What is Crohn's disease?
Crohn's disease is an inflammation of the intestines (bowel). It can affect the part of the small intestine called the ileum or the large intestine (colon) or both. It is a life-long condition, but your symptoms may come and go. Crohn's disease is 1 of the 2 illnesses called inflammatory bowel disease. (The other disease is ulcerative colitis.)
Crohn's disease causes swelling, redness, and even sores (ulcers) in the intestines. The ulcers can make a hole in the wall of the intestine, which can cause life-threatening infection and bleeding. Both the swelling and scar tissue from the sores can block the passage of food through the intestines.
How does it occur?
The cause of Crohn's disease is not known. It is believed to be an autoimmune problem. This means that the body's defenses against infection are attacking your own tissue, but this has not been proven.
What are the symptoms?
Symptoms of Crohn's disease include:
- abdominal pain or cramping, often on the lower right side
- slight fever
- weight loss
- tenderness of the rectum
- rectal pain with bowel movements
- mucus in bowel movements.
How is it diagnosed?
Your healthcare provider will review your symptoms and examine you. The exam will include a rectal exam to look for inflammation and sores and to check for blood in the stool. Tests you may have are:
- blood tests
- a barium swallow X-ray exam to look at the upper small intestine
- a barium enema X-ray exam to look for inflammation in the lower intestine.
You will usually have a colonoscopy. This is a procedure in which your provider uses a thin, flexible tube with a tiny camera to look at the inside of your intestine, checking for the redness, swelling, and ulcers of Crohn's disease. During this procedure your provider may do a biopsy, taking a small piece of tissue for lab tests.
How is it treated?
Because there is no cure for Crohn's disease, treatment for mild illness is based on your symptoms. The goals of treatment are to:
- Prevent pain.
- Help your bowel work normally--for example, help it absorb food properly and prevent blockage.
- Avoid problems that can be caused by this disease.
You will need medicine. The 5 main types of medicines used for Crohn's disease are:
- salicylic acid anti-inflammatories, such as sulfasalazine and mesalamine
- antibiotics, such as metronidazole (oral) or ciprofloxacin
- steroid anti-inflammatories, such as hydrocortisone
- immune-suppressing drugs, such as mercaptopurine and azathioprine.
- infliximab (Remicade), which is a medicine that helps reduce swelling and pain.
Some of these medicines are available as creams or ointments to be used in the rectal area. Some are available as enemas to help with lower bowel and rectal symptoms.
Your healthcare provider may also prescribe antidiarrheal medicine. The diarrhea can limit your normal daily activities as well as cause mineral imbalances, malnutrition, and dehydration.
If you are having symptoms that medicine is not controlling well, you may need to stay at the hospital. Your treatment at the hospital may include:
- resting your bowel by not eating
- intravenous (IV) feeding to give you nourishment you while you are resting your bowel
- blood transfusions to restore any blood you have lost
- IV medicines
- nasogastric suction (done through a tube passed from the nose to the stomach) to drain out acidic digestive juices and help rest the intestines.
Crohn's disease can cause complications. These problems include blockage of the bowel, infection and sores in the abdomen or rectum, and fistulas. A fistula is an abnormal connection that can form between 2 parts of the bowel or between the bowel and other organs, such as the bladder or vagina. It can cause infection and stool leakage. Complications from Crohn's disease often require surgery.
How long will the effects last?
Crohn's disease is an unpredictable chronic disease. You may go for weeks or months without symptoms or you may have symptoms every day. However, with treatment the disease can be well managed. Most people with Crohn's disease live full, active lives.
People with Crohn's disease have an increased risk of cancer of the colon or anus. Your healthcare provider will recommend that you have a colonoscopy on a regular schedule to look for cancer and catch it at an early stage if it happens. How often you need a colonoscopy depends in part on how long you have had Crohn's disease.
How can I take care of myself?
It is important to follow your healthcare provider's instructions. Ask your provider when you should call about pain, diarrhea, or bleeding.
If you have diarrhea:
- Avoid foods that have a laxative effect, such as raw fruits and concentrated fruit juices.
- Rest your bowel by not eating solid foods for a few hours. Instead of eating during this time, just drink clear liquids, such as the rehydrating fluids (sports drinks) that you can buy at the store.
- As the diarrhea gets better after a few hours, eat frequent small, bland meals.
- Gradually, over a couple of days, return to your usual diet.
Don't use a lot of stimulants, such as caffeine (coffee, tea, chocolate, soft drinks) and nicotine. Avoid milk products if they cause symptoms.
Ask your healthcare provider if you should increase or decrease the amount of fiber in your diet.
If you have cramps or abdominal pain, it may help to put heat on your abdomen using a covered hot water bottle or a heating pad set on low.
- Take the full course of treatment your provider prescribes.
- Don't smoke. Smoking seems to cause repeated attacks of pain and diarrhea.
- Follow a balanced, healthy diet according to your provider's advice.
- Stay physically active according to your provider's recommendation.
- Learn relaxation techniques to reduce stress.
- Talk with a counselor or mental health professional about managing the anxiety, stress, and depression often caused by a serious chronic illness.
- Develop a support system (family and friends) to help with the normal stresses of daily life.
- Keep your regular follow-up appointments with your healthcare provider.
- Ask your healthcare provider how often you should have a colonoscopy for cancer screening.
For more information you may also want to contact:
Crohn's and Colitis Foundation of America
Web site: http://www.ccfa.org
How can I help prevent Crohn's disease?
There is no known way to prevent Crohn's disease.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.
HIA File gase4009.htm Release 13/2010