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Crohn’s Disease is a type of inflammatory bowel disease that can go into remission but then suddenly reappear with nasty symptoms. Doctors may prescribe medication or, in severe cases, even surgery.

Good lifestyle choices and general symptom management can help ease the hardships of this disease.

Here we will look at examining what the disease entails and the best treatment options available today.


What is Crohn’s Disease?


Crohn’s disease falls under the category of inflammatory bowel diseases. As such, it’s a condition that stays with those suffering from it for life.

While it does differ quite significantly from inflammatory bowel disease, Crohn’s disease does involve chronic inflammation of the digestive tract.

The hardest part about living with Crohn’s disease is living with life-disrupting symptoms. Even when symptoms are not present, though, the disease can be a real hindrance to a stress-free life because Crohn’s disease is prone to remission with sudden flare-ups a common occurrence.

Lifestyle changes are required by most people living with the disease to manage the disease as carefully as possible in an attempt to lower its negative effects on normal school, work, and social life.

In this article, we will look into what makes Crohn’s disease part of the Inflammatory Bowel Disease umbrella term, how it differs from ulcerative colitis, the typical signs and symptoms one can expect when dealing with Crohn’s disease, and potential treatment options.




Inflammatory Bowel Disease and Crohn’s Disease


Crohn’s disease is a form of inflammatory bowel disease (IBD).

IBD is the collective term for describing disorders that involve chronic inflammation of the digestive tract. The digestive tract is comprised of everything from the mouth and oesophagus through to the small and large intestine.

The digestive tract is what keeps you alive by breaking down your food, retaining the valuable parts, and ridding itself of the rest.

The definition of IBD is broad in scope but defines the parent term for two sub-categories of IBD, namely ulcerative colitis and Crohn’s disease.

It’s important to note that while we can draw clear separations between the two on paper, it can sometimes be quite a tricky task to diagnose the correct IBD in patients.

That said, let’s take a look at how Crohn’s disease is similar and contrasting to ulcerative colitis.


How is Crohn’s Disease Different from Ulcerative Colitis?


Ulcerative colitis involves inflammation of the large intestine with inflammation only present in the innermost layer of the lining of the colon.

Apart from inflammation, ulcerative colitis can also present as sores, or ulcers, on the colon lining. Another characteristic of this form of IBD is that the damaged areas are continuous.

This is in contrast to how Crohn’s disease presents.

Whereas ulcerative colitis is limited to the large intestine, Crohn’s disease can involve any part of the gastrointestinal tract from the mouth all the way to the end – the anus. 

Most commonly, it develops in the final part of the small intestine and colon. Another differentiating factor is that it occurs in distinct patches.

Unlike the continuous inflammation found in ulcerative colitis patients, those suffering from Crohn’s disease present with quite distinct healthy and inflamed areas of tissue.

Crohn’s disease seems to be increasing in occurrence with time – studies in the United States suggest that over half a million people are suffering from the disease.

The distinction between the two forms of IBD is not always crystal clear.

When a doctor is unable to determine whether a patient has ulcerative colitis or Crohn’s disease, they will classify the patient’s condition as “indeterminate colitis” implying that there are cases where it’s not always clear one way or the other.



Signs and Symptoms of Crohn’s Disease


Due to the involvement of the small or large intestine and the fact that inflammation can be spread out in multiple segments, signs and symptoms can be widespread.

When Crohn’s disease is in remission, that is to say, that when inflammation is not severe, patients will present with no signs or symptoms. This can change quite rapidly though and often without warning.

When Crohn’s disease is fully active (i.e. not in remission), a number of signs and symptoms can be found, some more painful and debilitating than others.

Depending on the location of the diseased inflammation, symptoms can vary with inflammation of the lower gastrointestinal tract possibly including some or all the following symptoms: 

  • Abdominal pain and cramping
  • Fatigue
  • Reduced appetite and weight loss
  • Persistent, sudden diarrhoea
  • The sensation of incomplete bowel evacuation
  • Constipation which could lead to bowel obstruction

Some of these symptoms may also be present if Crohn’s disease is in the upper GIT but symptoms are fewer in number and milder in severity.

Crohn’s disease has even been known to present silently (no outward symptoms) when the disease affects the small intestine. What often happens is that those with silent symptoms later exhibit symptoms such as intestinal blockage, infection, or persistent pain and fever.

There are also several symptoms, already touched on earlier, that affect one’s general health such as mouth sores, night sweats, and unusual menstrual cycles.

In more severe cases, patients with well-established Crohn’s disease may also experience inflammation of the skin, eyes, and joints, iron deficiency, delayed growth in children, and even kidney stones.

There is quite a range of displayed signs and symptoms of Crohn’s disease. It’s important to remain vigilant in monitoring one’s own health and consulting your doctor at any sign of irregularity in one’s health when Crohn’s disease is suspected. 



Treatment of Crohn’s Disease


Due to the inflammation being the main problem in Crohn’s disease with cascading effects, anti-inflammatory drugs are the first step in a treatment plan.

Before starting a treatment plan, one’s doctor will first check out what kind of complications might be present, the severity of the symptoms and other medical conditions that may be present.

Apart from this, the doctor will want to understand how one’s body has responded to medication before such that he or she can ascertain what medical route to go down. Understanding potential side-effects are the primary goal here.

Apart from reducing inflammation, it is important to lower the immune response in an attempt to stop the immune system from attacking the bowel which causes inflammation. Immune suppressants are administered for this.

An example of an immune suppressant that may be administered is a corticosteroid that can help ease swelling. Immunomodulators can be given to stop inflammation but these are more intense and can take weeks or months to kick in.

Aminosalisylates are likely prescribed when one is diagnosed with Crohn’s disease but only present with mild symptoms.

There are risks of side effects with any medication, so doctor consultation is important to establish the right medication on a case-by-case basis.

Antibiotics can also be administered to target bacteria that may be triggering or worsening Crohn’s disease symptoms.

Once the main symptoms have been dealt with, it’s important to maintain good lifestyle choices to further reduce symptoms and risk of re-onset. This includes addressing the loss of fluid by drinking plenty of water and avoiding potential bowel irritants such as dairy products.

In some cases, surgery can be necessary.

For people with Crohn’s disease, surgery can be a means used to remove affected parts of the intestine.


 Crohn's Disease Explained


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© Dr. Eduan Deetlefs, Registered Gastroenterologist, GI Doc Cape Town

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