Crohn's Disease

Topic Overview

What is Crohn's disease?

Crohn's disease is a lifelong inflammatory bowel disease (IBD). Parts of the digestive tract get swollen and have deep sores called ulcers. Crohn’s disease usually is found in the last part of the small intestine and the first part of the large intestine. But it can develop anywhere in the digestive tract, from the mouth to the anus.

What causes Crohn's disease?

Doctors don't know what causes Crohn’s disease. You may get it when the body’s immune system has an abnormal response to normal bacteria in your intestine. Other kinds of bacteria and viruses may also play a role in causing the disease.

Crohn’s disease can run in families. Your chances of getting it are higher if a close family member has it. People of Eastern European (Ashkenazi) Jewish family background may have a higher chance of getting Crohn’s disease. Smoking also puts you at a higher risk for the disease.

What are the symptoms?

The main symptoms of Crohn’s disease are belly pain and diarrhea (sometimes with blood). Some people may have diarrhea 10 to 20 times a day. Losing weight without trying is another common sign. Less common symptoms include mouth sores, bowel blockages, anal tears (fissures), and openings (fistulas) between organs.

Infections, hormonal changes, smoking, and stress can cause your symptoms to flare up. You may have only mild symptoms or go for long periods of time without any symptoms. A few people have ongoing, severe symptoms.

It’s important to be aware of signs that Crohn’s disease may be getting worse. Call your doctor right away if you have any of these signs:

• You feel faint or have a fast and weak pulse.
• You have severe belly pain.
• You have a fever or shaking chills.
• You are vomiting again and again.

How is Crohn's disease diagnosed?

Your doctor will ask you about your symptoms and do a physical exam. You may also have X-rays and lab tests to find out if you have Crohn’s.

Tests that may be done to diagnose Crohn's disease include:

• Barium X-rays of the small intestine or colon. In this test, you will drink a white liquid to coat the inside of your intestine so that the doctor can see it more clearly on an X-ray.
• Colonoscopy or flexible sigmoidoscopy. In these tests, the doctor uses a thin, lighted tube to look inside the colon.
• Biopsy. The doctor takes a sample of tissue and tests it to find out if you have Crohn’s or another disease, such as cancer.
• Stool analysis. This is a test to look for blood and signs of infection in a sample of your stool.

How is it treated?

Your treatment will depend on the type of symptoms you have and how bad they are.

The most common treatment for Crohn’s disease is medicine. Mild symptoms of Crohn's disease may be treated with over-the-counter medicines to stop diarrhea. But talk with your doctor before you take them, because they may cause side effects.

You may also use prescription medicines. They help control inflammation in the intestines and keep the disease from causing symptoms. (When you don't have symptoms, you are in remission.) These medicines also help heal damaged tissue and can postpone the need for surgery.

If your symptoms are severe and these medicines don't help, you may need stronger treatment. You may get medicine through a vein (IV). In rare cases, you may need surgery to remove part of the intestine. Crohn's disease often comes back after surgery.

There are a few steps you can take to help yourself feel better. Take your medicine just as your doctor tells you to. Cut back on sugar. Exercise, and eat healthy meals. Don't smoke. Smoking makes Crohn’s disease worse.

Crohn’s disease makes it hard for your body to absorb nutrients from food. A meal plan that focuses on high-calorie, high-protein foods can help you get the nutrients you need. Eating this way may be easier if you have regular meals plus two or three snacks each day.

How do you cope with Crohn's disease?

Having Crohn’s disease can be stressful. The disease affects every part of your life. Seek support from family and friends to help you cope. Get counseling if you need it.

Many people with inflammatory bowel diseases look to alternative treatments to improve their well-being. These treatments have not been proven effective for Crohn’s disease, but they may help you cope. They include massage, supplements such as vitamins D and B₁₂, and herbs like aloe and ginseng.

Frequently Asked Questions

Learning about Crohn's disease:	What is Crohn's disease? What causes it? What are the symptoms of Crohn's disease? Who gets it? What are the types of inflammatory bowel disease?
Being diagnosed:	What tests are used to diagnose Crohn's disease? What other conditions have symptoms similar to it? What happens during a medical history and physical exam? How can a colonoscopy be used to diagnose Crohn's disease? How can a stool analysis be used to diagnose it? How does a barium enema show Crohn's disease?
Getting treatment:	How is Crohn's disease treated? What medicines are used to treat it? What types of surgery can be used to treat Crohn's disease? What other treatments are available?
Ongoing concerns:	Can I prevent flare-ups of Crohn's disease? When should I see a doctor? What can I do at home to treat symptoms? How can I eat a healthy diet when I have Crohn's disease? How will Crohn's disease affect pregnancy?

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Author:	Monica Rhodes	Last Updated October 24, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Arvydas D. Vanagunas, MD - Gastroenterology
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