What is Crohn’s Disease?
Crohn’s disease is a chronic bowel condition which can cause inflammation, swelling and irritation predominantly within the small intestine.
The exact cause of crohn’s disease is unknown. However, it is believed factors such as an adverse reaction linked to the immune system or genetics, may play a role. (1)
Crohn’s disease can affect anyone although there does appear to be a trend towards people aged between 20 and 29 years and those who have family history of the disease. (2)
Symptoms
Crohn’s disease affects the digestive system also known as the gastrointestinal (GI) tract. This is a group of long, twisting tubes running from the mouth to the anus.
The GI tract helps the movement of food through the body while releasing hormones to help with the digestion.
When a person develops crohn’s disease it will cause inflammation deep within the lining of the affected area, this can cause swelling and irritation. Eventually it results in scar tissues which restricts movement of food causing further discomfort and cramping.
The disease can also present a set of complications including: abscesses (pus-filled infection), fistulas (abnormal passageway between organs) or malnutrition. People affected by crohn’s disease also have a higher risk of developing colon cancer. (3)
Symptoms of crohn’s disease are very much dependent upon where in the digestive tract you have the inflammation and it’s severity. (4)
It’s possible for a person to have periods of respite, where no symptoms occur. Whereas other people may feel certain foods or stress trigger episodes.
Common symptoms include:
Diarrhea
Diarrhea is where stools become runny or watery instead of having the usual firm consistency. You will also find your bowel movements become more frequent.
It can have different causes and it’s not a rare condition. For most people it lasts about one or two days. However, it’s important to drink plenty of fluids as it can cause dehydration.
Diarrhea in crohn’s disease is usually caused by swelling in the GI tract which makes the bowel empty more often. (5)
Abdominal Cramps or Pain
In many cases, slight pain or cramps in the stomach are not usually a major cause of concern. They typically don’t last long and won’t cause too much discomfort.
In terms of crohn’s disease, cramps and pain can be caused by swelling and irritation or when scar tissue causes a stricture (narrowing) of the passageway. This makes it harder for food to move through easily, which can result in pain and or stomach cramps. (6)
Weight Loss
Weight loss is commonly seen in people with crohn’s disease. This is mainly down to the condition affecting the body’s ability to obtain adequate nourishment from foods digested. In fact, it’s not uncommon for crohn’s patients to suffer from malnutrition.
However, it can have also psychological reasons. Research indicates many people with crohn’s disease lose pleasure sensations relating to food and eating, plus others display a significant lack of appetite or hunger. (7)
Fever
A fever is a sign the body is trying to fend off disease or infection. However, a high body temperature can result in shivering, chills and excessive sweating.
Fevers can also be caused by autoimmune disorders or inflammatory diseases such as crohn’s disease. (8)
Fatigue
If you suddenly experience a total lack of energy and motivation, you’re highly likely to be suffering from fatigue.
Fatigue can be caused by lack of nutrition, boredom, physical activity, lack of sleep or emotional stress.
It’s not uncommon for people with crohn’s disease to feel extreme tiredness. (9)
Stages
There are three stages of crohn’s disease. They provide an explanation of the body’s response when the disease takes hold. Symptoms will start during the first stage and worsen as it progresses. (10)
Below is a general description of the three stages:
Stage #1
During the first stage, digestive matter breaks through the protective mucus layer inside the intestines and into the bowel tissue. This is where the immune system starts to attack.
This can also be accelerated if the person has an infection or a defect in the muscle barriers.
Stage #2
More of the intestinal tract is under assault by the immune system, causing further inflammation and damage. The body is also unable to clear the digestive matter from the weakened area, which exacerbates symptoms.
The person will now be experiencing severe symptoms and if these aren’t treated it can progress to the last stage.
Stage #3
In the last stage, much of the healthy tissues inside the GI tract have become inflamed. This does trigger a compensatory response from the body, yet because the damaging cells have accumulated in such numbers there are too many to reverse the effects.
