Health News Of The Day : Understanding Crohn’s Disease

What is Crohn’s disease?

Crohn’s disease is a type of inflammatory bowel disease. As many as 780,000 Americans have the condition, according to the Crohn’s & Colitis Foundation (CCF).

More research about Crohn’s disease is necessary. Researchers aren’t sure how it begins, who is most likely to develop it, or how to best manage it. Despite major treatment advances in the last three decades, no cure is available yet.

Crohn’s disease most commonly occurs in the small intestine and the colon. It can affect any part of your gastrointestinal (GI) tract, from your mouth to your anus. It can involve some parts of the GI tract and skip other parts.

The range of severity for Crohn’s is mild to debilitating. Symptoms vary and can change over time. In severe cases, the disease can lead to life-threatening flares and complications.

Get a broader understanding of the basics of Crohn’s disease.

What causes Crohn’s disease?

It isn’t clear what causes Crohn’s disease. However, the following factors may influence whether you get it:

— your immune system

— your genes

— your environment

Up to 20 percent of people with Crohn’s disease also have a parent, child, or sibling with the disease, according to the Crohn’s & Colitis Foundation.

According to a 2012 study, certain things can affect the severity of your symptoms. These include:

— whether you smoke

— your age

— whether or not the rectum is involved

— length of time you’ve had the disease

People with Crohn’s are also more likely to develop intestinal infections from bacteria, viruses, parasites, and fungi. This can affect the severity of symptoms and create complications.

Crohn’s disease and its treatments can also affect the immune system, making these types of infections worse.

Yeast infections are common in Crohn’s and can affect both the lungs and the intestinal tract. It’s important that these infections are diagnosed and properly treated with antifungal medications to prevent further complications.

Crohn’s symptoms

The symptoms of Crohn’s disease often develop gradually. Certain symptoms may also become worse over time. Although it’s possible, it’s rare for symptoms to develop suddenly and dramatically. The earliest symptoms of Crohn’s disease can include:

— diarrhea

— abdominal cramps

— blood in your stool

— a fever

— fatigue

— loss of appetite

— weight loss

feeling as if your bowels aren’t empty after a bowel movement

feeling a frequent need for bowel movements

It’s sometimes possible to mistake these symptoms for the symptoms of another condition, such as food poisoning, an upset stomach, or an allergy. You should see your doctor if any of these symptoms persist.

The symptoms may become more severe as the disease progresses. More troublesome symptoms may include:

a perianal fistula, which causes pain and drainage near your anus

ulcers that may occur anywhere from the mouth to the anus

inflammation of the joints and skin

shortness of breath or decreased ability to exercise due to anemia

Early detection and diagnosis can help you avoid severe complications and allow you to begin treatment early.

Crohn’s diagnosis

No single test result is enough for your doctor to diagnose Crohn’s disease. They will begin by eliminating any other possible causes of your symptoms. Making a Crohn’s disease diagnosis is a process of elimination.

Your doctor may use several types of tests to make a diagnosis:

Blood tests can help your doctor look for certain indicators of potential problems, such as anemia and inflammation.

A stool test can help your doctor detect blood in your GI tract.

Your doctor may request an endoscopy to get a better image of the inside of your upper gastrointestinal tract.

Your doctor may request a colonoscopy to examine the large bowel.

Imaging tests like CT scans and MRI scans give your doctor more detail than an average X-ray. Both tests allow your doctor to see specific areas of your tissues and organs.

Your doctor will likely have a tissue sample, or biopsy, taken during an endoscopy or colonoscopy for a closer look at your intestinal tract tissue.

Once your doctor has completed reviewing all the necessary tests and ruled out other possible reasons for your symptoms, they may conclude that you have Crohn’s disease.

Your doctor may go on to request these tests several more times to look for diseased tissue and determine how the disease is progressing.

Treatment for Crohn’s disease

A cure for Crohn’s disease isn’t currently available, but the disease can be well-managed. A variety of treatment options exist that can lessen the severity and frequency of your symptoms.

Medications

Several types of medications are available to treat Crohn’s. Anti-diarrheal and anti-inflammatory drugs are commonly used. More advanced options include biologics, which use the body’s immune system to treat the disease.

