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Crohn's disease

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Dr. Rohit Sureka


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.

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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:

  • Abdominal pain

  • Frequent diarrhoea with bloody stools or mucus

  • Loss of appetite

  • Weight loss

  • A sensation of incomplete evacuation

  • Constipation

  • Delayed growth and development in children

  • Fatigue

  • Fever

  • Night sweats

Causes And Risk Factors


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:

  • Genetic predisposition: In some cases, Crohn’s disease is known to run in families, indicating that it is hereditary. However, the correlation is still not established.

  • Age: It has been observed that Crohn’s disease mostly affects people in the age group of 30-40 years. However, evidence of this disorder has also been found in people in the age group of 50-80 years.

  • Smoking: This habit does not lead to Crohn’s Disease. It can only make the condition severe.

  • Medicines: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, as well as oral contraceptives can cause inflammation in your gastrointestinal tract. This can make your symptoms worse.

  • Diet: High-fat diet, processed foods, and carbonated beverages can increase your risk of developing Crohn’s disease.


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:

  • Physical Examination: After your doctor asks about your medical and family history, he might consider doing a physical examination. He will check for abdominal swelling, listen to sounds in the abdomen using a stethoscope, tap the abdomen to know about pain or tenderness.

  • Blood Tests: Depending on his observations from physical examination, your doctor may suggest a CBC (Complete Blood Count) test. It provides information about changes in the blood cells - RBCs (Red Blood Cells) and WBCs (White Blood Cells). A decrease in the number of RBCs might indicate anaemia, whereas an increase in the number of WBCs is observed in the case of inflammation or infection.

  • Stool Test: In this, a lab technologist analyses your stool sample for any infection or blood to rule out other causes of GI tract inflammation.

  • Intestinal Endoscopy: It includes imaging tests like colonoscopy, capsule endoscopy and enteroscopy.

  • Colonoscopy: It is done to view the entire colon. In the case of Crohn’s disease, clusters of inflammatory cells are present in the body. This confirms the diagnosis.

  • Capsule Endoscopy: For this test, you have to swallow a capsule fixed to your camera that passes through the intestinal tract and painlessly exits the body through stool.

  • Enteroscopy: It examines the small intestine with the help of a specially designed endoscope. It can be single- or double-balloon enteroscopy or spiral endoscopy, where an endoscope is inserted deep into the gut.

  • MRI (Magnetic Resonance Imaging): It is useful in evaluating the anal area to diagnose Crohn’s disease. In this test, a scanner is used to create detailed images of organs and tissues.

  • Small Bowel Imaging: The part of the small intestine which is not visible through colonoscopy can be seen with the help of this technique. It helps in detecting the inflammation of the GI tract through an X-ray, CT scan or MRI.


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.

Prognosis And Complications

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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