Crohn’s Disease

More than half a million Americans have Crohn’s disease, and it’s becoming more common, according to the National Institute of Diabetes and Digestive Kidney Diseases.

Most people find out they have Crohn’s in their 20s and 30s, but it can happen to anyone at any age. Crohn’s disease and ulcerative colitis are the two most common types of inflammatory bowel disease. While Crohn’s can affect any part of the digestive tract, it typically affects the small intestine and parts of the large intestine (colon). It can attack some parts of the digestive tract while skipping over other parts. Ulcerative colitis only causes inflammation in the large intestine and does not skip sections of the tract.

There is no cure for Crohn’s. While its symptoms or complications can be life threatening, it’s not a fatal disease. People with Crohn’s have a similar life expectancy to people without it, but their quality of life will be decreased. With the proper treatment, people with the disease can manage symptoms and improve their quality of life.

There are five types of Crohn’s disease according to the Crohn’s & Colitis Foundation. These are ileocolitis, ileitis, gastroduodenal Crohn’s disease, jejunoileitis and Crohn’s colitis. Some medical centers recognize a sixth type called perianal disease.

Each type affects a different part of the digestive tract and causes different symptoms and complications.

Ileocolitis

Ileocolitis is the most common type of Crohn’s disease, and it affects about 50 percent of patients, according to Beth Israel Deaconess Medical Center. The end of the small intestine and the large intestine are affected.

It causes pain in the lower and middle abdomen. Other symptoms include cramping, diarrhea and significant weight loss.

Ileitis

Ileitis only affects the ileum, the last part of the intestine. About 30 percent of Crohn’s patients experience this type.

It has the same symptoms as ileocolitis, but severe cases may cause abscesses in the lower part of the abdomen and fistulas — abnormal connections between two body parts, such as organs or blood vessels.

Gastroduodenal Crohn’s Disease

Gastroduodenal Crohn’s disease is also called upper GI Crohn’s disease, and it affects the stomach and the first part of the small intestine called the duodenum. This type is uncommon and affects about five percent of patients.

Symptoms include vomiting, nausea, weight loss, loss of appetite and pain in the upper abdomen.

Jejunoileitis

Jejunoileitis affects the upper half of the small intestine, called the jejunum. It causes patchy areas of inflammation and is uncommon.

Symptoms include abdominal pain after eating that may be mild to intense, weight loss, diarrhea and malnutrition. In severe cases, fistulas may form.

Crohn’s (Granulomatous) Colitis

Crohn’s colitis only affects the large intestine, or colon, and affects about 20 percent of patients. Symptoms include rectal bleeding, abdominal pain, diarrhea and anal disorders such as abscesses and ulcers. People who have this type may also develop joint pains and skin lesions.

Perianal Disease

Perianal disease affects the anus — up to one-third of Crohn’s patients have this type of disease. Symptoms include fistulas, sores or ulcerations, abscesses and skin tags outside the anus.

Symptoms of Crohn’s range from mild to very severe. For example, people with mild disease may have abdominal pain or frequent diarrhea, but can eat normally and don’t have weight loss. People with very severe disease have high fevers, persistent vomiting, intestinal obstructions or abscesses and severe weight loss.

While Crohn’s affects the digestive tract, it may also cause extraintestinal symptoms. These symptoms affect parts of the body outside the digestive tract, such as the eyes, joints and skin.

Researchers don’t fully understand what causes Crohn’s. At one time, doctors speculated that stress and diet might cause the disease. More studies led doctors to believe that while these factors may aggravate symptoms, they don’t cause Crohn’s.

Now, the most popular theory is that Crohn’s is an autoimmune condition. This means that the immune system overreacts to bacteria or viruses in the gastrointestinal tract. While attempting to fight these organisms, it also attacks healthy cells, causing chronic inflammation.

Some scientists believe that certain people’s genes may make them more susceptible to having Crohn’s.

People who have been diagnosed with cancer after taking the antacid Zantac may also receive a Crohn’s diagnosis from their doctor. Stomach, intestine, colorectal and bladder cancers are a handful of the main cancers associated with Zantac in claims.

While researchers don’t know what causes Crohn’s, certain factors increase a person’s risk for developing the disease.

People who have Crohn’s are at risk for several complications from bowel obstructions to colon cancer.

Doctors diagnose Crohn’s with blood tests, fecal tests and imaging procedures that look inside the colon, such as a colonoscopy, CT scans and MRIs.

Crohn’s disease has no cure, so treatment focuses on preventing complications, healing the intestinal lining and preventing surgery. Each person’s treatment plan is different depending on the severity of the disease.

Medications

Medications for Crohn’s suppress the immune system to treat symptoms or complications such as diarrhea and infections.

Antibiotics

Antibiotics treat infections which can lead to can lead to abscesses. These include ciprofloxacin, tetracycline, ampicillin and metronidazole.

Antidiarrheal Medication

People with Crohn’s may have severe diarrhea. Antidiarrheal drugs — such as Imodium A-D (loperamide), Lomocot, Lomotil (diphenoxylate), Prevalite and Questran (cholostyramine) and Pepto-Bismol (bismuth subsalicylate) — can help manage this symptom.

Immune System Suppressors

These medications suppress the immune system to calm inflammation. Examples include Remicade (infliximab), Humira (adalimumab), Cimzia (certolizumab pegol), Trexall (methotrexate), Stelara, (ustekinumab) and Entyvio (vedolizumab).

Corticosteroids

Prednisone, cortisone and other corticosteroids reduce inflammation. These should not be used long term and are usually a bridge to stronger medications.

Nutrition and Diet

Diet doesn’t cause Crohn’s but certain foods may make symptoms worse. It’s also important to eat a healthy diet to replace lost nutrients and promote healing.

For people with Crohn’s, eating can be uncomfortable because of pain in the abdomen. Loss of appetite may also make it difficult to eat. Additionally, diarrhea can make it more difficult for the body to absorb nutrients.

These challenges may affect a patient’s overall health, especially because an estimated 70 percent to 80 percent of immune cells live in the gut.

There is no specific meal plan for Crohn’s patients, but the Crohn’s & Colitis Foundation recommends eating smaller meals, drinking slowly, preparing meals in advance and using simple techniques such as steaming, poaching, grilling or steaming.

Procedures

If medications aren’t enough, doctors may recommend other procedures to control Crohn’s and treat complications.

Bowel Rest

Bowel rest involves not eating or drinking for several days or longer. This gives the intestines a chance to heal. Patients will get their nutrition intravenously or through a feeding tube.

Surgery

Surgery isn’t a cure for Crohn’s but it may be necessary to treat complications such as bleeding, fistulas, blockages or intestinal perforations (holes).