Crohn's disease is a long-term condition that causes inflammation of the digestive system. Crohn's can affect any part of the digestive system but most commonly affects the end of the ileum - the last part of the small bowel before it joins the large intestine or colon.
This inflammation often spreads deep into affected tissues, where it can cause scarring that may tunnel inward, forming strictures or narrowing points in affected areas and segments of bowel, which may eventually block normal movement of contents through the digestive tract. This may prevent the absorption of essential nutrients and lead to a variety of symptoms. Learn more about Crohn's disease, its symptoms, causes and available treatment options through this article.
The Dangers of Crohn's Disease
Crohn's disease is one of the two main forms of Inflammatory Bowel Diseases (IBD), the other being ulcerative colitis. Crohn's disease is named after Dr. Burrill B. Crohn, who throughout his lifetime researched this condition with his colleagues. There are more than 80,000 Australians living with this disease, with a prediction of 100,000 by 2022, according to Crohn's & Colitis Australia.
Crohn's disease is an inflammatory bowel disease, where the body's immune system attacks its own digestive system. Crohn's can affect any part of the digestive tract, from mouth to anus. It mainly causes inflammation in the ileum, or the last part of the small intestine, but it may also affect sections further down as well as all other parts of the gastrointestinal tract. The result is redness, swelling and irritation to affected areas which are often accompanied by pain.
Crohn's disease can be serious, but it will rarely lead to cancer, although it increases the risk of colorectal cancer in later life. However, the condition is primarily managed through drug treatment and surgery rather than being cured.
What Causes Crohn's Disease?
Crohn's disease can be classified into four types depending on the severity of symptoms and the area of intestine that is affected. The most common type, Crohn's ileitis, causes inflammation just in the surface layer of the wall of the intestine.
There are two further subtypes which affect mainly deeper layers: Crohn's colitis affects only part of the bowel wall, while fistulising Crohn's disorder creates abnormal passageways (fistulas) between an organ or body cavity with another part of the digestive tract or sometimes another organ such as skin around it. There may also be more than one section of bowel affected at any time, called segmental Crohn's disease.
The exact cause of Crohn's isn't known although many doctors believe that certain factors such as family history and genetic factors play a role alongside environmental factors such as diet or stress. These abnormalities mean that patients with the disease have a higher risk of developing complications than people without it.
According to health experts, around 1 in 20 people who have Crohn's disease has at least one parent or first-degree relative with Crohn's or colitis; often the other parent does not have Crohn's but will carry the gene responsible for the disease. That means, their child may still develop Crohn's disease even if only one of them carries this gene. This form of transmission is known as autosomal recessive inheritance.
Other risk factors for Crohn's disease include smoking cigarettes and taking synthetic drugs. More than 45 percent of people with Crohn's who smoke are at risk of severe disease and surgery. In addition, anti-inflammatory drugs are associated with intestinal obstruction.
What are the Symptoms of Crohn's Disease?
As it can affect different parts of the digestive tract, the symptoms of Crohn's disease will vary from person to person. It may be intense for some people, while others may only experience mild symptoms. Common Crohn's disease symptoms include:
- Diarrhoea (which may be bloody)
- Abdominal pain
- Cramping and bloating
- Constipation or extreme urgency to go to the toilet
- Mucous or blood in stool
- Nutritional deficiencies and weight loss
- Rectal bleeding
Bleeding during bathroom trips is not only painful for sufferers but can also cause anaemia due to blood loss, which is serious because they already have a higher risk of developing anaemia than other people. Crohn's disease symptoms are different for everyone who has it even if they manifest typical symptoms.
Treatment Options for Crohn's Disease
Regardless of the patient's symptoms, they can find relief with the appropriate medication. However, many patients have severe symptoms that may require surgery to remove all or part of the bowel which has become damaged by Crohn's disease. Additionally some events related to the disease activity cannot be prevented so early diagnosis and effective management are really important because they can reduce health complications in sufferers.
Crohn's disease is a chronic illness, so there is no complete cure for it. The good news is that there are several treatment options which can help to control the symptoms. However, lifestyle changes, especially maintaining a healthy diet and not smoking, are known to reduce the risk of developing Crohn's. The following are often prescribed to people living with Crohn's disease:
- A liquid diet allows the colon to rest by reducing bowel movements
- Probiotics and other nutritional supplements aids digestion and prevents bacterial infections
- Mind-body therapies, such as yoga, mindfulness and hypnosis, are very helpful and don't make symptoms worse
- Regular exercise is beneficial to Crohn's disease as it reduces stress
Health professionals may recommend biologic therapies to strengthen the patient's immune response and reduce the likelihood of infections. Diarrhoea is the most common symptom of Crohn's disease that can lead to serious repercussions if not treated properly. Crohn's sufferers with severe diarrhoea are advised to keep a food diary so that they can track what they eat. Dairy products and greasy foods are the main culprits and must be avoided at all costs.
Besides combining medical therapy and complementary therapies, surgery may be recommended if the inflammatory response cannot be controlled. Surgery to remove part of the intestinal tissue is usually only considered if other treatments have failed to work because it does not cure the condition and there are possible risks associated with an operation.
Crohn's disease can be effectively managed by doctors who are familiar with all drug types used in its treatment, as well as how they are combined together. The aim is to find a balance between relieving symptoms, reducing diarrhoea and controlling inflammation at any one time.
While medical treatment is a common approach to Crohn's disease, new techniques like ileocecal valve surgery have been used successfully to control symptoms without the need for long-term or lifelong drug use. When a patient is first diagnosed with Crohn's they may spend weeks or months receiving infusions of corticosteroids; these drugs usually help to improve symptoms within days, which makes it easier for doctors to see if other medications, such as immunosuppressants, will work as well.
Diagnosis of Crohn's Disease
Crohn's disease can be confirmed through testing but cannot be identified based on someone's symptoms alone. A gastroenterologist will conduct a number of tests to find out if someone has Crohns disease such as:
- Blood tests
- Stool samples for parasites and other infections
- Imaging scans such as CT or MRI scans, which can help to confirm the diagnosis by showing any abnormalities in intestinal walls.
Laxatives may need to be stopped before these imaging procedures so that accurate results can be obtained. Ultrasound is also used to look at the small intestine and pancreas.
Diagnosis for Crohn's disease usually comes after other potential causes of similar symptoms have been ruled out; this can be done through blood tests. These tests look for markers in the blood associated with Crohn's to determine if it may be the cause of their symptoms; these markers include antibodies against certain foods and parts of the gastrointestinal tract, antibodies produced by white blood cells and C-reactive protein (to check for inflammation).
If Crohn's disease is strongly suspected but blood tests do not identify elevated levels of those antibodies, the patient may be given an X-ray or a colonoscopy to reveal abnormalities in the bowel wall.
Crohn's disease affects the quality of life and may lead to severe disease if left untreated. If you or someone you care about suffers from this condition, consult a qualified healthcare provider immediately. You may get in touch with a natural health practitioner in your area for complementary therapies that can help reduce the side effects of conventional therapy.