Crohn’s disease is an autoimmune disorder that occurs when the immune system, which usually fights infection, attacks the lining of the digestive tract, causing it to bleed and develop ulcers.
“Crohn’s disease is typically disruptive to people’s lives,” says Ernest DiGiovanni, DO, a gastroenterologist with Regional Medical Center Bayonet Point in Hudson, Florida. “It’s usually classified as mild-to-moderate or moderate-to-severe. A person can have excruciating pain or so many bowel movements a day that they can’t leave the house. It can be disruptive for sure.”
Causes and symptoms of Crohn’s disease
What causes Crohn’s disease is unknown. “It may be genetic, it may be infectious,” says Dr. DiGiovanni. “Researchers have found some genes that are potentially associated with the condition, and between 15 and 20 percent of people with Crohn’s have a relative with Crohn’s.”
Infection, such as a viral or bacterial illness, or exposure to another environmental trigger could cause those with a genetically higher risk for Crohn’s to develop the condition.
The most common features of Crohn’s disease include abdominal pain, diarrhea, weight loss and fatigue. Depending on where in the body the Crohn’s affects, other symptoms could include:
- Mouth sores
- Eye inflammation
- Problems of the anus, including tears, ulcers, fistulas, infection and narrowing
People with Crohn’s may also have joint inflammation or arthritis, particularly in their larger joints, which tends to worsen during IBD flare-ups.
Crohn’s disease vs. ulcerative colitis
Crohn’s disease can affect any part of the digestive tract. When inflammation is limited to the colon and rectum, it’s known as ulcerative colitis.
Crohn’s and ulcerative colitis are similar but different, DiGiovanni says. “The main difference is what part of the body each affects,” he says. “Both affect the colon, but ulcerative colitis always affects the rectum—the most bottom part of the colon—and extends upward. In Crohn’s, the most common affected area is in the last part of the small intestine, but it can affect anywhere in the gastrointestinal tract, including the stomach and even the mouth.”
Crohn’s disease and ulcerative colitis are the two main disorders known collectively as inflammatory bowel disease, or IBD. Keep in mind, IBD should not be confused with irritable bowel syndrome (IBS). “IBS is a syndrome of exclusion commonly characterized by alternating constipation and diarrhea,” says Dr. DiGiovanni, meaning that IBS is something that is diagnosed only when other likely diagnoses are ruled out.
Between 1 million and 1.3 million Americans have IBD. Colitis is slightly more common overall, and is more common in men than women, while Crohn’s disease is more likely to affect women.
Treatment options
There is no cure for Crohn’s disease but there are many treatment options. The drugs used to help manage the condition, including steroids and antibiotics, aim to reduce inflammation. Since Crohn’s is an autoimmune disease, immunotherapy drugs known as biologics can also help ease inflammation, but these medications can have severe side effects. Some healthcare providers will start a patient with the strongest drugs (the top-down approach), while others will save those drugs until after other treatments have failed (the step-up approach).
If medication doesn’t help, the next option is surgery. One surgical option is removing part of the colon and then reattaching the two ends. If this isn’t possible, a surgeon can make an opening in the abdomen, through which waste will exit the body and be collected in an ostomy bag. Another option is opening blockages in the bowel called strictures.
Preventing flare-ups
There may be certain foods that could worsen your symptoms during a Crohn's disease flare-up, but it’s also important to ensure that you’re getting adequate nutrition. Many people with Crohn’s have vitamin deficiencies because the intestines don’t absorb nutrients as efficiently as in people without Crohn’s, notes DiGiovanni.
Be sure to work with your doctor or a dietitian who specializes in IBD to develop a personalized eating plan that meets your individual needs.
It’s also essential to avoid or quit smoking. Smoking increases the risk of developing Crohn’s and may make the condition more severe. “Smoking has been shown to be very detrimental,” DiGiovanni says. “The first thing you need to do is stop smoking.”
