Crohn's disease - (chronic inflammatory bowel disease)

• Article
• 2021-03-02

Crohn's disease is a chronic disease that causes inflammation and irritation in your digestive tract. Most of the time, Crohn's affects your small intestine and the beginning of your colon. However, the disease can affect any part of your digestive tract, from your mouth to your anus. Learn about your digestive system and how it works.

Crohn's disease is an inflammatory bowel disease (IBD). Ulcerative colitis and microscopic colitis are other common types of IBD.

Crohn's disease usually starts gradually and can get worse over time. You can have periods of remission that can last for weeks or years.

How common is Crohn's disease?

Researchers estimate that more than half a million people in the United States have Crohn's disease. ¹ Studies show that Crohn's disease is more common over time in the United States and other parts of the world. ^1,2 Experts do not know the reason for this increase.

Who is more likely to develop Crohn's disease?

Crohn's disease can develop in people of any age and is more common in people

• between the ages of 20 and 29 ²
• who have a family member, usually a sibling, or parent, with IBD
• who smoke cigarettes

What Are the Complications of Crohn's Disease?

Complications from Crohn's disease can include the following:

• Intestinal obstruction. Crohn's disease can make the wall of your intestines thicker. Over time, the thickened parts of your intestines can narrow, which can block your intestines. A partial or complete bowel obstruction, also called bowel blockage, can block the movement of food or stool through the intestines.
• Fistulas. In Crohn's disease, inflammation can travel through the wall of your intestines and create tunnels or fistulas. Fistulas are abnormal passages between two organs, or between an organ and the outside of your body. Fistulas can become infected.
• Abscesses. Inflammation that travels through the wall of your intestines can also lead to abscesses. Abscesses are painful, swollen, pus-filled foci of infection.
• Anal fissures. Anal fissures are small cracks in your anus that can cause itching, pain, or bleeding.
• To swear. Inflammation anywhere in your digestive tract can lead to ulcers or open sores in your mouth, intestines, anus, or perineum.
• Malnutrition. Malnutrition occurs when your body does not get the correct amount of vitamins, minerals and nutrients it needs to maintain healthy tissues and organ function.
• Inflammation in other parts of your body. You may have inflammation in your joints, eyes, and skin.

What other health problems do people with Crohn's disease have?

If you have Crohn's disease in your colon, you are more likely to get colon cancer through the NIH external link . If you receive ongoing treatment for Crohn's disease and remain in remission, you can lower your chance of developing colon cancer. ³

Talk to your doctor about how often you should be screened for colon cancer. Screening is testing for illnesses where you don't have symptoms. Colon cancer screening may include colonoscopy with biopsies. While screening does not reduce your chances of developing colon cancer, it can help detect cancer at an early stage and increase the chances of the cancer being cured.

Symptoms

The most common symptoms of Crohn's disease are

• diarrhea
• cramps and pain in your stomach
• weight loss

Other symptoms include

• Anemia
• eye redness or pain
• feeling tired
• fever
• joint aches or pains
• nausea or loss of appetite
• skin changes with red, tender bumps under the skin

Your symptoms can vary depending on the location and severity of your inflammation.

Some research suggests that stress, including the stress of living with Crohn's disease, can make symptoms worse. Some people may also discover that certain foods can cause or distract their symptomsto annoy.

What Causes Crohn's Disease?

Doctors aren't sure what causes Crohn's disease. Experts believe the following factors may play a role in the development of Crohn's disease.

Autoimmune response

One cause of Crohn's disease can be an autoimmune reaction - when your immune system attacks healthy cells in your body. Experts think bacteria in your digestive tract can inadvertently activate your immune system. This immune system response causes inflammation, which leads to Crohn's disease symptoms.

Genes

Crohn's disease sometimes runs in families. Research has shown that if you have a parent or sibling with Crohn's disease, you are more likely to develop the disease. Experts continue to study the link between genes and Crohn's disease.

therapy

Doctors treat Crohn's disease with drugs, bowel movements, and surgery.

No single treatment works for everyone with Crohn's disease. The goal of treatment is to reduce inflammation in your gut, prevent flare-ups of your symptoms, and keep you in remission.

Medicines

Many people with Crohn's disease require medication. Which medications your doctor prescribes will depend on your symptoms.

While no medication will cure Crohn's disease, many can reduce symptoms.

Aminosalicylates. These medicines contain 5-aminosalicylic acid (5-ASA), which helps control inflammation. Doctors use aminosalicylates to treat people newly diagnosed with Crohn's disease who have mild symptoms. Aminosalicylates

• balsalazide NIH link is external
• mesalamine NIH link is external
• olsalazine NIH link is external
• sulfasalazine NIH link is external

Some of the common side effects of aminosalicylates include:

• diarrhea
• headache
• gastric acid
• nausea and vomiting
• pain in your stomach

Corticosteroids. Corticosteroids, also called steroids, help reduce the activity of your immune system and reduce inflammation. Doctors prescribe corticosteroids for people with moderate to severe symptoms. Include corticosteroids

• budesonide NIH link is external
• hydrocortisone NIH link is external
• methylprednisolone NIH link is external
• prednisone NIH link is external

Side effects of corticosteroids include

• acne
• loss of bone mass
• high blood glucose
• high bloodpressure
• a greater chance of developing infections
• mood swings
• weight gain

In most cases, doctors don't prescribe corticosteroids for long-term use.

Immunomodulators. These drugs decrease immune system activity, resulting in less inflammation in your digestive tract. It can take several weeks to 3 months for immunomodulators to start working. Include immunomodulators

• 6-mercaptopurine NIH link external , or 6-MP
• azathioprine NIH link is external
• cyclosporine NIH link is external
• methotrexate NIH link is external

Doctors prescribe these drugs to help you go into remission or to help you if you don't respond to other treatments. You can have the following side effects:

• a low number of white blood cells, which can increase the risk of infection
• feeling tired
• nausea and vomiting
• pancreatitis

Doctors usually only prescribe cyclosporine if you have severe Crohn's disease because of the drug's serious side effects. Talk to your doctor about the risks and benefits of cyclosporine.

Biological Therapies. These drugs target proteins made by the immune system. Neutralizing these proteins reduces inflammation in the intestines.

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