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Crohn's disease is a form of inflammatory bowel disease (IBD). It usually affects the intestines, but may occur anywhere from the mouth to the end of the rectum (anus).
See also: Ulcerative colitis
Inflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis; IBD- Crohn's disease
While the exact cause of Crohn's disease is unknown, the condition is linked to a problem with the body's immune system response.
Normally, the immune system helps protect the body, but with Crohn's disease the immune system can't tell the difference between normal body tissue and foreign substances. The result is an overactive immune response that leads to chronic inflammation. This is called an autoimmune disorder.
People with Crohn's disease have ongoing (chronic) inflammation of the gastrointestinal tract. Crohn's disease may occur in any area of the digestive tract. There can be healthy patches of tissue between diseased areas. The inflammation causes the intestinal wall to become thick.
There are different types of Crohn's disease, depending on the part of the gastrointestinal tract that is affected. Crohn's disease may involve the small intestine, the large intestine, the rectum, or the mouth.
A person's genes and environmental factors seem to play a role in the development of Crohn's disease. The body may be overreacting to normal bacteria in the intestines.
The disease may occur at any age, but it usually occurs in people between ages 15 - 35. Risk factors include:
Symptoms depend on what part of the gastrointestinal tract is affected. Symptoms range from mild to severe, and can come and go with periods of flare-ups.
The main symptoms of Crohn's disease are:
Other symptoms may include:
A physical examination may reveal an abdominal mass or tenderness, skin rash, swollen joints, or mouth ulcers. Tests to diagnose Crohn's disease include:
A stool culture may be done to rule out other possible causes of the symptoms.
This disease may also alter the results of the following tests:
DIET AND NUTRITION
No specific diet has been shown to improve or worsen symptoms in Crohn's disease. Specific food problems may vary from person to person.
You should eat a well-balanced, healthy diet. It is important for you to get enough calories, protein, and essential nutrients from a variety of food groups.
Certain types of foods may worsen diarrhea and gas symptoms. The problem is more likely during periods when symptoms are present. Possible changes you can make to your diet include:
People who have a blockage of the intestines may need to avoid raw fruits and vegetables and other high-fiber foods.
Ask your doctor about extra vitamins and minerals you may need:
You may feel worried, embarrassed, or even sad and depressed about having a bowel accident. Other stressful events in your life, such as moving, a job loss, or the loss of a loved one can cause digestive problems.
Ask your doctor or nurse for tips on how to manage your stress.
You can take medication to treat very bad diarrhea. Loperamide (Imodium) can be bought without a prescription. Always talk to your doctor or nurse before using these drugs.
Other medicines to help with symptoms include:
Your doctor may also give you a prescription for stronger pain medicines.
Medicines that may be prescribed include:
If medicines do not work, a type of surgery called bowel resection may be needed to remove a damaged or diseased part of the intestine or to drain an abscess. However, removing the diseased portion of the intestine does not cure the condition.
Patients who have Crohn's disease that does not respond to medications may need surgery, especially when there are complications such as:
Some patients may need surgery to remove the entire large intestine (colon), with or without the rectum.
The Crohn's and Colitis Foundation of America offers support groups throughout the United States. See http://www.ccfa.org/chapters/
There is no cure for Crohn's disease. The condition is marked by periods of improvement followed by flare-ups of symptoms.
It is very important to stay on medications long-term to try to keep the disease symptoms from returning. If you stop or change your medications for any reason, let your doctor know right away.
You have a higher risk for small bowel and colon cancer if you have Crohn's disease.
Call for an appointment with your health care provider if:
Lichtenstein GR, Hanauer SB, Sandborn WJ; Practice Parameters Committee of American College of Gastroenterology. Management of Crohn's disease in adults. Am J Gastroenterol. 2009;104(2):465-483.
Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.
Sands BE, Siegel CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 111.