Crohn's disease is an inflammatory bowel disease (IBD) that causes chronic inflammation (swelling) and damage to the GI tract. The GI tract is in charge of digestion, nutrient absorption, and waste elimination.
Crohn's disease may manifest in "patches," affecting some areas of the GI tract while leaving others unaffected.
Inflammation (swelling) impairs the ability of the affected GI organs to function normally, resulting in symptoms such as chronic diarrhea, abdominal pain, rectal bleeding, weight loss, and fatigue. Symptoms differ and can shift over time. The disease can cause life-threatening flares and complications in severe cases.
The initial laboratory evaluation detects inflammation and screens for other diagnoses. To confirm the diagnosis and determine the extent of disease, endoscopy and cross-sectional imaging are used. Treatment decisions are guided by disease severity and risk of poor outcomes.
Treatment for Crohn's disease and other IBD types may include medication, dietary and nutritional changes, and, in some cases, surgical procedures to repair or remove affected portions of your GI tract.
Crohn's disease patients are more likely to develop cancer, osteoporosis, anemia, nutritional deficiencies, depression, infection, and thrombotic (blood clotting) events. It is critical to maximize prevention measures when caring for these patients.
The symptoms of IBD vary from person to person, may change over time, and can range from mild to severe.
During a flare of Crohn’s disease symptoms, a person may also develop
There are five types of Crohn's disease including:
The exact cause of IBD is unknown, but it is thought to involve a combination of genetic predisposition, infectious, immunological, dietary, and environmental factors.
Crohn's disease causes inflammation (swelling) anywhere from the mouth to the anus. However, the disease most commonly affects the junction of the small intestine and the colon (ileum). It begins with lesions near the intestinal crypt (a gland found in intestines). It eventually spreads to form ulcers, first in the superficial layer and then in deeper intestine tissues.
As the swelling worsens, non-caseating granuloma (cell swelling without cell death) forms, which is very common in Crohn's disease. This ongoing swelling causes bowel obstruction and stricture formation (a narrowing of the bowel which can lead to an intestinal blockage).
Risk factors for Crohn's disease may include:
Genetics may also play a role, since Crohn's disease can run in families. Having a close relative with Crohn's disease increases the likelihood of developing the condition. If both parents have inflammatory bowel disease (IBD), the risk of developing Crohn's disease rises to 35%.
Note: As per study it has been found that children who have one parent with Crohn's disease have a 7 to 9 percent lifetime risk of developing the condition.
They also have a 10 percent chance to develop some form of inflammatory bowel disease.
CD can occur at any age but the condition mostly develops before or around 30 years of age.
Crohn’s disease is an autoimmune-mediated inflammatory condition. Foreign invaders such as bacteria, viruses, fungi, and other microorganisms are typically attacked and killed by the immune system.
An autoimmune reaction occurs when your immune system incorrectly attacks healthy cells in your body, causing an abnormal response to the intestinal tract and swelling. This causes chronic inflammation (swelling), ulceration, intestinal wall thickening, and, eventually, Crohn's disease symptoms.
Check out our immune test package.
Stress may also have an important role in the pathogenesis of IBD. It has been proposed that stress may initiate or reactivate the gastrointestinal inflammation leading to the deterioration of clinical symptoms of IBD.
Learn more about how stress can affect the body.
There are several environmental factors that can increase the risk of developing and flaring up Crohn’s disease, such as:
To diagnose Crohn's disease, doctors typically use combination of tests. Before undergoing a physical examination, you must inform your doctor about your medical history, including any medications you are taking and your family history.
It includes blood tests (RBC and WBC’s count) and stool test.
Stool test: It checks for bacteria or parasites. It is useful in ruling out infections that cause chronic diarrhea.
Intestinal endoscopy- It includes the following
The "treat to target" or "tight control" approach is quickly becoming the approach in the treatment and management of many chronic conditions, including IBD and Crohn's disease.
Certain lifestyle modifications can help prevent the condition as follows-
Such as limiting dairy products, having a fibrous diet comprising fruits, vegetables, legumes and whole grains. Restrict foods with low amounts of fiber such as processed and packaged foods, milk and meat products.
Want to know how a healthy diet can help you?
Drink a minimum of 8 glasses of water during a day. Restrict intake of alcohol and caffeine in the form of coffee and soft drinks as they tend to dehydrate the body.
Cigarette smoking flare up the Crohn’s symptoms or even worsen them.
Looking to quit smoking, but finding it very difficult? Read about some practical ways that will help you get rid of this unhealthy habit .
Consult your doctor about getting screened for colorectal cancer. Patients with IBD may need to begin colorectal cancer screening before the age of 50. Talk to your doctor about how to prevent cervical cancer if you are a woman with IBD. Cervical cancer is more common in IBD patients.
Immunizations against infectious diseases are part of primary prevention efforts. IBD patients are more likely to contract vaccine-preventable illnesses such as influenza, pneumococcal pneumonia, and shingles. As a result, following vaccination guidelines for inactivated vaccines can help to reduce these infectious complications.
Note: Immunization is the key to the prevention of diseases.
Want to Know More About Immunization?
Stay active by exercising regularly. To aid digestion, perform light exercises such as walking after consuming heavy meals.
Stress and anxiety can aggravate Crohn's disease symptoms. Stress can also precipitate flare-ups.
