Crohn's disease is an inflammatory bowel disease (IBD) that causes painful swelling in the lining of the affected organ. Crohn's disease normally affects the small intestine, but it can occur anywhere along the digestive tract. The condition is sometimes called ileitis or enteritis.
The most common signs are pain in the stomach area (usually on the right side) and diarrhea. Others include rectal bleeding, weight loss and fever. Bleeding may be serious and lead to anemia. Children with Crohn's disease may experience delayed or stunted growth.
Although the exact cause of Crohn's disease is unknown, many professionals believe that the body's immune system reacts to a virus or certain type of bacteria, which results in inflammation. People with Crohn's tend to have abnormal immune systems, but doctors do not know whether these problems are a cause or a result of the disease. The disease affects men and women equally and seems to run in some families. About 20% of patients with Crohn's disease have a blood relative with some form of IBD, usually a brother or sister, parent or child. Crohn's disease in not caused by emotional stress.
A thorough physical exam and a series of tests may be needed to confirm Crohn's disease. Blood tests can check for anemia (a sign of bleeding in the intestines) or a high white blood cell count (indicating inflammation in the body). A stool sample can reveal bleeding or infection in the intestines.
A patient may undergo an upper gastrointestinal (GI) series, which involves drinking barium (a chalky solution that coats the lining of the intestine) before X-rays are taken to expose inflammation or other problems. A colonoscopy (a long, lighted tube linked to a computer monitor) may be inserted into the anus to look for signs of bleeding or swelling inside of the large intestine. A biopsy may be performed during a colonoscopy to remove a sample of tissue from the lining of the intestine for inspection under a microscope.
Patients with Crohn's disease may have these complications:
- The most common complication is blockage of the intestine, which occurs because the intestinal wall tends to get thick with swelling and scar tissue, causing the passageway to become narrower.
- Sores or ulcers may tunnel past the affected area and get into nearby areas, such as the bladder, vagina, rectum or skin around the anus. These passageways are called fistulas and can become infected. Usually they can be treated with medicine, but sometimes surgery is needed to remove them.
- Poor nutrition is common among IBD patients. Too little protein, calories and vitamins may result from not eating enough food, intestinal loss of protein or poor absorption of food and nutrients.
At this time, treatment can control Crohn's disease but not cure it. Treatment depends on the location, severity, complications and response to earlier treatment. The goal of the Cedars-Sinai Inflammatory Bowel Disease (IBD) Center is to control inflammation, correct nutrition problems and relieve symptoms of pain, diarrhea and rectal bleeding.
Crohn's disease usually appears several times randomly over the course of a person's lifetime, but some patients have long periods (sometimes years) when the symptoms go away. This diversity makes knowing if treatment helped or not difficult. Patients may need medical care for a long time, including regular visits to the doctor's office.
Treatment options include:
- Medication
- Nutrition supplements
- Surgery
