Crohn’s disease is one of the inflammatory diseases that affect the bowel. Around 1.6 million Americans are affected and there is no cure. Because it is lifelong and unpredictable, it can have a profound impact on quality of life. The good news is that Crohn’s is very controllable and with proper treatment, most sufferers lead normal lives. This article will help you learn more about Crohn’s and how it can be managed.
Crohn’s disease is an inflammatory bowel disease or IBD. Crohn’s disease is seen in the small bowel right where the colon begins. The disease causes inflammation in the tissue of the bowel that causes debilitating pain. The disease can be life-threating. This can be due to complications including:
Ulcerations (open sores in the digestive system)
Scarring from inflammation
Fistula (openings through the intestinal wall)
Malabsorption of medications and nutrients
Anal fissure (tear in the anus)
Complications of Crohn’s can be prevented with good disease management.
The symptoms of Crohn’s disease are often very similar to ulcerative colitis, but the two diseases are different. Symptoms of Crohn’s include:
The inflammation of Crohn’s tends to make the food move slower through the bowels. The can be either severely painful or just mild cramping.
Crohn’s disease causes diarrhea. Cramping of the bowels can worsen this symptom.
Crohn’s can cause blood in the stools. There may be fresh bright red blood or dark red blood in the stools. The doctor may find “occult blood” in a stool test. Occult blood cannot be seen.
Sores in Your Mouth.
Sores may show up in your mouth that are like cold or canker sores.
Fatigue and Low-Grade Fevers.
The inflammatory response with Crohn’s can make you run a low-grade fever. Some people also have fatigue and lack of energy during flares.
Crohn’s causes less absorption of the nutrients in your food and may cause you to lose weight. Also, abdominal cramping can lower your appetite.
You may also suffer symptoms of perianal disease that causes drainage near the anus. It can also be painful.
Inflammation can also affect your joints and cause joint pain.
Researchers are still unsure of the cause of Crohn’s disease. It is possibly an auto-immune disorder where certain triggers cause the body to attack itself. There may be a genetic factor involved and people that have someone in their family with Crohn’s seem to have a higher incidence of getting Crohn’s themselves. Adding to the mystery, there are cases of Crohn’s where there is no family history present.
There are certain risk factors for Crohn’s disease including:
Age. Most common in people ages 15 to 35 years of age.
Family History of Crohn’s. There is about a 20 to 25 percent increase in risk if you have someone else in the family with Crohn’s.
Ethnicity. Caucasians and African Americans seem to have a slightly elevated rate of Crohn’s. There is also a higher incidence in Eastern European Jewish people. There seem to be less cases among Asians and Latinos.
Appendectomy. People who have had their appendix removed tend to have a high risk of Crohn’s.
Smokers. There is a higher incidence of Crohn’s among smokers.
If you have the above symptoms, see your doctor. They will ask you about your symptoms and often this is enough to make a diagnosis. Crohn’s is a “diagnosis of exclusion” mostly based on certain criteria because not all tests can positively diagnose the disease.
The problem with diagnosis is that the symptoms of Crohn’s often mimic other things. So, the doctor will have to do testing to rule out other causes of your symptoms before a Crohn’s diagnosis can be made. This takes time. Here are a few tests you may have done:
Fecal (stool) Tests
Endoscopy (looking into the upper colon with a lighted camera)
Colonoscopy (looking at the lower colon with a lighted tube)
During an endoscopy and colonoscopy the doctor can biopsy some of the colon tissue. Actually, biopsy of the tissue when analyzed in the lab can provide a Crohn’s diagnosis if you are in a flare stage.
Chromo endoscopy (colonoscopy with dye that can check intestinal tissues)
Imaging of Small Intestines (involves drinking an oral contrast solution with x-rays, CT Scan or MRI scan)
The main treatment for Crohn’s disease involves reducing the inflammation in the body and the bowels. The treatments include:
Corticosteroids. Corticosteroids help to lower inflammation in the body, but can have side-effect including; fluid retention, increased appetite, reduced absorption of calcium and risk of infection.
Sulfa Drugs. Some sulfa drugs can help Crohn’s, but only in the large intestine. They also have side-effects including; diarrhea, vomiting, headache, and heartburn.
Immune System Suppressants. These will suppress the immune response and reduce inflammation. They do require careful monitoring by your doctor and be followed with lab testing to make sure your immune system isn’t too suppressed.
Biologics or TNF Inhibitors. These suppress a protein in the immune system called, “tumor necrosis factor.” They can help the disease go into remission or at least suppress many of the disease symptoms. There are risks of infection with these drugs.
Antibiotic Therapy. Antibiotics can help reduce bacteria in the intestines and may help reduce the inflammation bacteria causes. They can also be used if infections develop due to fistulas.
Other medications are used to relieve symptoms including:
Vitamin supplementation (iron, calcium vitamin D, and B-12)
Nutrition. You may need to be fed with a feeding tube if you have trouble absorbing nutrients. This allows the colon to rest and heal. You may need to see a dietician for a low-fiber and low-residue diet to prevent strictures and blockage.
As a last resort, the doctor may need to do surgery if other treatments do not work for you. They will surgically remove the part of the colon that is unhealthy, possibly close up any fistulas and put the colon back together. They can also widen areas with strictures.
Reduce Stress. Stress can trigger inflammation in the body and make Crohn’s worse. Learn techniques that can reduce the stress in your daily life.
Increase Fluid Intake. People with Crohn’s can become dehydrated easily due to poor absorption of fluids in the colon. Drink extra fluids, especially if you exercise.
Quit Smoking. Smoking makes Crohn’s worse. Talk to your doctor about medications to help you quit smoking or join a program.
There are some herbal remedies that may help reduce inflammation in the colon. This has not been proven, but check with your doctor if you would like to add them to your treatment plan. These herbs include:
<pBoswellia. This herb is a natural anti-inflammatory and there are some studies that show it may have some positive effects for people with Crohn’s. There may be drug interactions with this herb.
Slippery Elm. This herb may have properties that can help heal any irritated intestinal tissues. It needs to be taken apart from any other medications.
Cat’s Claw. Cat’s claw is often used as an anti-inflammatory. While its benefits are not proven, you need to use caution with this herb. It can cause blood pressure to drop and worsen other autoimmune disorders.
Marshmallow. Marshmallow can help soothe irritated colon tissue. It can interact with the drug lithium and affect diabetes. It needs to be taken apart from other medications.
There is no way to prevent the onset of Crohn’s disease, but new research does show that a “semi-vegetarian diet” may help prevent flare relapses of the disease. The best way to manage and prevent flares is by eating a healthy diet, taking any medications prescribed, quitting smoking, and a healthy lifestyle.
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