Which medications, or combination of medications, you need depends on your symptoms, your disease history, the severity of your condition, and how you respond to treatment.

Anti-inflammatory drugs

The two main types of anti-inflammatory drugs doctors use to treat Crohn’s are oral 5-aminosalicylates and corticosteroids. Anti-inflammatory drugs are often the first drugs you take for Crohn’s disease treatment.

You typically take these drugs when you have mild symptoms with infrequent disease flares. Corticosteroids are used for more severe symptoms but should only be taken for a short time.

Immunomodulators

An overactive immune system causes the inflammation that leads to the symptoms of Crohn’s disease. Drugs that affect the immune system, called immunomodulators, may reduce the inflammatory response and limit your immune system’s reaction.

Antibiotics

Some doctors believe antibiotics may help reduce some of the symptoms of Crohn’s and some of the possible triggers for it.

For example, antibiotics can reduce drainage and heal fistulas, which are abnormal connections between tissues that Crohn’s can cause. Antibiotics can also kill off any foreign or “bad” bacteria present in your gut that could be contributing to inflammation and infection.

Learn more about antibiotics in Crohn’s disease.

Biologic therapies

If you have severe Crohn’s, your doctor may try one of a number of biologic therapies to treat the inflammation and complications that can occur from the disease. Biologic drugs can block specific proteins that may trigger inflammation.

Learn more about medications for Crohn’s disease.

Dietary changes

Food doesn’t cause Crohn’s disease, but it can trigger flares.

After a Crohn’s diagnosis, your doctor will likely suggest making an appointment with a registered dietitian (RD). An RD will help you understand how food may affect your symptoms and what diet changes may help you.

In the beginning, they may ask you to keep a food diary. This food diary will detail what you ate and how it made you feel.

Using this information, the RD will help you create eating guidelines. These dietary changes should help you absorb more nutrients from the food you eat while also limiting any negative side effects food may be causing. Read on for more info on diet in the next section.

Surgery

If less invasive treatments and lifestyle changes don’t improve your symptoms, surgery may be necessary. Ultimately, about 75 percent of people with Crohn’s disease will require surgery at some point in their lives, according to the Crohn’s & Colitis Foundation.

Some types of surgery for Crohn’s include removing damaged portions of your digestive tract and reconnecting the healthy sections. Other procedures repair damaged tissue, manage scar tissue, or treat deep infections.

Crohn’s disease diet

A diet plan that works for one person with Crohn’s disease may not work for another. This is because the disease can involve different areas of the GI tract in different people.

It’s important to find out what works best for you. This can be done by keeping track of your symptoms as you add or remove certain foods from your diet. Lifestyle and diet changes may help you reduce the recurrence of symptoms and lessen their severity.

You may need to:

Adjust your fiber intake

Some people need a high-fiber, high-protein diet. For others, the presence of extra food residue from high-fiber foods such as fruits and vegetables may aggravate the GI tract. If this is the case, you may need to switch to a low-residue diet.

Limit your fat intake

Crohn’s disease may interfere with your body’s ability to break down and absorb fat. This excess fat will pass from your small intestine to your colon, which can cause diarrhea.

Limit your dairy intake

Previously, you may not have experienced lactose intolerance, but your body can develop difficulty digesting some dairy products when you have Crohn’s disease. Consuming dairy can lead to an upset stomach, abdominal cramps, and diarrhea for some people.

Drink water

Crohn’s disease may affect your body’s ability to absorb water from your digestive tract. This can lead to dehydration. The risk for dehydration is especially high if you’re having diarrhea or bleeding.

Consider alternative sources of vitamins and minerals

Crohn’s disease can affect your intestines’ ability to properly absorb other nutrients from your food. Eating high-nutrient foods may not be enough. Talk to your doctor about taking multivitamins to find out if this is right for you.

Work with your doctor to figure out what best suits your needs. They may refer you to an RD or nutritionist. Together, you can identify your dietary limitations and create guidelines for a well-balanced diet.

Natural treatments for Crohn’s

Many people use complementary and alternative medicine (CAM) for various conditions and diseases, including Crohn’s disease. The U.S. Food and Drug Administration hasn’t approved these medicines for treatment, but many people use them in addition to mainstream medications.

