Crohn's disease

Definition

Crohn's disease is a disease where parts of the digestive tract become inflamed.

Crohn's disease is a form of inflammatory bowel disease (IBD).

Ulcerative colitis is a related condition.

Alternative Names

Inflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis; IBD- Crohn's disease

Causes

The exact cause of Crohn's disease is unknown. It occurs when your body's immune system mistakenly attacks and destroys healthy body tissue (autoimmune disorder).

When parts of the digestive tract remain swollen or inflamed,  the walls of the intestines become thickened.

Factors that may play a role in Crohn's disease include:

Crohn's disease may occur at any age. It most often occurs in people between ages 15 - 35.

Symptoms

Symptoms depend on what part of the digestive tract is involved. Symptoms range from mild to severe, and can come and go with periods of flare-ups.

The main symptoms of Crohn's disease are:

Other symptoms may include:

Exams and Tests

A physical exam may show a mass or tenderness in the abdomen, skin rash, swollen joints, or mouth ulcers.

Tests to diagnose Crohn's disease include:

A stool culture may be done to rule out other possible causes of the symptoms.

This disease may also alter the results of the following tests:

Treatment

DIET AND NUTRITION

You should eat a well-balanced, healthy diet. Include enough calories, protein, and nutrients from a variety of food groups.

No specific diet has been shown to make Crohn's symptoms better or worse. Types of food problems may vary from person to person.

Some foods can make diarrhea and gas worse. To help ease symptoms, try:

Ask your doctor about extra vitamins and minerals you may need, such as:

STRESS

You may feel worried, embarrassed, or even sad and depressed about having a bowel disease. Other stressful events in your life, such as moving, a job loss, or the loss of a loved one can worsen digestive problems.

Ask your doctor or nurse for tips on how to manage your stress.

MEDICINES

You can take medication to treat very bad diarrhea. Loperamide (Imodium) can be bought without a prescription. Always talk to your doctor or nurse before using these drugs.

Other medicines to help with symptoms include:

Your doctor may also prescribe medicines to help control Crohn's disease:

SURGERY

Some people with Crohn's disease may need surgery to remove a damaged or diseased part of the intestine. In some cases, the entire large intestine is removed, with or without the rectum.

People who have Crohn's disease that does not respond to medications may need surgery to treat problems such as:

Surgeries that may be done include:

Support Groups

The Crohn's and Colitis Foundation of American offers support groups throughout the United States.

Outlook (Prognosis)

There is no cure for Crohn's disease. The condition is marked by periods of improvement followed by flare-ups of symptoms. Although Crohn's disease cannot be cured even with surgery, treatment can offer significant help to most patients.

Possible Complications

You have a higher risk for small bowel and colon cancer if you have Crohn's disease. At some point, your doctor may recommend tests to screen for colon cancer.

Those with more severe Crohn's disease may have these problems:

When to Contact a Medical Professional

Call your health care provider if:

References

Cheifetz AS. Management of active Crohn disease. JAMA. 2013 May 22;309(20):2150-8.

Lichtenstein GR, Hanauer SB, Sandborn WJ; Practice Parameters Committee of American College of Gastroenterology. Management of Crohn's disease in adults. Am J Gastroenterol. 2009;104(2):465-483.

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.

Sands BE, Siegel CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 111.

Lichenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 143.