Crohn’s disease is a type of inflammatory bowel disease (IBD) that is a chronic inflammatory condition of the gastrointestinal tract.
Crohn’s disease can affect any part of the gastrointestinal (GI) tract from the mouth to the anus. Another type of inflammatory bowel disease, ulcerative colitis, only affects the colon (large intestine).
Symptoms of Crohn’s disease may include:
- Persistent diarrhea
- Rectal bleeding
- Urgent need to have a bowel movement
- Abdominal pain that feels like cramping
- Feeling of incomplete bowel evacuation
- Constipation (may lead to bowel obstruction)
Crohn’s disease can also cause symptoms in the body outside the GI tract, including:
- Eye problems
- Redness
- Pain in the eyes
- Vision changes
- Mouth sores
- Joint pain and swelling
- Skin complications
- Bumps
- Rash
- Sores
- Fever
- Night sweats
- Loss of appetite
- Weight loss
- Fatigue
- Changes in menstrual cycle
- Osteoporosis
- Kidney stones
- Liver problems such as primary sclerosing cholangitis and cirrhosis (rare)
What Causes Crohn’s Disease?
The cause of Crohn’s disease is not fully understood. Several factors may contribute to the development of the disease, including:
- Genetic factors
- Crohn’s disease tends to run in families
- Between 5% and 20% of people with IBD have a first-degree relative, such as a parent, child, or sibling, who has IBD
- The risk is significantly higher when both parents have IBD
- Crohn’s disease is most common among people of eastern European backgrounds
- Environmental factors
Crohn’s disease is more common in:
- Developed countries
- Urban cities and towns
- Northern climates
How Is Crohn’s Disease Diagnosed?
Crohn’s disease is diagnosed with a patient history and physical examination, along with tests to look for signs of Crohn’s disease and rule out other medical conditions. Tests may include:
- Laboratory tests of blood and stool
- X-rays of the upper and lower GI tract
- Endoscopy
- Colonoscopy
- Chromoendoscopy: may be performed during a colonoscopy to check for polyps or precancerous changes.
- Upper endoscopy
- Small intestine imaging
- Fluoroscopic X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Biopsy
What Is the Treatment for Crohn’s Disease?
Crohn’s disease is often treated with a combination of medication, diet changes, and sometimes surgery.
Medications used to treat Crohn’s disease include:
- Aminosalicylates (5-ASA)
- Sulfasalazine
- Mesalamine
- Olsalazine
- Balsalazide
- Corticosteroids
- Prednisone
- Methylprednisolone
- Immunomodulators
- Azathioprine
- 6-mercaptopurine
- Cyclosporine
- Tacrolimus
- Antibiotics
- Metronidazole
- Ampicillin
- Ciprofloxacin
- Biologic/Biosimilar Therapies
- Adalimumab
- Certolizumab pegol
- Infliximab (biosimilars: Infliximab-abda, infliximab-dyyb, infliximab-qbtx, and infliximab-axxq)
- Natalizumab
- Ustekinumab
- Vedolizumab
Diet changes used to treat Crohn’s disease include:
- Maintain good nutrition
- Consume soft, bland foods during flares
- Avoid spicy or high-fiber foods during flares
- Restricting dairy intake if you are lactose-intolerant
Surgery used to treat Crohn’s disease includes:
- Strictureplasty: repairs a narrowing (stricture) by widening the narrowed area without removing any portion of the intestine
- Proctocolectomy: removal of the colon and rectum
- Colectomy: removal of the colon
- Fistula removal
- Bowel resection: removes a portion of the small or large intestine damaged by Crohn’s disease
- Abscess drainage