Talk to your doctor if you’re interested in trying any of these treatments alongside your current regimen.

Popular alternative treatments for Crohn’s disease include the following:

Probiotics. These are live bacteria that can help you replace and rebuild the good bacteria in your intestinal tract. Probiotics may also help prevent microorganisms from upsetting your gut’s natural balance and causing a Crohn’s flare.

Scientific data about effectiveness is limited. You can find a wide selection of probiotic supplements online.

Prebiotics. These are potentially beneficial materials found in plants, such as asparagus, bananas, artichokes, and leeks, that help feed the good bacteria in your gut and increase their numbers. Prebiotics are also available to buy in supplement form.

Fish oil. Fish oil is rich in omega-3s. According to a 2017 study, research is ongoing regarding its possible treatment of Crohn’s disease. Oily fish like salmon and mackerel are rich in omega-3s. You can also try fish oil supplements, which you can shop for online.

Supplements. Many people believe certain herbs, vitamins, and minerals ease the symptoms of a variety of diseases, including the inflammation associated with Crohn’s disease. Research is ongoing as to which supplements may be beneficial.

Aloe vera. People believe that the aloe vera plant has anti-inflammatory properties. Because inflammation is one of the key components of Crohn’s disease, people often use it as a natural anti-inflammatory. However, there is no current research that suggests aloe vera helps with Crohn’s. If you are interested, you can find a selection of aloe vera gels, creams, juices, and more online.

Acupuncture. This is the practice of strategically sticking needles in the skin to stimulate various points on the body. One theory is that acupuncture may cause the brain to release endorphins, chemicals that block pain and strengthen the immune system.

A 2014 study found that acupuncture, combined with moxibustion — a type of traditional Chinese medicine that involves burning dried medicinal herbs on or near your skin —improves symptoms of Crohn’s disease. People with active Crohn’s disease reported less stomach pain, diarrhea, and inflammation after getting acupuncture.

Tell your doctor if you use any CAM treatments or over-the-counter medications. Some of these substances can affect the efficiency of medications or other treatments. In some cases, an interaction or side effect could be dangerous, even life-threatening.

Crohn’s surgery

Surgery for Crohn’s disease is considered a last-resort treatment, but three-quarters of people with this Crohn’s will ultimately need some type of surgery to relieve symptoms or complications.

Once medications are no longer working or side effects have become too severe to treat, your doctor may consider one of the following surgeries.

Strictureplastywidens and shortens the intestines in an attempt to reduce the effects of scarring or damage to the tissue.

During a bowel resection, portions of damaged intestine are removed. Healthy intestine is stitched together to reform the intestines.

An ostomy creates a hole through which your body can eliminate waste. These are usually performed when a portion of the small or large bowel is removed. They can be permanent or temporary when your doctor wants to give your intestines time to heal.

A colectomy removes sections of the colon that are diseased or damaged.

A proctocolectomy is surgery to remove the colon and rectum. If you have this surgery, you will also need a colostomy (a hole in the large intestine for emptying waste).

Crohn’s disease surgery is helpful for relieving symptoms, but it’s not without its risks.

What are the variations of Crohn’s disease?

There are six variations of Crohn’s disease, all based on location. They are:

Gastroduodenal Crohn’s disease mainly affects your stomach and the duodenum, which is the first part of your small intestine. About 5 percent of people with Crohn’s disease have this type.

Jejunoileitis occurs in the second portion of your intestine, called the jejunum. Like gastroduodenal Crohn’s, this variation is less common.

Ileitis is inflammation in the last part of the small intestine, or ileum. About 30 percent of people with Crohn’s disease are affected at this location.

Ileocolitis affects the ileum and the colon and is the most common variation of Crohn’s. Approximately 50 percent of people with Crohn’s disease have this variation.

Crohn’s colitis is found in about 20 percent of people with Crohn’s disease. It affects the colon only. Both ulcerative colitis and Crohn’s colitis impact the colon only, but Crohn’s colitis can affect deeper layers of the intestinal lining.

Perianal disease affects about 30 percent of people with Crohn’s. This variation often involves fistulas, or abnormal connections between tissues, deep tissue infections, as well as sores and ulcers on the outer skin around the anus.