Crohn’s disease is an autoimmune inflammatory bowel disease, the cause of which is unknown. It occurs when your body's immune system mistakenly attacks and destroys healthy body tissue. It also seems to run in some families and most commonly starts between the ages of 13-30. Anything from the mouth to the anus can be affected, including the liver, skin, eyes and joints.

Factors that may play a role in Crohn's disease include:

  • Genes and family history (People of Jewish descent are at higher risk.)
  • Environmental factors (antibiotics, animal fat, red meat, smoking, toxins)
  • Microbes in the stomach
  • Tendency of your body to overreact to normal bacteria in the intestine
Diagnosing Crohn’s can be extremely tricky, due to the facts that symptoms are unreliable and depend on the part of the digestive tract is involved. Symptoms mimicking Crohn’s can be present without the actual disease being active and active disease can be present with no or minimal symptoms.

The most common symptoms are pain in the abdomen and diarrhea.

Other common symptoms include:

  • Rectal bleeding and bloody stools
  • Weight loss/loss of appetite
  • Fever
  • Fatigue
  • Feeling that you need to pass stools, even though your bowels are already empty. This may involve straining, pain, and cramping.
  • Watery diarrhea, which may be bloody
  • Constipation
  • Sores or swelling in the eyes
  • Draining of pus, mucus or stools from around the rectum or anus
  • Joint pain and swelling
  • Mouth ulcers
  • Swollen gums
  • Tender, red bumps (nodules) under the skin, which may turn into skin ulcers

Symptoms range from mild to severe, and can come and go with periods of flare-ups. Complications like bowel perforation (fistulas) and bowel blockages may occur.

Diagnosis

Your doctor will perform a physical exam to look for symptoms of Crohn’s disease. Blood and stool studies will be done to rule out other possible causes. Laboratory tests, imaging studies and endoscopic procedures will help provide a precise diagnosis.

Tests that diagnose and monitor flare-ups of Crohn’s and response to treatment include:

  • Upper endoscopy
  • Enteroscopy
  • Double or single balloon endoscopy
  • Video capsule endoscopy, “pill camera”
  • Colonoscopy or sigmoidoscopy
  • Confocal laser endomicroscopy
  • CT enterography scan of the abdomen
  • MRI enterography of the abdomen
  • Endoscopic rectal ultrasound
  • Surgical exam
  • Confocal laser endomicroscopy: This relatively new endoscopic technology allows for real-time microscopic views of the bowels. A high-resolution laser probe attached to the endoscope provides a noninvasive “optical biopsy” of nearly any GI surface. 

 Treatment

There is no cure for Crohn's. Treatment can help control symptoms and may include medicines, nutrition supplements and/or surgery. Learning how to control and deal with stress also helps. A healthy, well-balanced diet may also help manage Crohn’s.

Steroids may be used during the initial phase of a flare-up. However, while steroids may help you feel better fast, they do not actually heal the bowel and are only short-term solutions that should be replaced by immunosuppressants, which make up the majority of the current therapies. Some are given as oral medications (Azathioprine, 6-MP) others are self-injectable (methotrexate, Humira, Cimzia, Simponi) or infusions (Remicade, Entyvio). The Ohio State Inflammatory Bowel Disease Center has many active clinical trials that can be beneficial for Crohn's patients. 

Some people with Crohn's disease may need surgery to remove a damaged or diseased part of the intestine. In some cases, parts of the small bowel and large bowel or even the entire large intestine are removed, with or without the rectum.

 

 

 

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