., Sensi, B., Siragusa, L., & Sica, G. S. (2020). Pathophysiology of Crohn’s disease inflammation and recurrence. Biology direct, 15(1), 23.
  3. Veauthier, B., & Hornecker, J. R. (2018). Crohn’s Disease: Diagnosis and Management. American family physician, 98(11), 661–669.
  4. Seyedian, S. S., Nokhostin, F., & Malamir, M. D. (2019). A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease. Journal of medicine and life, 12(2), 113–122.

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