Crohn’s disease is an inflammatory bowel disease in which the immune system attacks the lining of the intestine, usually the ending of the small intestine (called the ileum) or the colon. But it's more than just a case of irritable bowels. Crohn's disease symptoms range from abdominal cramps to ulcers that eat through the intestinal wall, and the complications—including pain, diarrhea, and malnutrition—can be sometimes be fatal. But with a proper diagnosis and the right medical care, managing the condition is possible for patients with Crohn’s. Here are more facts about Crohn's disease, from testing to treatments.
1. Crohn's disease causes are unknown, but genetics may be involved.
The exact causes of Crohn’s disease haven’t been identified, but for many people, family history plays a role. About 15 percent of Crohn’s patients share the diagnosis with a first-degree relative (parent, sibling, or child). Whether the family cluster patterns have more to do with genetics or environment is still unclear, though environmental factors appear to have more of an impact on the development of Crohn's disease symptoms. Scientists have also identified more than 200 gene variants that could influence Crohn's disease risk, mostly affecting genes related to immune system function.
2. Crohn's disease symptoms can come and go.
Crohn’s disease is characterized by inflammation of the digestive tract, and common signs include abdominal pain, rectal bleeding, diarrhea, fatigue, and fever. In severe cases, the inflammation can cause ulcers in the intestinal wall that prevents nutrient absorption, which can lead to weight loss and malnutrition. The intensity of these symptoms can be unpredictable. Flare-ups of gastrointestinal distress can last weeks to months, and there can also be long stretches of time when patients live symptom-free. Anti-inflammatory treatments can encourage the symptoms to go into remission, but the disease can never be cured completely.
3. Your diet can make Crohn's disease symptoms worse.
Doctors used to think of diet as one of the main causes of Crohn’s disease, but now it’s just thought to be a factor that exacerbates the symptoms. Certain foods can aggravate the digestive systems of people with Crohn’s. High-fiber foods, such fruits, vegetables, and whole grains, are some of the worst culprits, though cooked fruits and vegetables are generally gentler on the GI tract than raw ones.
4. Crohn's disease and ulcerative colitis are not the same.
People commonly confuse ulcerative colitis (UC) and Crohn’s disease. The two conditions are both inflammatory bowel diseases (which are different than irritable bowel syndrome, or IBS, which involves intestinal muscle contractions rather than inflammation). Both UC and Crohn's disease share symptoms such as weight loss, rectal bleeding, and diarrhea. But they differ in important ways: UC is limited to the large intestine, while Crohn’s disease can develop anywhere on the gastrointestinal tract between the mouth and anus. UC inflammation is also concentrated on the innermost intestinal lining, whereas can Crohn’s can penetrate the entire bowel wall. If you suspect you have an IBD, a doctor can help you identify the exact condition.
5. Crohn's disease can also affect the joints, eyes, and skin.
Crohn’s disease is known as a gastrointestinal disease, but the symptoms can extend beyond the digestive tract. People experiencing inflammation in the colon can also have inflammation in the joints. Up to 25 percent of patients with Crohn’s or UC also suffer from arthritis. Other complications include inflammation of the skin and eyes. Because eye tissue is so sensitive, ocular symptoms like redness and itchiness often appear before the first gastrointestinal signs.
6. A fecal occult blood test is one way to diagnose Crohn's disease.
There’s no one test for Crohn’s disease. Instead, doctors diagnose the condition by performing a series of tests to rule out other possible ailments. Testing poop samples with a fecal occult blood test can reveal hidden (or occult) blood in a patient’s stool, and testing antibodies can indicate whether symptoms are caused by Crohn’s or UC. Imaging tests—such as an ultrasound, MRI, X-ray, CT scan, or colonoscopy—gives doctors visual clues to the extent of a patient’s condition.
7. Incidence of Crohn's disease is increasing.
Crohn’s affects people of all ages, but symptoms usually appear in younger patients: People in the 15-to-35 age group are most likely to be diagnosed with the condition. Childhood cases of Crohn’s disease can lead to complications like delayed growth. Some studies have shown that the disease is becoming more prevalent, especially in Western countries and in children. Researchers think the "Westernized lifestyle" of poor-quality diet and lack of exercise are contributing factors to the increase.
8. Crohn's disease complications can be deadly.
If left untreated, Crohn’s disease can lead to some life-threatening complications. Inflammation can permanently damage the intestines, scarring parts the GI tract and causing tissue to thicken. In some cases, the damage is so severe that the bowel becomes blocked and surgery is required to remove the obstruction. Another possible complication is a fistula: an ulcer that has penetrated the intestinal wall and connected into a different part of the body, such as another organ or skin. An infected fistula is potentially fatal if ignored. Crohn's disease also increases a patient's risk of developing colorectal cancer. Inflammatory bowel disease is the third highest risk factor for colorectal cancer cases, though IBD-related cancer incidence is decreasing in some countries.
9. Surgery is a last resort for Crohn's disease.
Though Crohn’s disease can’t be cured, it can be managed. Most patients are initially put on anti-inflammatory medications. Other drugs, like pain relievers, nutritional supplements, and anti-diarrheal medications, are prescribed to treat the symptoms of the disease. If the condition doesn't improve, patients may require surgery to remove damaged portions of the bowel, close fistulas, and drain abscesses. Doctors may also recommend specific dietary changes to avoid flare-ups.
10. Crohn's disease was identified in the 1930s.
In 1932, gastroenterologist Burrill B. Crohn and his colleagues Leon Ginzburg and Gordon D. Oppenheimer identified the condition now known as Crohn’s disease, which Crohn called ileitis (meaning inflammation of the ileum). Prior to the report, the condition was thought to be type of a tuberculosis and not an inflammatory bowel disease. In addition to helping define the disease that bears his name, Crohn was one of the first medical professionals to link gastrointestinal distress to anxiety. He also published a book with the charming title Affections of the Stomach in 1927 and commented in media reports when President Dwight D. Eisenhower came down with ileitis symptoms in 1956.