Crohn's disease, a type of inflammatory bowel disease (IBD), is a condition in which the lining of your digestive tract becomes inflamed, causing severe diarrhea and abdominal pain. The inflammation often spreads deep into the layers of affected tissue. Like ulcerative colitis, another common IBD, Crohn's disease can be both painful and debilitating and sometimes may lead to a life-threatening complication.
While there's no known medical cure for Crohn's disease, therapies can greatly reduce the signs and symptoms of Crohn's disease and even bring about a long-term remission. With these therapies, many people afflicted with Crohn's disease are able to function normally in their everyday lives.
Step 1
Know the signs and symptoms of Crohn's disease. They include:
- Diarrhea. The inflammation that occurs in Crohn's disease causes cells in the affected areas of your intestine to secrete large amounts of water and salt. Because the colon can't completely absorb this excess fluid, you develop diarrhea.
- Abdominal pain and cramping. Inflammation and ulceration may cause the walls of portions of your bowel to swell and eventually thicken with scar tissue. This affects the normal movement of intestinal tract contents through your digestive tract and may lead to pain and cramping.
- Blood in your stool. Food moving through your digestive tract can cause inflamed tissue to bleed, or your bowel may also bleed on its own.
Ulcers. Crohn's disease begins as small, scattered sores on the surface of the intestine. Eventually these sores may become large ulcers that penetrate deep into — and sometimes through — the intestinal walls. - Reduced appetite and weight loss. Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
- Fistula or abscess. Inflammation from Crohn's disease may tunnel through the wall of the bowel into adjacent organs, such as the bladder or vagina, creating an abnormal connection called a fistula. This can also lead to an abscess, a swollen, pus-filled sore.
Other signs and symptoms. People with severe Crohn's disease may experience fever and fatigue as well as problems that occur outside the digestive tract, including arthritis, eye inflammation, skin disorders, and inflammation of the liver or bile ducts. Children with Crohn's disease may have delayed growth or sexual development.
Step 2
Know when to seek medical advice. Call your doctor right away if you have any of these signs:
- Feel faint or have a fast and weak pulse.
- Severe belly pain.
- Unexplained fever or shaking chills lasting more than a day or two.
- Vomiting again and again.
- Blood in your stool.
- Ongoing bouts of diarrhea that don't respond to over-the-counter (OTC) medications.
Step 3
See your doctor who may refer you to a gastroenterologist to undergo different diagnostic tests including:
- Blood tests. Your doctor may suggest blood tests to check for anemia.
- Colonoscopy. This test allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera.
- Flexible sigmoidoscopy. In this procedure, your doctor uses a slender, flexible, lighted tube to examine the sigmoid, the last 2 feet of your colon.
- Barium enema. This diagnostic test allows your doctor to evaluate your large intestine with an X-ray. Before the test, barium, a contrast dye, is placed into your bowel in an enema form.
- Small bowel X-ray. This test looks at the part of the small bowel that can't be seen by colonoscopy.
Computerized tomography (CT). Sometimes you may have a CT scan, a special X-ray technique that provides more detail than a standard X-ray does. This test looks at the entire bowel as well as at tissues outside the bowel that can't be seen with other tests. - Capsule endoscopy. If you have signs and symptoms that suggest Crohn's disease but the usual diagnostic tests are negative, your doctor may perform capsule endoscopy.
Step 4
Follow your doctor's advice regarding treatment of Crohn's disease including drug therapy, lifestyle modifications and surgical intervention:
- Anti-inflammatory drugs. These drugs are often the first step in the treatment of inflammatory bowel disease. They include sulfasalazine (Azulfidine), mesalamine (Asacol, Rowasa), and corticosteroids.
- Immune system suppressors. These drugs also reduce inflammation, but they target your immune system rather than treating inflammation itself. They include azathioprine (Imuran) and mercaptopurine (Purinethol), infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia), methotrexate (Rheumatrex), cyclosporine (Neoral, Sandimmune), and natalizumab (Tysabri).
- Antibiotics. These can heal fistulas and abscesses in people with Crohn's disease. They include metronidazole (Flagyl) and ciprofloxacin (Cipro).
- Other medications that may relieve your signs and symptoms include anti-diarreals (fiber supplement), laxatives, pain relievers, iron supplements, vitamin B12 shots, and calcium and vitamin D supplements.
- Nutrition. Your doctor may recommend a special diet given via a feeding tube (enteral) or nutrients injected into a vein (parenteral) to treat your Crohn's disease.
- Diet. There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up in your condition. It's a good idea to try eliminating from your diet anything that seems to make your signs and symptoms worse.
- Stress. Although stress doesn't cause Crohn's disease, it can make your signs and symptoms much worse and may trigger flare-ups. Although it's not always possible to avoid stress, you can learn ways to help manage it.
- Surgery. If diet and lifestyle changes, drug therapy or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery to remove a damaged portion of your digestive tract or to close fistulas or remove scar tissue.
Tips
- Take only medications prescribed by your doctor or gastroenterologist.
- Follow up closely with your doctor and have your blood checked regularly to look for side effects of the medications you are taking.
- Crohn's disease can strike at any age, but you're likely to develop the condition when you're young.
- Although whites have the highest risk of the disease, it can affect any ethnic group.
- You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease.
- If you live in an urban area or in an industrialized country, you're more likely to develop Crohn's disease.
- If you smoke, you are far more likely to develop Crohn's disease.
- Educate yourself and connect to organizations to provide you access with support groups.
Warnings
- Use anti-diarrheals with great caution and only after consulting your doctor, because they increase the risk of toxic megacolon, a life-threatening inflammation of your colon.
- Talk to your doctor before taking any laxatives, because even those sold over-the-counter may be too harsh for your system.
- Don't use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve). These are likely to make your symptoms worse.
