Understanding Crohn’s Disease
Crohn’s disease is a type of inflammatory bowel disease. As many as 780,000 Americans have the condition, according to the Crohn’s & Colitis Foundation (CCF).
More research about Crohn’s disease is necessary. Researchers aren’t sure how it begins, who is most likely to develop it, or how to best manage it. Despite major treatment advances in the last three decades, no cure is available yet.
Crohn’s disease most commonly occurs in the small intestine and the colon. It can affect any part of your gastrointestinal (GI) tract,from your mouth to your anus. It can involve some parts of the GI tract and skip other parts.
The range of severity for Crohn’s is mild to debilitating. Symptoms vary and can change over time. In severe cases, the disease can lead to life-threatening flares and complications.
It isn’t clear what causes Crohn’s disease. However, the following factors may influence whether you get it:
- your immune system
- your genes
- your environment
Up to 20 percent of people with Crohn’s disease also have a parent, child, or sibling with the disease, according to the Crohn’s & Colitis Foundation.
According to a 2012 study,certain things can affect the severity of your symptoms. These include:
- whether you smoke
- your age
- whether or not the rectum is involved
- length of time you’ve had the disease
People with Crohn’s are also more likely to develop intestinal infections from bacteria, viruses, parasites, and fungi. This can affect the severity of symptoms and create complications.
Crohn’s disease and its treatments can also affect the immune system, making these types of infections worse.
Yeast infections are common in Crohn’s and can affect both the lungs and the intestinal tract. It’s important that these infections are diagnosed and properly treated with antifungal medications to prevent further complications.
The symptoms of Crohn’s disease often develop gradually. Certain symptoms may also become worse over time. Although it’s possible, it’s rare for symptoms to develop suddenly and dramatically. The earliest symptoms of Crohn’s disease can include:
- Abdominal cramps
- Blok in your stool
- a fever
- Loss of appetite
- Weight loss
- feeling as if your bowels aren’t empty after a bowel movement
- feeling a frequent need for bowel movements
It’s sometimes possible to mistake these symptoms for the symptoms of another condition, such as food poisoning, an upset stomach, or an allergy. You should see your doctor if any of these symptoms persist.
The symptoms may become more severe as the disease progresses. More troublesome symptoms may include:
- a peeianal fistula,which causes pain and drainage near your anus
- ulcers that may occur anywhere from the mouth to the anus
- inflammation of the joints and skin
- shortness of breath or decreased ability to exercise due to anemia
Early detection and diagnosis can help you avoid severe complications and allow you to begin treatment early.
No single test result is enough for your doctor to diagnose Crohn’s disease. They will begin by eliminating any other possible causes of your symptoms. Making a Crohn’s disease diagnosis is a process of elimination.
Your doctor may use several types of tests to make a diagnosis:
- Blood tests can help your doctor look for certain indicators of potential problems, such as anemia and inflammation.
- A stool test can help your doctor detect blood in your GI tract.
- Your doctor may request an endoscopy to get a better image of the inside of your upper gastrointestinal tract.
- Your doctor may request a colonoscopy to examine the large bowel.
- Imaging tests like CT scans and MRI scans give your doctor more detail than an average X-ray. Both tests allow your doctor to see specific areas of your tissues and organs.
- Your doctor will likely have a tissue sample, or biopsy, taken during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.
Once your doctor has completed reviewing all the necessary tests and ruled out other possible reasons for your symptoms, they may conclude that you have Crohn’s disease.
Your doctor may go on to request these tests several more times to look for diseased tissue and determine how the disease is progressing.
A cure for Crohn’s disease isn’t currently available, but the disease can be well-managed. A variety of treatment options exist that can lessen the severity and frequency of your symptoms.
Several types of medications are available to treat Crohn’s. Anto-diarrheal and anti-inflammatory drugs are commonly used. More advanced options include biologics, which use the body’s immune system to treat the disease.
Which medications, or combination of medications, you need depends on your symptoms, your disease history, the severity of your condition, and how you respond to treatment.
The two main types of anti-inflammatory drugs doctors use to treat Crohn’s are oral 5-aminosalicylates and corticosteroids. Anti-inflammatory drugs are often the first drugs you take for Crohn’s disease treatment.
You typically take these drugs when you have mild symptoms with infrequent disease flares. Corticosteroids are used for more severe symptoms but should only be taken for a short time.
An overactive immune system causes the inflammation that leads to the symptoms of Crohn’s disease. Drugs that affect the immune system, called immunomodulators,, may reduce the inflammatory response and limit your immune system’s reaction.
Some doctors believe antibiotics may help reduce some of the symptoms of Crohn’s and some of the possible triggers for it.
For example, antibiotics can reduce drainage and heal fistulas, which are abnormal connections between tissues that Crohn’s can cause. Antibiotics can also kill off any foreign or “bad” bacteria present in your gut that could be contributing to inflammation and infection.
If you have severe Crohn’s, your doctor may try one of a number of biologic therapies to treat the inflammation and complications that can occur from the disease. Biologic drugs can block specific proteins that may trigger inflammation.