Gain a better understanding of Crohn’s disease, a chronic inflammatory bowel condition that can affect various parts of the digestive tract.

Delve into the potential causes, common symptoms, and the diagnostic process to understand this complex autoimmune disorder better.

What is Crohn’s Disease?

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that affects the lining of the digestive tract, also known as the gastrointestinal (GI) tract.

It can involve any part of the GI tract from the mouth to the anus, but it most commonly affects the end of the small intestine (ileum) and the beginning of the large intestine (colon).

The inflammation caused by Crohn’s disease can penetrate deep into the layers of the affected bowel tissue, leading to pain, discomfort, and various digestive symptoms.

The inflammation can also cause complications such as strictures (narrowing of the intestine), fistulas (abnormal connections between different parts of the intestine or between the intestine and other organs), and abscesses (pockets of infection).

Causes and Risk Factors

The exact cause of Crohn’s disease is still not completely understood, but it is believed to result from a complex interplay of genetic, environmental, and immune system factors.

Here are some of the known causes and risk factors associated with Crohn’s disease:

Genetics:
There is a clear genetic component to Crohn’s disease, as individuals with a family history of the condition are more likely to develop it. Several genes have been identified that may increase the risk of developing Crohn’s disease, but not everyone who carries these genes will develop the condition.
 

Immune system:
Crohn’s disease is considered an autoimmune disorder, in which the immune system mistakenly attacks healthy cells in the gastrointestinal tract. This immune response leads to chronic inflammation and tissue damage. The exact reason for this abnormal immune response is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

Environmental factors:
Although the exact environmental triggers of Crohn’s disease are not known, several factors have been associated with an increased risk of developing the condition. These factors include smoking and having a diet high in fat and low in fiber. It has also been suggested that infections, particularly those involving the gastrointestinal tract, may play a role in triggering Crohn’s disease in susceptible individuals.

Age:
Crohn’s disease can occur at any age, but it is most commonly diagnosed in young adults between the ages of 15 and 35. However, it is important to note that the condition can develop later in life as well.

Smoking:
Smoking is a significant risk factor for the development of Crohn’s disease and is also associated with more severe disease and a higher risk of complications. Quitting smoking can help reduce the risk of developing the condition and improve the overall health of those who already have it.

Common Symptoms of Crohn’s

The symptoms of Crohn’s disease can vary widely depending on the severity of inflammation and the specific parts of the digestive tract affected. Some common symptoms associated with Crohn’s disease include:

Abdominal Pain and Cramping:
This is often experienced in the lower right part of the abdomen but can occur anywhere along the digestive tract. The pain may be mild to severe and can come and go, often worsening after meals.

Diarrhea:
Frequent loose and watery stools are a common symptom of Crohn’s disease. In some cases, diarrhea may be severe and accompanied by blood or mucus.

Fatigue:
People with Crohn’s disease often experience a general feeling of tiredness and low energy levels due to inflammation, malabsorption of nutrients, and the impact of other symptoms on daily life.

Weight loss:
Unintentional weight loss can result from a combination of reduced appetite, malabsorption of nutrients, and increased calorie expenditure due to the ongoing inflammation in the digestive tract.

Fever:
A low-grade fever can sometimes accompany active inflammation in Crohn’s disease, particularly during flare-ups.

Mouth sores:
Painful sores, or ulcers, can develop in the mouth as a result of inflammation in the digestive tract.

Perianal disease:
This includes symptoms like pain, swelling, or drainage around the anus, which can result from the formation of abscesses, fissures, or fistulas.

Nutritional deficiencies:
Crohn’s disease can cause malabsorption of nutrients, leading to deficiencies in essential vitamins and minerals such as iron, vitamin B12, and vitamin D.

Joint pain:
Arthritis or joint pain can occur in some individuals with Crohn’s disease, affecting the knees, ankles, wrists, or other joints.

Skin issues:
Some people with Crohn’s disease may develop skin problems, such as erythema nodosum (painful red nodules under the skin) or pyoderma gangrenosum (painful ulcers that develop rapidly).

Eye inflammation:
Inflammation of the eyes, such as uveitis or episcleritis, can also be a symptom of Crohn’s disease.

Diagnosis and Testing

Diagnosing Crohn’s disease can be challenging due to its varied symptoms and the fact that it can mimic other gastrointestinal conditions.

A combination of medical history, physical examination, and various tests and procedures is often required to accurately diagnose Crohn’s disease.

Here are some of the common steps and tests involved in diagnosing the condition:

Medical History and Physical Examination:
The physician will begin by taking a detailed medical history, including information about symptoms, family history of Crohn’s disease or other gastrointestinal disorders, and any medications the patient is taking. A physical examination will follow, focusing on signs of inflammation, malnutrition, or complications related to Crohn’s disease.

Blood Tests:
Blood tests can help identify signs of inflammation, anemia, and possible nutritional deficiencies. Common blood tests include complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).

Stool Tests:
Stool samples may be analyzed to rule out other causes of gastrointestinal symptoms, such as infections or parasites. The presence of fecal calprotectin, a protein that indicates inflammation in the intestines, can also be detected in stool samples and may be a marker for Crohn’s disease.

Imaging Studies:
Various imaging tests can help visualize the gastrointestinal tract and identify areas of inflammation, strictures, or other abnormalities. These tests may include X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasound.
 

Endoscopy:
Endoscopic procedures involve inserting a flexible tube with a camera at its tip into the gastrointestinal tract to directly visualize the lining of the digestive tract and take biopsies (tissue samples) for further analysis. Two common endoscopic procedures used in diagnosing Crohn’s disease are:

Colonoscopy:
This procedure allows the physician to examine the entire colon and the end of the small intestine (ileum). Biopsies can be taken during a colonoscopy to help confirm the diagnosis.

Upper endoscopy:
This procedure is used to examine the esophagus, stomach, and the first part of the small intestine (duodenum). It may be performed if symptoms suggest Crohn’s disease is affecting the upper gastrointestinal tract.

Capsule endoscopy:
In some cases, a capsule endoscopy may be recommended to visualize the small intestine, which can be difficult to examine using conventional endoscopy. The patient swallows a small capsule containing a camera, which takes pictures of the digestive tract as it passes through, transmitting the images to a recording device worn by the patient.

Conclusion

Dr. Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond.

Dr Eduan prides himself on his ability to help his patients to the best of his ability by embracing good listening skills, effective communication, compassion and knowledge and skill honed during years of private gastroenterology practice.

If you would like to book an appointment with a gastrointestinal (GI) specialist or would simply like more information on a particular GI topic, don’t hesitate to use our online booking form
or call Dr. Deetlefs at 021 551 867.