Crohn’s disease is a type of inflammatory bowel disease (IBD) that is a chronic inflammatory disease of the gastrointestinal tract.
Crohn’s disease can affect any part of the gastrointestinal (GI) tract from the mouth to the anus. It is different from ulcerative colitis, another type of IBD, that only affects the colon (large intestine).
Symptoms of Crohn’s disease may come on slowly and gradually and progressively worsen.
- Diarrhea
- Frequent bowel movements
- Abdominal pain
- Cramping
- Nausea
- Vomiting
- Fatigue
- Fever
- Loss of appetite
- Weight loss
- Gastrointestinal ulcers
- Disease around the anus
- Rectal bleeding/blood in stool
- Shortness of breath due to anemia
- Skin lesions and joint pain and swelling (most commonly seen in Crohn's granulomatous colitis
- Fistulas or inflammatory abscesses (in severe cases)
Crohn's Triggers
When symptoms of Crohn’s disease worsen, it is called a flare. Triggers for Crohn’s disease flares include:
- Not taking medications as prescribed
- Missing, skipping, or taking the wrong dose of medication can result in a flare
- Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- Use of antibiotics
- Can alter the bacteria in the intestine which may cause diarrhea or inflammation
- Physical and emotional stress
- Foods that irritate the gastrointestinal (GI) tract
- There is no specific food that causes flares, but every person is different and some patients may find certain foods aggravate symptoms
- Smoking
- This can also include prolonged exposure to secondhand smoke
- Infections
- Gastrointestinal tract infections (such as C. difficile)
How Is Crohn’s Disease Diagnosed?
Crohn’s disease is diagnosed with a patient history and physical examination, along with tests to look for signs of Crohn’s disease and to rule out other medical conditions such as:
- Blood tests
- Stool tests
- X-rays of the gastrointestinal (GI) tract
- Colonoscopy
- Upper endoscopy
- Small intestine imaging
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Fluoroscopic X-ray
- Biopsy
What Is the Treatment for Crohn’s Disease?
Crohn’s disease is treated with a combination of medication, diet changes, and sometimes surgery.
Medications used to treat Crohn’s disease include:
- Aminosalicylates (5-ASA)
- Corticosteroids
- Azathioprine
- Antibiotics
- Biologic/biosimilar therapies
- Sulfasalazine
- Immunomodulators
Diet changes used to treat Crohn’s disease include:
- Eating a healthy, balanced diet that includes:
- Low-fiber fruits
- Lean protein
- Refined grains
- Vegetables that are fully cooked, seedless, skinless, and non-cruciferous
- Oral nutritional supplements
- Homemade protein shakes
- Water, broth, tomato juice, and rehydration solutions to stay hydrated
- Eating four to six small meals daily.
- Restricting dairy intake in patients who are lactose-intolerant
- During flares:
- Consume soft, bland foods
- Avoid spicy or high-fiber foods
Surgery used to treat Crohn’s disease includes:
- Strictureplasty: repairs a narrowing (stricture)
- Colectomy, which is the removal of the colon
- Proctocolectomy, which removes the colon and rectum
- Bowel resection to remove a damaged portion of the small or large intestine
- Fistula removal
- Abscess drainage
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