Crohn’s Disease: Symptoms,Causes and Treatment

Crohn's disease treatment
Medically reviewed by Dr. Ola Tarabzuni

Overview

Crohn’s disease is an autoimmune disorder mostly caused by bacterial attacks. It is a manageable disease that may lead to severe complications if left untreated.

Please read the article for comprehensive knowledge about Crohn’s symptoms and the best treatment.

What is Crohn’s Disease?

Crohn’s disease is a subcategory of inflammatory bowel disease (IBD). It is a gastrointestinal disorder that mainly affects the small intestine’s last part and results in inflammation of the intestinal wall. 

Due to inflammation in intestinal walls, complications like malabsorption of water, micronutrients, and vitamins may occur, resulting in diarrhea and other symptoms of Crohn’s.

Diarrhea, abdominal pain, and fatigue are common symptoms of Crohn’s disease that can collectively result in weight loss in patients. 

Crohn’s disease and ulcerative colitis both cause weight loss as a symptom. Malnutrition can occur when you are not getting enough calories to meet your nutritional needs, resulting in weight loss. Many factors contribute to this, including:

  • A lack of appetite
  • Intolerances to foods
  • Absorption problems
  • Increasing your body’s ability to burn calories
  • Diarrhea or intestinal bleeding can result in nutrient losses

Studies have shown that people who lose weight due to Crohn’s disease are less hungry and enjoy eating less than those who don’t. On average, the people who lost weight eliminated 16 food items out of 52. Thus, the diet consisted of a limited amount of calories. 

Let us look at the types commonly observed in the clinical manifestations of Crohn’s disease.

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Types of Crohn’s Disease

Crohn’s disease is a type of IBS and may affect different types of  

Ileocolitis

Ileocolitis affects part of the large intestine (colon) and the end of the small intestine (ileum). As part of a group of conditions known as inflammatory bowel disease (IBD), it is the most common type of Crohn’s disease.

Chronic diseases, such as ileocolitis, persist over a long period. Ileocolitis and Crohn’s disease are currently incurable. As it progresses, it usually gets worse.

You may experience the following symptoms:

  • A significant weight loss
  • Diarrhea
  • Cramping
  • Pain in the middle or lower right part of your abdomen

Causes of ileocolitis 

The causes of ileocolitis and other types of Crohn’s disease are still unknown. Some of the most common causes include:

Autoimmune response: An overactive immune system can result in inflammation and lead to Crohn’s disease when it attacks healthy cells.

Medication: Your risk of developing Crohn’s disease may increase somewhat if you take certain medications. Antibiotics, birth control pills, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, all fall into this category.

Genetics: It is estimated that 15 percent of people have Crohn’s if their parents or siblings have it

Diet: Eating a high-fat diet can also increase your risk of Crohn’s disease.

Smoking: You are more likely to develop the risk of Crohn’s disease if you smoke.

Ileitis 

As a result of Crohn’s disease, the ileum is often inflamed. A wide range of conditions can cause ileitis.

You may experience the following symptoms:

  • Loss of substantial weight
  • A diarrheal illness
  • Cramping
  • Right or middle abdomen pain
  • Lower right abdominal fistulas, or inflammatory abscesses, can occur

Causes of ileitis 

Inflammation in your ileum may be due to Crohn’s disease but might have multiple other reasons. Some of the commonly observed causes are 

  • Infectious disease
  • Medications, i.e., NSAIDS 
  • Spondyloarthropathies
  • Vasculitides 
  • Ischemia
  • Cancerous growths

Gastroduodenal Crohn’s Disease

Small intestines, stomach, and duodenum are affected by this form.

You may experience the following symptoms:

  • Loss of appetite
  • Nausea
  • Weight loss
  • Fatigue 

In case of narrow segments of the bowel being obstructed, vomiting may occur.

Jejunoileitis

Small intestine or jejunum inflammation results in jejunoileitis.

You may experience the following symptoms:

  • Post-meal cramps
  • Fistulas
  • Diarrhea
  • Abdominal pain can become intense.

Crohn’s (Granulomatous) Colitis

In this case, Crohn’s disease only affects the colon.

You may experience the following symptoms:

  • Lesions on the skin
  • Pain in the joints
  • A diarrheal illness
  • Blood in the rectal cavity
  • Inflammation of the anus, fistulae, and abscesses

Note that the different types of Crohn’s disease can overlap; therefore, the digestive tract can be affected in multiple areas simultaneously.

