Digestive Diseases: Crohn's Disease
Introduction
Crohn's disease is a chronic illness of children and adults in which the
intestines (bowel) become inflamed.
The disease affects the full thickness of the intestinal wall and this
inflammation can lead to serious complications that may require surgery. The
condition typically affects the lower part of the small intestine (ileum), although it can occur in any part of the gastrointestinal tract
from the mouth to the anus. Sections of
diseased bowel can be interrupted by sections of healthy bowel. Crohn's disease
can disrupt the normal function of the bowel in a number of ways, causing the
tissue to:
- Swell and thicken, narrowing or blocking the
passageway inside the bowel.
- Develop ulcers that involve the deep layers of the
wall of the bowel.
- Lose its ability to absorb nutrients from digested
foods (malabsorption).
- Develop abnormal passageways (fistulas) from one part
of the bowel to another part of the bowel, or from the bowel to a nearby
organ.
When grouped together, Crohn's disease and ulcerative
colitis are referred to as inflammatory bowel diseases (IBD) because they cause inflammation of the bowel (intestines).
What Are the Symptoms of Crohn's Disease?
People with Crohn's disease can experience periods of
severe symptoms followed by periods of remission that can last for weeks or years. The symptoms
of Crohn's disease depend on where the disease occurs in the bowel and its
severity. In general, symptoms can include:
Other symptoms can develop, depending on complications related
to the disease. For example, a person with a fistula (abnormal
passageway between various organs or tissues) in the rectal area may have pain
and leaking discharge around the rectum.
Severe inflammation and obstruction of various parts of
the gastrointestinal tract due to swelling and scar formation can cause other
problems like bowel perforation, abdominal distension (swelling), severe pain, and fever. This can
be life-threatening.
Also, because Crohn's disease is an autoimmune disease (see
below), other parts of the body can become inflamed including the joints, eyes,
mouth and skin. In addition, gallstones, and kidney stones may also develop as a result of
Crohn's disease.
Moreover, children with the disease may experience
decreased growth or delayed sexual development.
What Causes Crohn's Disease?
The cause of Crohn's disease is unknown. However, it is likely due to an
abnormal response of the immune system. Food or
bacteria in the intestines, or
even the lining of the bowel may cause the uncontrolled inflammation associated
with Crohn's disease.
Who Gets Crohn's Disease?
Crohn's disease is often inherited. About 20% of people
with Crohn's disease may have a close relative with either Crohn's or ulcerative
colitis. In
addition, Jewish people of European descent (Ashkenazi) are at greater risk for
the disease.
While Crohn's disease can affect people of all ages, it is primarily an
illness of the young. Most people are diagnosed before age 30, but the disease
can occur in people in their 60's, 70's or later in life.
How Is Crohn's Disease Diagnosed?
A variety of diagnostic procedures and laboratory tests are used to
distinguish Crohn's disease from other inflammatory gastrointestinal conditions
like ulcerative colitis.
First, your doctor will review your medical history. A specialist called a
gastroenterologist may
perform a colonoscopy or sigmoidoscopy to obtain bowel tissue for analysis.
Other tests your health care provider may order include:
- Blood tests, including blood counts (often high white blood cell
counts -- a sign of inflammation -- and low red blood cells
counts a sign of anemia from blood loss -- are present).
- Stool samples to rule out infections
as the cause of diarrhea.
- Special X-ray of both the upper and lower GI tract may be ordered as
well to confirm the location of the inflammation.
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