What is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel disease. Crohn’s disease most commonly occurs in the small intestine and the colon. However, the disease can affect any part of your gastrointestinal (GI) tract, from your mouth to your anus. The disease can involve some parts of the GI tract and skip other parts. As many as 780,000 Americans have this disease.
More research about Crohn’s disease is necessary. Researchers aren’t sure how it begins, who is most likely to develop it, or how to best manage it any one person. Despite major advances in treatment in the last three decades, no cure is available.
The range of severity can be from mild to debilitating. The symptoms vary and can change over time. In some people, the disease can lead to life-threatening flares and complications.
Symptoms of Crohn’s Disease
The symptoms of Crohn’s disease often develop gradually. Certain symptoms may also become worse over time.
Although it’s possible, it’s rare for symptoms to develop suddenly and dramatically.
The earliest symptoms of Crohn’s Disease can include:
- blood in your stool
- a fever
- a loss of appetite
- feeling a frequent need for bowel movements
- abdominal cramps
- weight loss
- feeling as if your bowels aren’t empty after a bowel movement
It’s sometimes possible to mistake these symptoms for the symptoms of another condition, such as food poisoning, an upset stomach, or an allergy. You should see your doctor if any of these symptoms persist.
The symptoms may become more severe as the disease progresses. These symptoms can include:
- inflammation of the joints and skin
- shortness of breath or decreased ability to exercise due to worsening anemia
- a perianal fistula, which causes pain and drainage near your anus
- ulcers that may occur anywhere from the mouth to the anus
Early detection and diagnosis can help you avoid severe complications and allow you to begin treatment early.
Causes Crohn’s Disease
It isn’t clear what causes Crohn’s disease. However, the following factors may influence whether you get it:
- your genetics
- your environment
- your immune system
Up to 20 percent of people with Crohn’s disease also have a parent, child, or sibling with the disease.
Certain things can affect the severity of your symptoms. This includes:
- whether or not the rectum is involved
- whether you smoke
- your age
- length of time with the disease
Individuals with Crohn’s disease are also more likely to develop intestinal infections from bacteria, viruses, parasites, and fungi. This could affect the severity of symptoms and create complications. Crohn’s disease and its treatments can affect the immune system, making these types of infections worse in people with inflammatory bowel disease (IBD).
Yeast infections from Candida are common in Crohn’s and can affect both the lungs and the intestinal tract. It’s important that these infections are diagnosed and properly treated with antifungal medications to prevent further complications.
Treatment for Crohn’s Disease
A cure isn’t available for Crohn’s disease, but it can be manageable. A variety of treatment options may be able to lessen the severity and frequency of your symptoms.
More than four classes of medication are used to treat Crohn’s disease. First-line treatments include anti-inflammatory drugs. More advanced options include biologics, which use the body’s immune system to treat the disease.
If less invasive treatments and lifestyle changes don’t alter or improve your symptoms, surgery may be necessary. Ultimately, about 70 percent of people with Crohn’s disease will require surgery at some point in their lives.
Some types of surgery may include removing damaged portions of your digestive tract and reconnecting the healthy sections. Other procedures may be required to repair damaged tissue, manage scar tissue, or treat deep infections.
Food doesn’t cause Crohn’s disease, but it can trigger disease flares. After a Crohn’s diagnosis, a doctor will likely suggest making an appointment with a registered dietitian (RD). An RD will guide you through the process of understanding how food may affect your symptoms.
In the beginning, they may ask you to keep a food diary. This food diary will detail what you ate and how it made you feel.
Using this information, the RD will set out guidelines for you to follow. These nutrition and dietary changes should help you absorb more nutrients from the food you eat while also limiting any side effects the food may cause.
Crohn’s Disease and Ulcerative Colitis
Crohn’s disease and ulcerative colitis (UC) are two types of IBD. They have many of the same characteristics, and people may mistake them for one another.
They have the following characteristics in common:
- The first signs and symptoms of both Crohn’s disease and UC are very similar. These symptoms can include diarrhea, abdominal pain and cramping, rectal bleeding, weight loss, and fatigue.
- Despite decades of research, scientists still don’t know what causes either disease. In both cases, an overactive immune system is a likely culprit, but other factors may play a role.
- Both UC and Crohn’s disease occur more commonly in people ages 15 to 35 and people with a family history of either type of IBD.
- In general, IBD tends to affect men and women equally, but this can vary depending on age.
Here’s how they differ:
- UC only affects the outermost layer of tissue lining your colon, the mucosa. Crohn’s disease can affect all layers of your intestinal tissue from superficial to deep.
