Crohn disease

Definition

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

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

Ulcerative colitis is a related condition.

Alternative Names

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

Causes

The exact cause of Crohn 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 disease include:

Crohn disease may occur at any age. It most often occurs in people between ages 15 to 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 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 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

Tips for managing Crohn disease at home:

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 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:

If you have an ileostomy, you will need to learn:

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 health care provider for tips on how to manage your stress.

MEDICINES

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

Other medicines to help with symptoms include:

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

SURGERY

Some people with Crohn 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 disease that does not respond to medicines may need surgery to treat problems such as:

Surgeries that may be done include:

Support Groups

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

Outlook (Prognosis)

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

Possible Complications

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

Those with more severe Crohn 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;309(20):2150-2158. PMID: 23695484 www.ncbi.nlm.nih.gov/pubmed/23695484.

Fry RD, Mahmoud NN, Maron DJ, Bleier JIS. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 52.

Lichenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 141.

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. PMID: 19174807 www.ncbi.nlm.nih.gov/pubmed/19174807.

Sandborn WJ. Crohn's disease evaluation and treatment: clinical decision tool. Gastroenterology. 2014;147(3):702-705. PMID: 25046160 www.ncbi.nlm.nih.gov/pubmed/25046160.

Sands BE, Siegel CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 115.

Terdiman JP, Gruss CB, Heidelbaugh JJ, Sultan S, Falck-Ytter YT; AGA Institute Clinical Practice and Quality Management Committee. American Gastroenterological Association Institute guideline on the use of thiopurines, methotrexate, and anti-TNF-a biologic drugs for the induction and maintenance of remission in inflammatory Crohn's disease. Gastroenterology. 2013;145(6):1459-1463. PMID: 24267474 www.ncbi.nlm.nih.gov/pubmed/24267474.