By Dr. Brian Bressler and Gary Gilles
What is Crohn’s disease?
If you have Crohn’s disease it means that you have inflammation of the lining of your digestive or gastrointestinal (GI) tract. This inflammation can affect any part of your GI tract, which includes your esophagus, stomach, the large intestine (also called the colon) and the small intestine. The primary purpose of the GI tract is move food through your system so that your body can absorb the fluids and nutrients it needs for healthy functioning before eliminating the waste. The inflammation that accompanies Crohn’s disease disrupts the healthy absorption of fluid and nutrients. Over time, this inflammation causes swelling of the intestinal passages. The swelling can slow the movement of food through the intestines resulting in pain, cramps and frequent emptying of the bowel.
Digestive or gastrointestinal (GI) tract
What causes Crohn’s?
We don’t know for certain what causes Crohn’s disease but researchers believe there is both a genetic and environmental link. Genetically, Crohn’s tends to run in families. Those with a first-degree relative with Crohn’s are at higher risk for getting the disease. Researchers are still working to understand the exact genetic link.
There also appears to be an environmental component to Crohn’s that creates an abnormal immune response. Typically, your immune system identifies harmful agents like unhealthy bacteria and viruses and destroys them. But, in Crohn’s disease, the immune system appears to attack beneficial bacteria causing an excess of white blood cells to accumulate in the lining of the intestines. This autoimmune response causes chronic inflammation of the intestines. Researchers believe that the autoimmune response might be triggered by environmental factors that are still under study.
Though certain foods and stress may worsen Crohn’s symptoms, neither are believed to be the cause of the disease.
What is the difference between Crohn’s and other inflammatory bowel diseases (IBDs)?
Crohn’s disease is often assumed to be the same condition as ulcerative colitis, both of which are considered to be inflammatory bowel diseases (IBDs). Though there is some overlap in symptoms between Crohn’s and ulcerative colitis, different parts of the body are affected. Crohn’s can affect any part of the GI tract, from the mouth to the anus, while ulcerative colitis is limited to the colon.
The inflammation that accompanies Crohn’s disease can affect the entire thickness of the bowel wall. In contrast, only the innermost lining of the colon is affected with ulcerative colitis.
Another difference is that in Crohn’s disease, the inflammation of the intestine can be intermittent with spaces of normal, non-inflamed areas between the affected areas. In ulcerative colitis this spacing of inflammation does not occur.
In only about 10% of cases a person will have symptoms of both Crohn’s disease and ulcerative colitis.
Who is likely to get Crohn’s?
Crohn’s disease affects people of all ages though first symptoms usually begin between the ages of 13 and 30. Both men and women are affected by Crohn’s and many have a biological relative with the disease. All ethnic groups are susceptible to Crohn’s but Caucasians and those from Eastern European Jewish heritage are at greater risk as are those who smoke.
Common symptoms of Crohn’s
Every person experiences Crohn’s differently. Some people have frequent occurrence of symptoms while others may have few, if any, symptoms. Here are the most common symptoms associated with Crohn’s:
- Diarrhea. The more inflamed the intestinal wall becomes, the harder it is for the intestine to absorb water. This leads to a loose stool and diarrhea.
- Abdominal pain, loss of appetite and weight loss. The abdominal pain and cramping is caused by the swelling of the intestinal passageways making it difficult for food to move through the intestines. Due to this discomfort, some eat less frequently and may experience weight loss.
- Anemia and fatigue. Rectal bleeding may also occur. This blood loss may possibly lead to anemia, which is a condition where there are not enough red blood cells. Anemia causes fatigue.
- Fistulas. The inflammation that accompanies Crohn’s may cause a fistula to develop. A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. In Crohn’s, a fistula typically will develop as a tunnel from one loop of intestine to another and most commonly occurs around the anal area. This might cause drainage of mucus or stool from the anal opening.
Is there a cure?
Because we haven’t clearly determined the cause of Crohn’s there is currently no cure. The basic goal of treatment is to decrease the inflammation of the GI tract, which then helps to control and manage the symptoms. Doctors typically use medications and nutrition to relieve symptoms and can even achieve a state of remission in some people. Sometimes surgery is also needed.
Though Crohn’s is considered a chronic or life-long condition, proper treatment allows many to go long periods without symptoms or flare-ups. And it is possible to live a full and productive life with Crohn’s. Your best starting point for taking control of Crohn’s is to learn as much as you can about the disease and how to manage your symptoms.