Crohn’s Disease is a condition causing chronic inflammation of the gastrointestinal tract, one of the inflammatory bowel diseases. Ulcerative colitis can cause chronic diarrhea, cramping and abdominal pain as well as symptoms elsewhere in the gastrointestinal tract. Unlike Ulcerative colitis, which affects only the most superficial layer of the colon and rectum, Crohn’s disease affects all of the layers of the gastrointestinal tract and occurs in patches throughout the digestive tract from the mouth all the way down to the anus. Crohn’s disease cannot be cured but can be treated medically. Risk factors for developing Crohn’s disease include a family history of inflammatory bowel disease, age around the thirties, being Caucasian or Ashkenazi Jewish, smoking, living in an urban area, and having used isotretinoin for acne. Crohn’s disease can lead to serious complications, especially if not treated and followed closely. Some of the complications of Crohn’s disease include weight loss, poor nutrition, dehydration, bleeding, anemia (low blood counts), increased risk of colon cancer, and connections between the gastrointestinal tract and different parts of the body that should not be there (fistulas).
Diarrhea, abdominal pain, blood in stool, dark stool, foul-smelling stool, weight loss, fatigue, ulcers, feer, skin lesions
After taking a history and examining your abdomen, your doctor will want to do some additional testing. Your doctor will likely check your blood for a high white blood cell count, low blood counts, and possibly for antibodies that are indicative of Crohn’s disease. Your stool may also be checked for signs of blood or infection that can be confused with Crohn’s disease. You may see a gastroenterologist for a procedure called a colonoscopy or flexible sigmoidoscopy. The colonoscopy involves placing a thin tube with a camera at the end into the rectum while you are under anesthesia to look at the colon. If anything looks abnormal, you doctor can take biopsies (small samples) of the tissue to look at under a microscope to see what might be causing your symptoms. Your doctor may want to repeat your colonoscopy when your symptoms go away and the inflammation in the colon should be gone. Crohn’s can be anywhere in the body, so you doctor may also recommend a scope of your upper gastrointestinal tract. Also, your doctor may recommend taking a small pill with a camera inside that travels through your body taking pictures and comes out the other end. Your doctor may also recommend x-rays of the abdomen after injecting barium into the rectum to look for abnormalities. Your doctor may also want a CT scan or MRI picture of your body.
Many treatments exist for Crohn’s disease. Most of these treatments aim to decrease inflammation which is the cause of the symptoms of Crohn’s disease. Everyone responds differently to the different medications available for Crohn’s disease, so being patient and trying different medications is essential to finding the best treatment. Many of these medications are available in pills, rectal creams, and injections. Medications that specifically decrease inflammation include sulfasalazine (Azulfidine), meselamine (Asacol, Rowasa), and corticosteroids like prednisone. Medications to moderate the immune system include azathioprine (Azasan, Imuran), infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia), methotrexate (Rheumatrex), cyclosporine (Gengraf, Neoral, Sandimmune), and natalizumab (Tysabri). To relieve symptoms of Crohn’s disease like antibiotics, anti-diarrhea medication or laxatives (depending on your specific symptoms), pain relievers, vitamin B 12 shots, calcium supplements, vitamin D supplements and iron supplements if your blood counts are low. If medications do not work to relieve your symptoms, surgery is an option. Unlike ulcerative colitis, Crohn’s disease is not limited to the colon, so only problem-causing portions of the gastrointestinal tract can be removed. Most people with Crohn’s disease will end up needing surgery at some point during their disease. During these surgeries, your surgeon removes the actively diseased part of the gastrointestinal tract and reconnects the two healthy portions together. You may requires surgery to repair fistulas or for drainage of infectious abscesses caused by Crohn’s disease. You will need to discuss with your gastroenterologist and surgeon the best treatment options for you.