Is stress affecting your overall well-being? Try some relaxation techniques to manage stress.
The first step is to find a qualified gastroenterologist who is a specialist in treating patients with Crohn’s disease or ulcerative colitis. In order to diagnose and treat the symptoms of Crohn's disease, you need to visit:
A gastroenterologist is a medical practitioner specializing in the diagnosis and treatment of disorders of the gastrointestinal tract and related organs.
An infectious disease specialists is a physician who diagnoses and treatments acute and chronic diseases caused by bacteria, viruses, fungi, parasites, and even prions.
When to see a doctor?
You must visit a doctor if Crohn's disease becomes a chronic problem and/or is accompanied by one or more of the following symptoms such as:
Consult India’s best doctors here with a single click.
The medical treatment is broadly classified into five groups-
It helps control swelling at the wall of the intestine. It is usually prescribed to treat people who are newly diagnosed with Crohn’s disease and have mild symptoms. These drugs include:
These, also known as steroids, help to suppress the immune system and reduce swelling. It is usually given to people who have moderate to severe symptoms. They are effective for controlling flare-ups in the short term. Because of their side effects, they are not recommended for long-term or maintenance use.
Drugs include:
These medications suppress the immune system, resulting in less swelling in the digestive tract. These medications are used to keep people in remission who have not responded to other medications or have only responded to steroids. The drugs include:
Biologic therapies are indicated for people with with moderate to severe active disease who have not responded well to conventional therapy.The drugs that are used include:
Even with medicines, many people will need surgery to treat their Crohn’s disease. There are different types of operations to treat Crohn’s disease such as-
1. Small bowel resection- This surgery often involves removal of the diseased segment of bowel (resection), the two ends of healthy bowel are then joined together (anastomosis). There are two types of small bowel resection-
2. Subtotal colectomy or large bowel resection- It is done to remove part of your large intestine.It is again of two types-
3 Proctocolectomy and ileostomy- It is a surgical procedure that removes your entire colon and rectum. An ileostomy is a stoma, or opening in your abdomen, created by a surgeon from a section of your ileum.
Some people develop complications that may require urgent medical care which includes-
1. Fistulas- Fistulas are ulcers on the intestine's wall that spread and form a tunnel (fistula) to another part of the intestine, the skin, or another organ.
2. Stricture- It is a narrowing of an intestine section caused by scarring, which can result in an intestinal blockage.
3. Abscess- A collection of pus that can form in the abdomen, pelvis, or around the anal area. A doctor may drain an abscess with a needle inserted through your skin or through surgery.
4. Perforated bowel- chronic intestine swelling can weaken the wall to the point where a hole forms.
5. Anal fissures- Anal fissures are small tears in the anus that can cause itching, pain, and bleeding. The majority of anal fissures heal with medical treatment, such as ointments, warm baths, and dietary changes.
6. Intestinal obstruction- a blockage in the intestine.
7. Ulcers- open sores in your mouth, intestines, anus, or perineum
8. Malabsorption and malnutrition, including deficiency of vitamins and minerals- You may need IV fluids or feeding tubes to replace lost nutrients and fluids.
9. Swelling (in other parts of body such as your joints, eyes, and skin)
Some patients develop symptoms that are related to the disease but affect other parts of the body. The extraintestinal complications include:
Along with the medicine your doctor prescribes, you may want to add “complementary” treatments to help with Crohn’s symptoms, boost your immune system, or just feel better every day.
1. Pay attention to diet: Changing your diet can help reduce symptoms. You must try the following diet modifications:
2. Probiotics: Probiotics aim to restore that balance by adding good bacteria in the gut. They can help improve digestion and certain strains have shown they help reduce symptoms of Crohn’s.
Food sources of probiotics include yoghurt, tofu etc.
Here’s more about the health benefits of probiotics.
3. Prebiotics: Prebiotics provide fuel for the good bacteria growing in your digestive tract.
Some prebiotic sources include asparagus, legumes, bananas etc.
Probiotics and prebiotics may prove effective in keeping our gut healthy. Check out our prebiotics and probiotics supplement range.
4. Anti-inflammatory food: It includes virgin olive oil, green leafy vegetables (spinach, kale), fatty fish (tuna, salmon), fruits (strawberry, cherries, oranges) etc. These foods will help combat free radical damage and encourage less overall inflammation (swelling).
Read more about an anti-inflammatory diet for a healthy body
5. Herbs:
Read more about 5 other benefits of turmeric for a healthy body
Note: Talk to your doctor or dietician if you have any concerns about diet or food. But do not start any supplements or dietary modifications on your own without consulting your doctor or dietician.
6. Exercise and yoga: Any form of exercise or yoga can ease stress is a great way to relax and help your intestines work more normally. That can be key for Crohn’s, since stress can trigger flare-ups and make symptoms worse.
Know more about yoga benefits.
7. Take proper rest: During flare-ups, you should consume a liquid diet to allow your system to rest and re-set. Aside from bowel rest, try to get extra sleep, go slowly, avoid stress and intense exercise, and take naps as needed. Allow your body to heal.
8. Moxibustion:It is a type of traditional Chinese medicine that is typically administered in conjunction with acupuncture. The two approaches are thought to complement each other best. It's similar to heat therapy.
Dry herbs are burned close to your skin, often near acupuncture points. Moxibustion combined with acupuncture may help with Crohn's symptoms.