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Diagnoses of Crohn’s Disease 

The symptoms of Crohn’s disease are not specific, which makes diagnosing the disease difficult. Therefore, it is crucial to consult an experienced doctor who can diagnose the condition by observing and examining the signs of Crohn’s disease.

To diagnose the disease and its type existing in you, doctors may usually use a two-step approach ; 

  • Patient examination 
  • Laboratory analysis 

Patient Examination 

During the examination, the patient may be monitored physically, or a doctor may ask questions to help figure out the problem. An examination of pulse rate, blood pressure, and weight by a doctor will assess the patient’s overall health. In addition, they will check for signs of Crohn’s disease, such as:

  • Bloating or swelling in the abdomen
  • Digestive sounds that are abnormal

Besides reviewing a patient’s symptoms, a doctor will examine their medical and family history.

Laboratory Tests

For the diagnosis of Crohn’s disease, a doctor may suggest the following lab tests:

  • A blood test
  • Sampling of stool
  • Abdominal CT or MRI scan
  • An exam of the colon’s interior is called a colonoscopy
  • Upper GI tract endoscopy and enteroscopy
  • Complete blood count ( CBC)
  • Antibody tests include The anti-Saccharomyces cerevisiae antibody test (ASCA) and the Perinuclear anti-neutrophil cytoplasmic antibody test.
  • C-reactive protein test
  • Kidney function tests
  • Liver function tests 
  • Electrolyte panel
  • Erythrocyte sedimentation rate Iron and B12 levels

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Complications of Crohn’s Disease

While symptoms can vary from person to person, the disease can cause several serious complications that can impact a patient’s health and quality of life.

Strictures

One of the primary complications that often arise from Crohn’s disease is the emergence of strictures, which refers to the narrowing of certain sections of the bowel. The development of strictures occurs due to the chronic inflammation caused by Crohn’s disease. This inflammation can lead to the thickening of the intestinal walls and the formation of scar tissue, which can cause the narrowing of the bowel. These strictures can cause obstruction, resulting in severe abdominal pain, vomiting, and diarrhea. Surgery may sometimes be necessary to remove the affected portion of the bowel. 

Fistulas

Another complication of Crohn’s disease is the development of fistulas, which are abnormal connections between different parts of the bowel or between the bowel and other organs. Fistulas can be very painful and can lead to infection and abscesses. They occur due to the inflammation caused by Crohn’s disease, which can weaken the walls of the intestine and cause abnormal connections to form. Consequently, the affected portion of the bowel may need to be removed, or the fistula may need to be closed surgically.

Abscesses

Crohn’s disease can also cause the development of abscesses, which are pus-filled pockets that can form in the bowel or other parts of the body. These abscesses can be painful and lead to infection and sepsis, a life-threatening condition. The inflammation caused by Crohn’s disease can cause the formation of pockets of infected material. Treatment typically involves drainage and antibiotics. 

Colorectal Cancer

Patients with Crohn’s disease also have an increased risk of developing colorectal cancer. They may develop dysplasia, a condition where the cells in the lining of the bowel become abnormal and can eventually become cancerous. Regular screening and surveillance are important to detect any signs of dysplasia early on. Colorectal cancer is more common in patients with Crohn’s disease than in the general population, so patients need to undergo regular colonoscopies to monitor for any signs of dysplasia.

Mental Health Issues

In addition to these physical complications, Crohn’s disease can significantly impact a patient’s mental health. Patients may experience depression and anxiety due to chronic pain and other symptoms associated with the condition. They may also struggle with isolation and embarrassment, especially if their symptoms include diarrhea and incontinence. Patients need to receive support and treatment for any mental health issues that they may be experiencing.

Malabsorption

Crohn’s disease can cause malabsorption by damaging the small intestine lining, which is responsible for absorbing nutrients from food. The inflammation caused by Crohn’s disease can lead to scar tissue formation, narrowing the intestine and reducing its surface area for absorption. As a result, patients with Crohn’s disease may be unable to absorb important nutrients, including fats, proteins, and vitamins. This malabsorption may lead to notable weight loss. Additionally, Crohn’s disease can lead to diarrhea, reducing the time food spends in the intestine and the opportunity for nutrient absorption. Malabsorption of vitamins B and D, folic acid, iron, and other critical nutrients can cause malnutrition and other health complications, such as anemia. It is important to remember that malnutrition and anemia can lead to serious oral health issues. 