- UC only affects the colon. Crohn’s disease can affect any part of your gastrointestinal tract, from your mouth to your anus.
UC is just one type of colon inflammation, known as colitis. Several other types of colitis exist. Not all forms of colitis cause the same type of intestinal inflammation and damage as UC.
Medications for Crohn’s Disease
Several types of medications are available to treat Crohn’s. First-line treatments include anti-inflammatory drugs. More advanced options include biologics, which use the body’s immune system to treat the disease.
Which medications you need and which your doctor may combine depends on your symptoms, your disease history, the severity of your condition, and how you respond to treatment.
An overactive immune system causes the inflammation that leads to the symptoms of Crohn’s disease. Immunomodulators may reduce the inflammatory response and limit your immune system’s reaction.
Some doctors believe antibiotics may help reduce some of the symptoms of Crohn’s and some of the possible triggers for it.
For example, antibiotics can reduce drainage and heal fistulas, abnormal connections between tissue, that Crohn’s causes.
Antibiotics can also kill off any foreign or “bad” bacteria present in your gut that could be contributing to inflammation and infection.
The two main types of anti-inflammatory drugs doctors use to treat Crohn’s are oral 5-aminosalicylates and corticosteroids. Anti-inflammatory drugs are often the first drugs people take for Crohn’s disease treatment. People typically take these drugs when they have mild symptoms with infrequent disease flares.
If you have severe Crohn’s, your doctor may try a number of biologic therapies to treat the inflammation and complications that can occur from the disease. Biologic therapies can block specific proteins that may trigger inflammation.
Diagnosing Crohn’s Disease
No single test result can allow your doctor to diagnose Crohn’s disease. Your doctor will begin by eliminating any other possible causes of your symptoms. Making a Crohn’s disease diagnosis is a process of elimination.
Your doctor may use several types of tests to make a diagnosis:
- Your doctor may perform a colonoscopy to examine the large bowel.
- Your doctor will likely take a tissue sample, or biopsy, during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.
- Imaging tests like CT scans and MRI scans give your doctor more detail than an average X-ray. Both tests allow your doctor to see specific areas of your tissues and organs.
- Blood tests can help your doctor look for certain indicators of potential problems, such as anemia and inflammation.
- A stool test can help your doctor detect blood in your stool.
- Your doctor may request an endoscopy to get a better image of the inside of your upper gastrointestinal tract.
Once your doctor has completed the necessary tests and ruled out other possible reasons for your symptoms, they may decide on a Crohn’s disease diagnosis. Your doctor may request these tests several more times to look for diseased tissue and determine how the disease is progressing.
Natural Treatment for Crohn’s Disease
Many people use complementary and alternative medicine (CAM) for various conditions and diseases, including Crohn’s disease. The U.S. Food and Drug Administration hasn’t approved these medicines for treatment, but many people use them in addition to mainstream medications.
Talk to your doctor if you’re interested in trying any of these treatments alongside your current regimen.
Popular alternative treatments for Crohn’s disease include the following:
- Prebiotics are potentially beneficial materials found in plants, such as asparagus, bananas, artichokes, and leeks, that may help feed the good bacteria in your gut and increase their numbers. Prebiotics can also be found in supplement form.
- Fish oil is rich in omega-3s, and research is ongoing in its possible treatment for people with Crohn’s disease.
- Probiotics are live bacteria that can help you replace and rebuild the good bacteria in your intestinal tract. Probiotics may also help prevent microorganisms from upsetting your gut’s natural balance and causing a Crohn’s flare. However, scientific data is limited.
- People believe that the aloe vera plant has anti-inflammatory properties. Because inflammation is one of the key components of Crohn’s disease, people often use it as a natural anti-inflammatory. However, there is no current research that suggests aloe vera helps with Crohn’s. You can find a great selection of aloe vera gels, creams, juices, and more here.
- Many people believe certain herbs, vitamins, and minerals ease the symptoms of a variety of diseases, including Crohn’s disease. Research is ongoing as to which supplements may be beneficial, especially when combined with current proven treatments.
Tell your doctor if you use any CAM treatments or over-the-counter medications.
Some of these compounds may negatively impact the efficiency of medicines or other treatments your doctor prescribes for you. In some cases, an interaction or side-effect could be dangerous, even life-threatening.
Food to eat for people with Crohn’s Disease
A diet plan that works for one person with Crohn’s disease may not work for another. This is because the disease can involve different areas of the gastrointestinal (GI) tract in different people.
It’s important to find out what works best for you. This can be done by keeping track of your symptoms as certain foods are added or removed from your diet. Changes to your diet and lifestyle may help you reduce the recurrence of symptoms and lessen their severity.
