What is Crohn’s disease?
Crohn’s disease is a chronic condition that causes inflammation in the gut (digestive tract). Crohn’s disease belongs to a group of conditions known as inflammatory bowel disease (IBD). It can affect any part of the digestive tract from the mouth to anus, but it generally affects the small intestine and the initial part of the large intestine.
Crohn’s disease is similar to other types of inflammatory bowel disease such as ulcerative colitis (UC) and microscopic colitis.
What are the signs and symptoms of Crohn’s disease?
The signs and symptoms vary from individual to individual. In patients with Crohn’s disease, there are times when symptoms worsen known as flares and times when individuals recuperate from the symptoms known as remission. The most common symptoms of Crohn’s disease include the following
- Abdominal pain or cramps
- Persistent diarrhea
- Urgent desire to defecate
- Feeling of incomplete bowel emptying
- Weight loss
Other less common symptoms of Crohn’s disease include
- Rectal bleeding
- Eye redness or pain
- Joint pain or soreness
- Nausea or loss of appetite
- Red, tender bumps under the skin
- Night sweats
- Rectal pain
What causes Crohn’s disease?
The exact cause of Crohn’s disease is unknown; however, an autoimmune reaction can incite Crohn’s disease. In an autoimmune reaction, the immune system may attack its healthy cells to cause inflammation of the tissues within the digestive tract. Heredity can also play an important role in causing Crohn’s disease. Stress and eating certain foods do not cause Crohn's disease; however, they can worsen the symptoms.
Who gets Crohn’s disease?
People with the following risk factors are at an increased risk of Crohn’s disease
- Family history
- Takes certain medications such as antibiotics, birth control pills and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Consumes a high-fat diet
- Age between 15 and 35 years old
- Exposure to environmental factors such as pollution
According to the Centers for Disease Control and Prevention, people meeting the following descriptions are more likely to report having irritable bowel disease (IBD), whether Crohn's disease or ulcerative colitis:
- Aged 45 years or older
- Hispanics (1.2%) and non-Hispanic whites (1.4%) were more likely than non-Hispanic blacks (0.5%)
- Those with less than a high school level of education (1.7%) were more likely than those with a bachelor’s degree or higher (1.1%).
- Those not currently employed were slightly more likely (1.6%) to have ever received a diagnosis of IBD, compared with 1.2% of adults who were currently employed.
- Those born in the United States were more likely (1.4%) than adults born outside of the United States (0.8%).
- Those living in poverty with incomes <100% of the federal poverty level were more likely (1.8%) compared to those living ≥400% of the federal poverty level (1.1%).
- Those living in suburban areas (1.4%) were more likely than those living in a metropolitan area (1.0%)
The numbers of men and women with Crohn's disease are about the same.
At what age is Crohn's disease diagnosed?
- For the age of onset in Crohn's disease, the first peak occurs between the ages of 15 and 30 years.
- The second peak occurs mainly in women between the ages of 60 and 70 years.
- Most cases of Crohn's disease begin before age 30.
- Approximately 20-30% of people with Crohn's disease are diagnosed before age 20.
How is Crohn's disease diagnosed?
There are no specific tests or procedures to diagnose Crohn’s disease. The physician evaluates the symptoms and uses information from diagnostic testing to exclude other potential causes.
The common diagnostic tests includes
- Blood tests
- X-rays of the upper and lower digestive tract
- Biopsy of the colon while performing endoscopy
- Imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI)
What is the treatment for Crohn’s disease?
Various treatment options help to control the disease and help patients lead a rewarding life. Treatment options include
Medications suppress inflammation by reducing the activity of the immune system. They also help reduce symptoms or complications. Mostly, antidiarrheals, nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics are used.
Bowel rest involves restricting eating any food by mouth to give the bowel a rest.
Surgery is useful to treat complications and reduce symptoms when other treatments are not useful.
Incorporating the following dietary changes helps to reduce symptoms
What are the complications of Crohn’s disease?
Crohn’s disease is not usually life-threatening; however, it can cause severe or fatal complications, which include
- Bowel obstruction
- Fistulas: Abnormal passages between a hollow or tubular organ and the body surface or between two hollow or tubular organs.
- Abscesses: Pus-filled pocket of infection.
- Anal fissures: Small tears in the anus.
- Ulcers or open sores in the mouth, intestine or anus
- Inflammation around the joints, eyes or skin
Appropriate treatment can augment the possibility of a good recovery.
What is the life expectancy of someone with Crohn's disease?
With appropriate management, patients with Crohn’s disease may expect a normal life expectancy and a good quality of life. Advancement in medical therapy has helped to improve the life expectancy of patients with Crohn’s disease.
There is no cure for Crohn's disease, as it is a chronic condition, but symptoms can be managed.
It is possible for some people to not know for years they have Crohn's disease and have no symptoms, or they could have several flare-ups over the years. Crohn's disease affects each person differently, and they tend to have the same life expectancy than others without the disease.
There are many treatments available that can help control Crohn's disease symptoms and potentially put it into remission for months or years, or even keep it in remission. Treatment can be individualized, which may include prescription medications, over-the-counter medications, surgery, stress management, and diet modifications.
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