What is Crohn’s Disease?
If you or someone you know has Crohn’s disease, you probably have a good idea of how it makes you feel. The symptoms are very hard to miss – they include stomach pain, diarrhea, blood in the stool, weight loss, fever, and fatigue. But it might not be all that clear what the disease is, exactly, outside of the symptoms it causes.
Crohn’s disease is an immune disorder under the umbrella of inflammatory bowel disease or IBD, a broad category of disease that also includes ulcerative colitis. The immune system is meant to recognize and fight bacteria and other causes of infection. But in the case of Crohn’s disease, it is thought that the immune system responds inappropriately to the bacteria that normally live in the gut or to the gut itself.
What are the Potential Complications of Crohn’s Disease?
This immune reaction in the gut results in inflammation and creates the symptoms mentioned above. It can affect any part of the digestive tract, from the mouth to the anus, but most cases are limited to the colon and the lower part of the small intestine. It can also lead to a number of complications.
Gastroenterology Malnutrition – because the inflammation affects the surface of the gut where nutrients are absorbed, and because diarrhea causes nutrients to be eliminated more quickly than they can be absorbed, poor nutrition can arise.
Fistulae – a fistula occurs when there is an abnormal connection between one hollow organ (in this case the bowel) and another. These can connect the bowel to skin, the vagina, the bladder, or to another part of the bowel. They can lead to infection and other serious complications.
Anal disease – Crohn’s disease can involve the anus, causing pain, infection, abscess, and fissures.
Bowel Obstruction – because the inflammation can scar and thicken the intestinal wall, or narrow the opening, constipation or even total obstruction can occur.
Ulcers – because inflammation can damage the lining of the digestive tract, erosions of the surface layers, called ulcers, can develop. They may appear anywhere from the mouth to the anus.
Non-intestinal complications – the activated immune system in Crohn’s disease can also react inappropriately to other body systems, resulting in issues such as arthritis, rashes, inflammation of the eye structures, and kidney stones.
Colon cancer – in patients with IBD, the risk of colon cancer is higher than for the general population.
Your gastroenterologist will have a good idea of the diagnosis based on your history of symptoms and physical exam. But x-ray studies, colonoscopy, and biopsy all help with the diagnosis and give an understanding of the extent of disease.
How is Crohn’s Disease Treated?
Anti-inflammatory and immune-modulating medications are used to treat Crohn’s disease. Most flare-ups will be treated with corticosteroids, while the other medications are used to try to prevent the ongoing inflammation. Surgery may be needed to correct fistulae or remove areas of the bowel that are causing obstruction.
A routine of colon cancer screening should also be adhered to, so that precancerous cell changes can be caught and removed before they have the opportunity to turn into cancer.
This is a chronic disorder that will require varied levels of treatment throughout your lifetime. Partnering with a gastroenterologist you trust will help ensure that you get consistent, knowledgeable care so that Crohn’s disease interferes as little as possible.
