Dr. Rohit Sureka
Gastroenterologist
Crohn’s disease is a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal (GI) tract, including the mouth, oesophagus, stomach, small intestine, large intestine known as (colon), rectum, or anus. However, it mostly affects the small intestine and the colon. Unlike ulcerative colitis, which affects the innermost lining of the colon, Crohn’s disease causes inflammation in the entire lining of the intestinal tract.
This gastrointestinal disorder can lead to severe abdominal pain, diarrhoea, extreme fatigue (tiredness), malabsorption of nutrients, and weight loss. The inflammation triggered by Crohn’s disease is likely to reach deep into the layers of your affected bowel tissue. As of now, there is no cure for this condition. Therapies aim to control symptoms and provide long-term remission.
This inflammatory disorder affects different parts of your gastrointestinal tract. It can be classified into the following categories based on this:
● Ileocolitis: It affects the colon and the ending of the small intestine. It is the most widespread form of Crohn’s disease.
● Crohn’s Colitis or Granulomatous Colitis: This form of Crohn’s disease attacks your colon only.
● Gastroduodenal Crohn’s Disease: It hits the stomach and the first part of the small intestine.
● Ileitis: This condition affects the final part of the small intestine, known as the ileum.
● Jejunoileitis: It leads to inflammation in the upper part of your small intestine.
The symptoms of Crohn’s disease might vary depending upon the site of the inflammation, severity of the disease and other factors. Moreover, as the disease worsens, the symptoms might change over time. However, people who have Crohn’s disease often go through periods of remission, (no or very few symptoms). This alternates with the active phase in which the disease flares up, leading to symptoms. Here are some of the common symptoms of Crohn’s disease:
Causes
Doctors have not been able to identify the exact cause of Crohn’s disease.
Risk Factors
Certain factors that make you more vulnerable to this condition include:
People who have Crohn’s disease experience a broad range of symptoms. So, a single test cannot diagnose the condition. Hence, your doctor might recommend a combination of tests to confirm the diagnosis and determine the exact location of the inflammation. Here are some of the tests you can expect:
Crohn’s disease is a life-long ailment that cannot be cured. Therefore, the treatment is aimed at reducing the symptoms and improving the quality of life. The treatment modality includes medications, surgery, and bowel rest.
● Medications
The prescription will depend on the location of inflammation and the severity of the condition. Some common drugs include:
- Aminosalicylates: They are mainly used to treat people with newly diagnosed Crohn’s disease. These drugs contain 5-aminosalicylic acid (5-ASA) that helps control inflammation.
- Corticosteroids: Commonly known as steroids, these drugs reduce immune activity and aid in decreasing inflammation.
- Immunomodulators: These drugs either weaken or modulate the activity of the immune system to decrease the inflammatory response.
- Apart from these, the doctor might recommend antibiotics, pain relievers, and laxatives based on the symptoms you experience.
● Surgery
On rare occasions, when the symptoms fail to subside with medications, you may need surgery. Surgical intervention is recommended to resolve associated complications like fistula, bowel obstruction, and severe or life-threatening bleeding. Your doctor might decide the type of surgery based on the severity and the site of inflammation. The types of surgery are as follows:
- Small bowel resection: A part of the small intestine is removed, and the ends are reconnected.
- Colectomy: It usually involves the surgical removal of a part of the large intestine.
- Proctocolectomy or ileostomy: In proctocolectomy, the entire colon and rectum are surgically removed. In case of an ileostomy, an opening is created in the ileum (last section of the small intestine) through surgery.
● Bowel Rest
In this method, you will be on a complete liquid diet for a few days or weeks. Your doctor will deliver nutrition through IV (intravenous) fluids that are inserted into your vein. It is a preferred choice of treatment in case of severe symptoms of Crohn’s disease.
Alongside medications, lifestyle modifications are necessary to manage Crohn’s disease well. It would help if you consider the following:
● Watch What you eat
Avoid spicy foods, alcohol, and caffeine as they may worsen your symptoms. Also, limit dairy products and high-fat foods as you may find them difficult to digest. While having fresh fruits and veggies, avoid having them raw. Steaming or boiling them will make it easy for your stomach to digest them. Keep yourself hydrated and have small meals through the day.
● Quit Smoking
The nicotine in tobacco products can worsen the symptoms of Crohn’s disease and lead to relapses. However, quitting smoking can improve the condition of your digestive tract.
● Keep Stress at bay
Stress can worsen the manifestations of Crohn’s disease. Alleviate stress with breathing techniques and meditation. Also, regular workouts can keep help in keeping you stress-free, thanks to endorphins, the happy hormones released during a session of exercise.
This inflammatory disease, in severe form, can come with a lot of complications. Some of them are as follows:
● Bowel Obstruction: If you have Crohn’s disease, it’s likely that parts of your intestinal walls get scarred and narrowed, blocking the flow of digestive contents. This may necessitate surgery.
● Ulcers: In Crohn’s disease, long-term inflammation can result in open sores, known as ulcers. They can form in any part of your digestive tract and even in the genital area.
● Fistulas: These are abnormal connections between different body parts. They can form between your intestine and skin or any other organ. Fistulas are commonly found around the anal area. If they develop in the abdominal region, the capacity of nutrition absorption is compromised. This can lead to weight loss. Fistulas also develop in the bladder or vagina.
● Anal Fissure: This is a tiny tear in the tissue lining of the anus or in the skin around the anal region. Infections can occur here. Fissure has been linked with painful bowel movements.
● Other Health Problems: Crohn’s disease can come with several other ailments like anaemia, skin disorders, osteoporosis, arthritis, and gallbladder or liver disease. If this disorder affects your colon, then it may increase your risk of developing colon cancer.
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