If you have Crohn’s disease, you may need to:
Adjust your fiber intake
Some people need a high-fiber, high-protein diet. For others, the presence of extra food residue from high-fiber foods such as fruits and vegetables may aggravate the GI tract. If this is the case, you may need to switch to a low-residue diet.
Crohn’s disease may affect your body’s ability to absorb water from your digestive tract. This can lead to dehydration. The risk for dehydration is especially high if you’re having diarrhea or bleeding.
Limit your fat intake
Crohn’s disease may interfere with your body’s ability to break down and absorb fat. This excess fat will pass from your small intestine to your colon. This could lead to diarrhea.
Limit your dairy intake
Previously, you may not have had lactose intolerance, but your body can develop difficulty digesting milk proteins when you have Crohn’s disease. Consuming dairy can lead to an upset stomach, abdominal cramps, and diarrhea for some people.
Consider alternative sources of vitamins and minerals
Crohn’s disease can affect your intestines’ ability to absorb other nutrients from your food properly. Eating high-nutrient foods may not be enough. Talk to your doctor about taking multivitamins to find out if they’re right for you.
Work with your doctor to figure out what best suits your needs. They may refer you to a dietitian or nutritionist. Together, you can identify your dietary limitations and create guidelines for a well-balanced diet.
Crohn’s Disease Statistics
The Crohn’s and Colitis Foundation of America (CCFA) reports the following statistics:
- A total of 1.6 million Americans have some form of inflammatory bowel disease. This total includes over 780,000 Americans who have Crohn’s disease.
- People who smoke are twice as likely to receive a diagnosis of Crohn’s disease.
- If they get treatment, medical or surgical, 50 percent of people with Crohn’s disease will go into remission or experience mild symptoms within five years of their diagnosis.
- About 11 percent of people who have Crohn’s will experience a chronically active disease.
The CCFA also reports the following:
- In 2004, 1.1 million doctors’ office visits were for the treatment and care of Crohn’s disease.
- In 2010, Crohn’s disease accounted for 187,000 hospitalizations.
- The average person with Crohn’s disease will spend anywhere from $8,265 to $18,963 annually to treat or manage the disease directly.
According to 2016 data:
- Crohn’s disease occurs about as frequently in men as in women.
- Two out of three individuals with Crohn’s disease will be diagnosed before the age of 40.
- During their 50s and 60s, more men are diagnosed with Crohn’s than women.
Crohn’s disease and disability benefits
Crohn’s disease can disrupt your work and personal life. It can also cause financial stress. If you don’t have health insurance and sometimes even if you do, your out-of-pocket expenses can total several thousand dollars per year.
If the disease becomes severe enough that it’s affecting your daily life in a significant way, you should consider filing for disability.
If you can prove that your condition prevents you from working or has prevented you from working for the last year, you may be eligible to receive disability income. Social Security Disability Insurance or Social Security Income may provide this type of assistance.
Applying for disability can be a long and tedious process. It requires a lot of appointments and checkups with doctors. You may have to pay for multiple doctors’ visits if you don’t have insurance. You’ll need to take time off of work if you’re currently employed. You could face a lot of ups and downs as you work through the process. You may also receive a denial and have to begin the whole process again.
You can begin your Social Security application process by doing one of the following:
- Apply online.
- Call the Social Security Administration’s toll-free hotline at 800-772-1213 Monday through Friday, 7 a.m. to 7 p.m.
- Find and visit your nearest Social Security office.
Variations of Crohn’s Disease
There are six common variations of Crohn’s disease based on its location. They include the following:
- Gastroduodenal Crohn’s disease mainly affects your stomach and the duodenum, which is the first part of your small intestine. About 5 percent of people with Crohn’s disease have this type.
- Perianal disease affects about 30 percent of people with Crohn’s. This variation often involves fistulas, or abnormal connections between tissues, deep tissue infections, along with sores and ulcers on the outer skin around the anus.
- Ileocolitis, which affects the ileum and the colon, is the most common variation of Crohn’s. Approximately 50 percent of people with Crohn’s disease have this variation.
- About 20 percent of people with Crohn’s disease have Crohn’s colitis, which affects the colon only. Both ulcerative colitis and Crohn’s colitis impact the colon only, but Crohn’s colitis can affect deeper layers of the intestinal lining compared to ulcerative colitis.
- Jejunoileitis occurs in the second portion of your intestine, called the jejunum. Like gastroduodenal Crohn’s, this variation is much less common.
- Ileitis is inflammation in the last part of the small intestine, or ileum. About 30 percent of people with Crohn’s disease are affected at this location.