Crohn’s Disease

What is this Condition?

Crohn’s disease is an inflammation of any part of the digestive tract. The inflammation extends through the intestinal wall. Swelling caused by a blockage in the intestinal wall leads to inflammation, sores, narrowing of passages and, possibly, abscesses and fistulas (abnormal passages between body cavities).
The most common site is the end of the small intestine. It may affect nearby lymph nodes as well as the membrane that holds the small intestines. Mild cases are relieved by changes in diet and life­style.

What Causes it?

Crohn’s disease is most common in adults ages 20 to 40 and may run in families. Its exact cause is unknown. Some experts suspect allergies and other immune disorders or infection; others are investigating possible genetic links.

What are its Symptoms?

Symptoms depend on the location and size of the inflammation. The mild, yet persistent symptoms of chronic Crohn’s disease are most common and include diarrhea, pain in the lower right abdomen, excessive fat in the stools, weight loss, occasionally fatigue and, rarely, clubbing of the fingers. In a flare-up of Crohn’s disease, symptoms mimic those of appendicitis: steady, colicky, pain in the lower right abdomen, cramping, tenderness, release of gas, nausea, fever, diarrhea and, possibly, bloody stools. Complications can include intestinal obstruction, bowel-bladder fistulas, abscesses in the abdomen and around the anus or rectum, and perforation.

How is it Diagnosed?

Lab tests will show an increase in white blood cells and other imbalances. A barium enema X-ray and other X-ray studies may be used to check changes in the shape of the bowel. Also, the doctor may use a special scope to inspect for patchy areas of inflammation to rule out ulcerative colitis. However, biopsy (obtaining a tissue specimen for study) is the only way to confirm a diagnosis.

How is it Treated?

Initial treatment involves easing symptoms. For example, if the person is very sick, the doctor will order intravenous liquids and nutrients to rest the gastrointestinal tract and prescribe drugs to reduce inflammation, subdue the body’s immune system, and fight bacterial infection. Serious side effects may necessitate surgery to correct bowel perforation or massive bleeding. Only in the most severe cases is the diseased colon surgically removed.

What can a Person with Crohn’s Disease do?

The most helpful steps you can take involve making lifestyle changes: get more rest, restrict dietary fiber (no fruit or vegetables), and eliminate dairy products (for lactose intolerance). If stress is clearly an aggravating factor, consider getting counseling.