  • Erythema
  • Edema
  • angular cheilitis
  • Glossitis
  • burning mouth syndrome
  • Candidiasis
  • leukoplakia patches
  • gingivitis

Pregnancy Issues

Crohn’s disease, a chronic inflammatory bowel disease, can lead to several pregnancy complications. Women with Crohn’s disease are at a higher risk of preterm labor and delivery, low birth weight, malnutrition, and fertility issues. These complications can result in health problems for both the mother and the baby, such as respiratory distress syndrome, developmental delays, and infections. It is, therefore, essential that women with Crohn’s disease work closely with their healthcare providers during pregnancy so that their condition can be effectively managed and complications minimized.

While many Crohn’s disease complications can be managed with medication, surgery, and other treatments, some patients may experience severe and life-threatening complications. These can include intestinal perforation, severe bleeding, and sepsis. Emergency surgery may be necessary to save the patient’s life. Patients with Crohn’s disease should work closely with their healthcare providers to manage their condition and address possible complications. Close monitoring and regular screening can help detect any signs of complications early on, allowing for prompt and effective treatment.

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Treatment Options for Crohn’s Disease

Treatment is the final and most important part of getting rid of the disease. In this regard, it is essential to get treatment promptly with the assistance of a professional doctor.

Your doctor is the only one who can guide you to the right treatment, depending on the type and severity of the disease.

Let’s have a look at possible treatments. 

Medications

Medication is an appropriate treatment for the signs of Crohn’s disease. Sometimes only one group of medications is enough to overcome the symptoms, but in other conditions, a combination of medications is prescribed by a doctor. The most common combinations of medications are: 

  • Immunomodulators
  • Aminocilisylates 
  • Corticosteroids 
  • Anti-inflammatory 
  • Antibiotics 
  • Biologic therapies

A debate continues over the best way to treat Crohn’s disease. The two main strategies currently in use are a traditional step-up approach and a top-down approach. 

Step-up approach 

In the step-up approach, depending on the severity of the disease, corticosteroids or mesalamine products are introduced, followed by immunomodulators or anti-tumor necrosis factor (anti-TNF) agents.

Top-down approach 

Top-down treatments begin with anti-TNF agents. While earlier reports suggested excluding specific food types as a possible treatment, a review found that corticosteroid therapy induces remission of active Crohn’s disease more effectively than enteral nutrition.

To get the right medication according to the severity of the illness, it is important to consult a doctor. You and your doctor work together to determine the right combination for you.

Surgery

Surgery is another viable option if the medication does not provide the expected recovery. Crohn’s patients often need surgery. The majority of people with Crohn’s disease undergo surgery within 20 years of diagnosis, according to one study.

If a person has any of the following conditions, a doctor may recommend surgery:

  • Fistulas
  • Intestinal strictures that are severe
  • Blocked or obstructed intestines
  • Life-threatening blood loss

Diet and lifestyle changes

Currently, there is no known way to prevent Crohn’s disease. However, some lifestyle modifications may reduce the risk of developing the disease or help manage its symptoms.

One important factor is maintaining a healthy diet and weight treatment; a high-fiber diet, fruits and vegetables, and a low intake of processed foods and saturated fats may reduce the risk of developing Crohn’s disease or flare-ups in those already diagnosed. Additionally, avoiding smoking and reducing stress levels can also help manage symptoms.

Genetic factors also play a role in Crohn’s disease, so individuals with a family history of the disease should be aware of their increased risk and discuss screening options with their healthcare provider. 

While there is no guaranteed way to prevent Crohn’s disease, a healthy lifestyle and awareness of risk factors may help reduce the likelihood of developing the disease or managing its symptoms.

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When to Consult a Doctor for Crohn’s Disease

It is suggested that you consult a doctor as soon as signs and symptoms of Crohn’s disease appear. Indicators to keep an eye on include the following: If you experience these symptoms, you should consult a doctor:

  • Unexplained weight loss ( preferably more than 4 kgs a month without any diet or physical exertion)
  • Constant abdominal pain or cramps
  • Bleeding from the rectal area or bloody stools
  • Prolonged diarrhea lasting more than a week

In case of the initiation of the symptoms mentioned above, feel free to consult Your doctor online professional doctors and get the treatment that is best for you and your health.

FAQs about Crohn’s disease Answered by Your Doctors Online Team

Is Crohn’s an autoimmune disease?

Crohn’s disease is an autoimmune disorder, which refers to your body’s immune system attacking healthy tissue. Researchers believe bacteria in the digestive tract can mistakenly cause your immune system to attack healthy tissue. The immune system responds by causing inflammation, resulting in Crohn’s disease symptoms.

What are the early warning signs of Crohn’s disease?

The early warning signs of Crohn’s disease are 

  • Diarrhea
  • Unexplained weight loss
  • Stomach pain or cramping
  • Bloating

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