Crohns Disease: Information on Causes, Diagnosis & Treatments
Crohn's Disease is a chronic, and sometimes life-threatening, inflammation of the intestines, usually involving fistulae and ulcers of the ileum (a portion of the small intestine) and the colon. This condition is different than ulcerative colitis that involves inflammation limited to the large intestine. More than 200,000 individuals in America are diagnosed with Crohn's disease every year. While treatment can provide some relief from most symptoms, there is yet a cure for the condition. In some cases, the disease affects the entire bowel wall.
- Crohn's Disease Symptoms
- Who Gets Crohn's Disease?
- Diagnosing Crohn's Disease
- Crohn's Disease Treatments
Crohn's Disease Symptoms
Common symptoms associated with Crohn's disease include abdominal pain, weight loss, diarrhea, fatigue, and anemia. Some individuals are prescribed drugs including immunosuppressive steroids to slow the disease's progression. Others undergo surgery to relieve many of the symptoms associated with an inflamed gastrointestinal tract. The symptoms include:
- Rectal bleeding
- The feeling of an incomplete bowel movement
- Abdominal pain and cramping
- The urgent necessity to defecate
- Persistent diarrhea
- Intense constipation that could be caused by a bowel obstruction
- Weight loss
- Loss of appetite
- Irregular menstrual cycle
- Night sweats
- Painful, reddened, or itchy eyes
- Mouth ulcers
- Abdominal tenderness
- Joint pain
- Pain or discomfort in the rectum
Determining if you have Crohn's disease requires a medical diagnosis and accurate testing. As a chronic disease, many of the symptoms will go away without explanation and return during flare-ups. An extremely inflamed bowel can cause the development of a fistula – an abnormal passageway from one intestine loop to another where the portion of the intestine connects to the skin, but join or bladder. Every developed fistula creates a medical emergency.
Who Gets Crohn's Disease?
More than 600,000 individuals in the U.S. suffer from Crohn's disease that affects both females and males equally. However, Crohn's disease can be an inherited condition when a close biological relative, especially a sister or brother, suffer from some type of IBD (irritable bowel disorder).
Approximately one out of every five Crohn's disease cases involve individuals who may have a genetic predisposition to ulcerative colitis or Crohn's disease. Additionally, Jewish families of European descent have a higher risk of developing the disease compared to other populations except for African-Americans, Asians, and Hispanics. Typically, individuals are most likely to develop Crohn's disease when they are between 20 years and 30 years old. That said, the elderly can develop Crohn's disease later in life.
Diagnosing Crohn's Disease
Medical scientists have yet to develop a single test that can determine if the patient is suffering from Crohn's disease. Because of that, doctors must take a complete history of the patient and determine their symptoms to rule out any other possible condition that has identical symptoms or indicators of Crohn's disease. The physician will perform a combination of laboratory tests and examinations and acquire numerous imaging studies before making a diagnosis. These results can help:
- Rule out any related health problem that displays common symptoms
- Determine the exact affected area of the patient's digestive tract
- Ensure that the diagnosis of Crohn's disease is exact
The physical examination and comprehensive medical history will determine if the patient is suffering from bloody diarrhea, fever, abdominal tenderness, or pain, or is predisposed to the disease. The laboratory tests will look for indicators of inflammation, infection, low substance levels of minerals, proteins or iron, and any indicator that the patient is suffering from an infection. Common laboratory tests involve:
- White and red blood cell counts
- Mineral levels
- The rate of blood sedimentation
- Detection of infectious microbes in stool samples
As a part of the diagnostic testing, the patient will likely undergo a colonoscopy procedure where the doctor uses a camera connected to a flexible, thin light to see every portion of the interior of the large intestine. If any abnormality is found, the doctor typically takes a tissue biopsy sample to be evaluated in a laboratory analysis to confirm the diagnoses of conditions.
However, the doctor can also use a sigmoidoscopy device to examine the sigmoid colon or view the entire digestive tract through a CT (computerized tomography) scan, MRI (magnetic resonance imaging) scan or small bowel x-ray image to see the portion of the small colon it cannot be viewed during a colonoscopy procedure. Finally, diagnostician might use a capsule endoscope or double-balloon endoscope to view a portion of the small bowel to confirm the diagnosis of Crohn's disease.
Crohn's Disease Treatments
Typically, doctors treating a patient with Crohn's disease recommend two different options including surgery or medication therapy. To date, there is no effective cure for the disease and no single treatment that alleviates all symptoms. Because of that, the doctor will recommend mild drugs to see what works best or prescribe stronger medications that produce quicker results.
Usually, the doctor's recommendation involves prescribing medications that improve the long-term prognosis of the difficult disease by limiting symptoms and complications. These treatments might include:
- Anti-inflammatory medications including Oral 5-aminosalicylates and corticosteroids including prednisone that is known to reduce inflammation throughout the body.
- Immune system suppressors including mercaptopurine, azathioprine, infliximab, adalimumab, certolizumab pegol, methotrexate, cyclosporine, natalizumab, vedolizumab, ustekinumab, and all their associated brand names.
- Antibiotics including ciprofloxacin, metronidazole, and their associated brand names. Antidiarrheal medications including Citrucel, Imodium, Metamucil, and others that treat severe diarrhea.
- Iron supplements
- Pain relievers including those containing acetaminophen, ibuprofen, and naproxen sodium.
- Vitamin D and calcium supplements.
- Vitamin B12 shots to help prevent the development of anemia while promoting proper nerve function.
- Nutritional therapy is given through an enteral nutrition feeding tube or through an injection to improve overall nutrition and provide a restful relief to the bowels.
- Surgical procedures including resection by removing the damaged part of the digestive tract or to drain abscesses, and close fistulas.
- Enemas that inject fluid in the anus to stimulate defecation.
These procedures are typically performed by gastroenterologists, primary health care providers, pediatricians, emergency medical doctors, surgeons, and nutritionists.
While there is no way to prevent the development of Crohn's disease, there are effective steps in reducing its severity over time. The following steps and strategies can minimize many of the symptoms associated with the disease. These include:
- Consume a Well-Balanced Diet – Consider reducing the intake of specific foods, especially those that are rich in refined sugar and trans-fats. Avoid meats when possible and choose instead to consume a diet rich in fruits, vegetables, omega-3 fatty acids in saturated fats. Avoid consuming process foods and choose wholesome organic options instead.
- Stay away from artificial preservatives, colors, and flavors that could produce inflammation in the digestive tract
- Quit Smoking or Don't Start – this effort will improve the function of the digestive tract and prevent the development of other diseases.
- Manage Stress Levels – Taking hold and managing stress levels can reduce inflammation in the body because it prevents the stomach from emptying more slowly while secreting higher levels of acid.
- Drink Sufficient Amounts of Water – When the intestines are bathed in fluids, they can perform their duties as designed. Dehydrated bodies tend to be at significantly higher risk for developing Crohn's disease.
While there is no specific diet plan to cure Crohn's disease, many individuals who follow the prevention strategies of a have enjoyed a life with reduced symptoms associated with the condition.