Crohn's disease

About

Crohn’s disease is an inflammatory bowel disease (IBD) in which the intestines become inflamed. It can affect any part of the digestive tract from the mouth to the anus, and usually occurs in the small intestine and colon. Symptoms vary from person to person, but typically include abdominal pain and cramping, diarrhea, fatigue, and weight loss. Treatment may involve lifestyle changes, medications, and/or surgery.

Symptoms

Common symptoms of Crohn’s disease include abdominal pain and cramping, diarrhea, vomiting and weight loss, fever and fatigue. Other symptoms may include rectal bleeding, small and painful lumps in the skin, mouth sores, joint pain, nausea and anemia. Other less common symptoms may include skin tags, delayed growth and development, fistulas and anal fissures.

Causes

The exact cause of Crohn’s disease is unknown, however it is believed to be due to a combination of environmental, genetic, and immune factors.

Environmental factors may include diet, smoking, and exposure to certain bacteria.

Genetic factors may include having a family history of the disease, or having a certain gene mutations.

Immune factors may include an abnormal response of the body’s immune system to the normal bacteria in the digestive tract. This abnormal response may lead to inflammation and damage to the digestive tract.

Risk factors

The exact cause of Crohn’s disease is unknown; however, there are various risk factors that may increase a person’s likelihood of developing the condition, including:

Family history: Having an immediate relative, such as a brother or sister, with Crohn’s disease increases a person’s risk of developing the condition.
Age: Crohn’s disease can affect individuals of any age; however, it is more commonly diagnosed in people who are between the ages of 15 and 35.
Ethnicity: People of Eastern European, Jewish, and indigenous descent are more likely to develop Crohn’s disease.
Smoking: Smoking cigarettes is associated with an increased risk of developing the condition.
Diet: Consuming a diet that is high in processed foods, refined sugars, and saturated fat may increase a person’s risk for Crohn’s disease.
Stress: High stress levels can trigger flare-ups of the condition.
Environment: Those who live in an industrialized or urban area may be exposed to certain environmental toxins, which can increase a person’s risk for Crohn’s disease.

Diagnosis

Crohn’s disease is typically diagnosed through a combination of physical examination, blood tests, imaging tests, and examination of a tissue sample from the intestine (biopsy). A doctor may also use a sigmoidoscopy or colonoscopy to examine the inside of the intestine. During these procedures, the doctor may take a small sample of tissue to be examined under a microscope. In some cases, the doctor may take a tissue sample to rule out other conditions. Once the diagnosis is confirmed, the doctor will develop a treatment plan based on the severity of the disease.

Sub-types

Crohn’s disease is an inflammatory bowel disease that can affect any part of the gastrointestinal (GI) tract. It is classified into five subtypes, depending on where it is found in the GI tract.

The most common type of Crohn’s disease is ileocolitis, which affects the lower part of the small intestine and the beginning of the large intestine (the colon). This form of Crohn’s is characterized by inflammation in these areas and may cause abdominal pain, fever, and diarrhea.

Jejunoileitis primarily affects the upper part of the small intestine. People with this type of Crohn’s often experience bouts of severe diarrhea, abdominal pain, and weight loss.

Crohn’s colitis is an inflammation of the entire large intestine. People with this type of Crohn’s may also experience frequent bouts of diarrhea, abdominal pain, and weight loss.

Granulomatous Crohn’s is a rare type of Crohn’s that involves inflammation and the presence of granulomas, or nodules, in the affected area. This form of Crohn’s can be difficult to diagnose but may lead to symptoms such as abdominal pain, fatigue, and nausea.

Crohn’s ileitis is an uncommon type of Crohn’s that is limited to the small intestine. People with this type of Crohn’s typically experience severe abdominal pain, nausea, and vomiting.

Treatments

The treatment for Crohn’s disease depends on the severity of the condition and the individual’s symptoms. Common treatment options include:

Anti-inflammatory medications, such as corticosteroids and 5-aminosalicylates
Immune system suppressors, such as azathioprine, mercaptopurine, and biologic therapies
Anti-diarrheal medications
Pain relievers
Nutritional support, such as vitamin supplements, dietary modifications, and tube feeding
Surgery, such as resection and strictureplasty
Probiotics and prebiotics
Psychological support to help manage stress and other emotions related to having Crohn’s disease.

Prevention

There are steps one can take to reduce the risk of Crohn’s disease, including:

Eating an anti-inflammatory diet high in fruits, vegetables, whole grains, nuts, and seeds
Regular exercise
Avoiding smoking and drinking alcohol
Stress reduction techniques such as meditation and yoga
Sleeping sufficiently and avoiding excessive stress
Taking probiotics
Taking regular supplements of omega-3 fatty acids
Participating in regular screening and follow-up with a Crohn’s specialist

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Crohn’s disease. Women tend to experience more severe symptoms than men, and are more likely to develop complications such as abscesses and fistulas. In addition, women are more likely to suffer from nutritional deficiencies, such as anemia and low body weight, due to the weight loss associated with Crohn’s disease. Women are also more likely to experience certain extraintestinal manifestations of the disease, such as arthritis, eye inflammation, and skin rashes. In terms of treatment, women tend to require lower doses of medications than men due to their higher risk of experiencing side effects. Furthermore, women with Crohn’s disease are more likely to experience negative reactions to certain medications, such as mesalamine and thiopurines, than men. Additionally, women are more likely to experience symptoms of depression than men and may benefit from mental health therapy in addition to medical treatment.

Nutrition

Nutrition plays a key role in the management of Crohn’s disease. Proper nutrition and healthy eating keeps the body fueled and supports the healing process. Eating a balanced diet and including nutrient-dense foods, such as lean proteins, fruits, vegetables, and whole grains, is essential to providing the body with the necessary nutrients it needs to thrive. Additionally, taking nutritional supplements, such as probiotics, vitamins, and minerals, can help to manage and alleviate symptoms of Crohn’s disease, including gas, cramping, and diarrhea. Finally, drinking plenty of water and limiting processed foods, fried foods, and high-fat foods can support digestive health, reduce inflammation, and promote overall wellness.

Physical Activity

Regular physical activity has the potential to reduce symptoms associated with Crohn’s disease, including fatigue, abdominal pain, and inflammation due to increased circulation. Regular exercise can also improve overall mental health, reduce stress levels, and help to maintain a healthy weight. Additionally, physical activity has been linked to improved gastrointestinal transit time, which can reduce the severity of flare-ups associated with Crohn’s disease.

Crohn’s disease