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Crohn’s Disease

OVERVIEW AND FACTS

Crohn’s disease, a chronic inflammatory bowel disease (IBD) which involves inflammation or ulceration of the lining of the digestive tract, can be agonizing and disabling. It is also known as ileitis or regional enteritis and usually develops in the lower area of the small intestine. Complications from Crohn’s disease could result in the possibility of threatening one’s life if not properly treated. Even though there is currently no cure for Crohn’s disease, proper treatment can ease the symptoms and long-term remission is possible.

SIGNS AND SYMPTOMS

Crohn’s disease may affect different portions of the digestive tract and symptoms may be minor or severe. Onset may be sudden and unexpected. During the active phase, signs and symptoms may consist of:

• Abdominal pain or tenderness, intestinal cramping
• Mass in lower right abdomen
• Diarrhea or loose stools that cannot be controlled with over-the-counter medications
• Bloody stools (bright or dark red or occult blood which cannot be seen)
• Anemia
• Fever, nausea & vomiting
• Ulcers in the mouth or on the intestinal surface
• Anal fissures & rectal bleeding
• Weight loss or loss of appetite
• Tiredness
• Arthritis
• Eye, skin, or liver disorders
• Developmental delays in children

CAUSES AND DIAGNOSIS

Medical researchers have not found the specific cause for Crohn’s disease. While there are many unproven theories, they do agree that it could be inherited, that a compromised immune system may be involved, and environmental elements may trigger a response from the immune system. Stress, smoking, and a poor diet aggravate the symptoms. Crohn’s may develop at any age, but is most commonly found in those between 15 and 30 years old.

Diagnosis involves a full review of medical and family medical history, a physical exam, and a series of tests performed at a hospital or as an outpatient by a gastroenterologist (digestive disease specialist) or a radiologist (medical imaging specialist). Diagnosis of Crohn’s is made after other diseases have been ruled out such as diverticulitis, colon cancer, or irritable bowel syndrome (IBS).

TESTS AND TREATMENTS

Since Crohn’s may affect the small or large intestine, the esophagus, the stomach, and/or the mouth, a combination of tests, blood work and imaging procedures may need to be performed to assist with proper diagnosis. The doctor will most likely order some of these tests to identify the exact location of the disease in your intestines:

• Physical Exam & History
• Lab tests and blood work
• Stool culture
• Video capsule endoscopy
• Barium X-rays & general X-rays
• CT scan or MRI
• Colonoscopy or sigmoidoscopy
• Upper & Lower GI series

Treatment for Crohn’s depends on its location in the digestive tract and how severe the disease is. Designed to relieve symptoms such as diarrhea, inflammation, abdominal pain, and rectal bleeding, treatment may include over-the-counter medications, prescription drugs, nutritional advice, or surgery. Treatment controls the disease but does not cure it, and some may need treatment throughout their lifetime. While remission is possible, the disease can return at any time. Treatment may include:

• Over-the-Counter medications: Imodium (loperamide) and fiber supplements for diarrhea; acetaminophen, aspirin, ibuprofen, and naproxin for pain.
• Prescription medications: Anti-inflammatory drugs, cortisone/steroids, immune system suppressors, biological injections, antibiotics, anti-diarrheal medications, and fluid replacements
• Surgery: Relieves intestinal blockage, abscesses, perforations, or bleeding; may involve removal of the diseased portion of the intestine, colon, or rectum; reconstruction of the ileum to attach to an opening in the abdomen; the disease often returns even with surgery.
• Nutritional supplements: High-calorie drinks or given through IV; vitamin/mineral supplements, change in diet
• Stress reduction

TIPS AND HOME REMEDIES

Here are some things that can be done at home to help control Crohn’s disease:

• Eat a balanced, healthy diet in smaller meals throughout the day to curb diarrhea: limit dairy foods and fiber, eat low fat foods, avoid foods that irritate the colon, drink plenty of fluid, take multivitamins, consult a dietitian if necessary.
• Exercise, biofeedback, and relaxation and breathing exercises help reduce stress.
•  Quit smoking.
• Try alternative therapies such as herbal supplements, probiotics, hypnosis, acupuncture, or fish oil.
• Contact a support group such as the Crohn’s and Colitis Foundation of America for more information.

While there is no cure for Crohn’s, proper treatment can allow most patients to lead a normal, productive life.