Having long-term digestive problems like stomach ache and diarrhoea can be frustrating, especially when the symptoms come and go. For some people these symptoms are linked to a type of inflammatory bowel disease called Crohn’s disease. It can affect different parts of your gut and cause symptoms that can disrupt your daily life.
Let’s understand what Crohn’s disease is, what are its symptoms and causes, how it’s diagnosed, and what can be done to manage it.
What is Crohn’s Disease?
Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes inflammation in the digestive tract (gut). It’s a chronic (life-long) condition that can affect different parts of the gut in different people. The most common areas it affects are the end of small intestines and the beginning of large intestines. It can affect different segments or can be continuous.
The inflammation caused by Crohn’s disease often spreads to the deeper layers of the intestines (bowels).
Symptoms of Crohn’s Disease
Symptoms of Crohn’s disease vary depending upon the part of the gut it affects, like mouth, stomach, bowel, or anus.
Common symptoms include:
- Diarrhoea
- Blood or mucus in poo
- Stomach ache and cramping
- Mouth ulcers
- Fever
- Fatigue
- Pain around the anus
- Loss of appetite
- Weight loss
- In children: delayed growth and puberty
Crohn’s disease can also cause symptoms in parts of your body other than the digestive tract. These symptoms include:
- Joint pain or arthritis
- Inflammation of eyes such as uveitis
- Rashes
- Kidney stones
- Skin tags (mostly around the anus)
- Osteoporosis
- Inflammation of liver or bile ducts
The symptoms of Crohn’s disease can vary in intensity, from mild to severe. They usually come and go over time, called flare-ups and remissions. The flare-ups can last anywhere between a few days to several months.
Causes of Crohn’s Disease
Crohn’s disease is an auto-imumune disorder and is caused by an abnormal immune system response. It makes your immune system attack the healthy tissues in a part of your digestive tract and cause inflammation. What makes your immune system react this way is not fully understood but it is believed that genetics play a role.
Risk Factors for Crohn’s Disease
There are a few factors that increase your risk of getting Crohn’s disease, like:
- Family history
- Smoking
- Stomach infection
- Appendectomy (in recent years)
- Stress
Diagnosis of Crohn’s Disease
To make a diagnosis of Crohn’s disease, your doctor will ask you questions about your symptoms and take your medical and family history.
Then they’ll do a physical examination to look for any signs of Crohn’s disease like tenderness in your belly.
Your doctor would also order some blood and stool tests.
If your doctor suspects Crohn’s disease they would refer you to a specialist (gastroenterologist) for further testing. These tests may include:
- Endoscopy, gastroscopy, or colonoscopy (a thin tube with small camera on the end is passed through your mouth or bottom to look inside your gut)
- Biopsy (a small sample of the tissues from your gut is taken)
- Scans such as Ultrasound, MRI, or CT scan
However, there’s no single specific test to diagnose Crohn’s disease. Since its symptoms vary and are similar to other conditions, it takes time to make the final diagnosis of Crohn’s disease.
Management of Crohn’s Disease
There’s no cure for Crohn’s disease but there are treatments that can help reduce your symptoms for a long time (remission).
Medicines
Medications for Crohn’s disease are mainly used to reduce inflammation and calm your immune response. Medicines are also used to treat some symptoms like belly pain and diarrhoea.
- Corticosteroids to reduce inflammation (for short-term)
- Oral 5-aminosalicylates (mesalazine and sulfasalazine) to reduce inflammation. However these are mainly used for Ulcerative Colitis and give little benefit for Crohn’s disease
- Immunosuppressants like azathioprine and methotrexate
- Medicines to to target your immune system like adalimumab or infliximab (biological therapy)
- Antibiotics to treat complications like abscesses
- Antidiarrheal medications like loperamide
- Pain killers to relieve pain
All these medicines have their own risks and benefits. Your doctor will assess your condition and recommend medicines that’ll help you.
Nutrition
In some cases if you’re not able to get enough nutrition that you need, your doctor might recommend enteral feeding (getting formula feed through a feeding tube).
Surgeries
If your symptoms are severe or not getting better, your doctor might recommend surgery for you.
Different surgical options include:
- Bowel resection (removing the affected part of your gut and joining the healthy parts together)
- Ileostomy or colostomy (removing a part of your gut and bringing the end of your bowel out through an opening in your tummy, called stoma)
You might also need surgery in case you develop certain complications like fistulas, strictures, and blockages.
Support
You can find help and support for people suffering from Crohn’s disease or Ulcerative Colitis, from organisations like Crohn’s & Colitis UK.
Complications of Crohn’s Disease
Crohn’s disease can cause serious complications due to inflammation and damage to your gut. But if you get the right treatment the risk of developing them decreases.
These complications include:
-
- Fistula (a tunnel is formed that connects your bowel to another part of your body like skin, bladder, or vagina)
- Anal fissure (a tear or sore near anus)
- Abscess (infected pus filled pocket) in the digestive tract
- Stricture (narrowing of part of the gut which can cause blockage)
- Perforated bowel (a hole in the bowel wall)
- Bowel cancer
- Malnutrition (due to inflammation in gut your body can’t absorb nutrients properly)
- Anemia
The Bottom Line
Crohn’s disease is a life-long condition that causes inflammation in your gut and can cause serious complications. Its flare-ups can come unexpectedly and disrupt your daily life.
But with the right diagnosis and treatment you can have a long symptoms free period (remission) and reduce the risk of developing complications.
If you have been experiencing digestive issues, don’t just ignore them. Talk to your doctor to find out the cause of your symptoms so they can be managed properly.