It is during this stage the inflammation becomes chronic and starts to have a significant impact upon the affected person’s life.
At this point the patient requires intense treatment both for the disease and the possible complications.
Treatment
Crohn’s disease is treated mainly with medication, bowel rest or surgery.
As there is no cure for the disease, treatment aims to minimize inflammation and to keep people in remission (no symptoms) for as long as possible. (11)
Less stress and a healthy diet should be incorporated alongside treatment. High stress levels and diets rich in fats can exacerbate symptoms. (12)
Medication
Most medication helps to alleviate symptoms and keep you in remission for as long as possible.
Medicine will help control the disease by either calming down the immune system reaction and activity. This in theory should help reduce inflammation and allow a state of respite. (13)
Other medical treatments can be used to address symptoms or the complications which can follow crohn’s disease.
Bowel Rest
People who experience severe symptoms are likely to be asked to rest their bowels for a couple of days up to a few weeks. (14)
During this time you might only be allowed to drink certain fluids. Depending on severity of symptoms it could mean witholding all food and drink.
If complete bowel rest is needed for longer periods you might be asked to stay in hospital. This allows for nutrition to be administered intravenously (IV) through a vein and a drip. (15)
Surgery
Most people with crohn’s disease could end up having surgery. One study estimated that 60 percent of people had surgery within 20 years of developing the disease. (16)
Although surgery doesn’t cure crohn’s disease, it can help reduce symptoms and treat complications.
Doctors can use different types of surgical procedures. A small bowel resection is a procedure which removes a part of the small intestine. Others include, a subtotal colectomy, where a part of the large intestine is removed. (17)
Proctocolectomy is another operation which removes the entire colon and rectum. This will be followed by a ileostomy, in which the last part of your intestine (ileum) is taken out through your abdomen. With this a small bag will be placed on the outside to collect the poop. (18)
FAQ
What is crohn’s disease? It is a chronic disease which causes inflammation and swelling along the GI tract.
What are the signs of crohn’s disease? Typical signs include: diarrhea, cramps or pain and fatigue. Unintentional weight loss is another symptom, this can be due to lack of appetite and malnutrition. (19)
How do you develop crohn’s disease? The exact cause is unknown, although autoimmune reactions or specific genes have shown to be linked with crohn’s disease. However some people do present a higher risk, such as smokers, those following high-fat diets, people with family history of the disease and who take certain medication. (20)
How are you diagnosed for crohn’s disease? Medical history of you and your family plus a physical examination of the abdominal area checks for bloating, pain or tenderness. Diagnostic tests can include: blood and stool samples. Others examine your GI tract such as a colonoscopy, a CT scan, upper GI endoscopy or a capsule endoscopy where you will swallow a small camera. (21)
What is the best treatment for crohn’s disease? Treatment comes down to the severity of your symptoms. For many people regular medication is enough to encourage remission, while others might need surgery. Bowel rest, where only fluid is taken can also be an alternative treatment in order to rest the intestine and let it recover as much as possible.
What are the long term complications of crohn’s disease? Long term complications can include different types of cancer such as colon or bowel cancer. Others include anemia, which is a lack of red blood cells, difficulty maintaining a healthy weight or emotional stress and even depression. (22, 23)
Is crohn’s disease considered a disability? Crohn’s disease is not considered a disability, although in severe stages it can have a significant impact on the person’s life.
Is there any cure for crohn’s disease? No, this disease is a chronic illness and therefore can only be controlled with treatment.
Is crohn’s disease life threatening? Crohn’s disease is a gradual progressive disease. If death occurs its normally due to untreated complications rather than the actual disease itself. (24)
Summary
Crohn’s disease is a long lasting illness with no cure. It will cause inflammation along the GI tract. It will cause symptoms such as diarrhea, abdominal pain or cramps and weight loss.
It can also affect anyone, although younger adults between the ages 20 and 29 present a higher risk, as well as people with family members who are already affected.
The disease can be debilitating and requires constant tracking of what you eat and your treatment. That said, with the help of the right management most people live long and happy lives.