All in all, Chron’s disease symptoms can be very unpleasant. They include intestinal ulcers, discomfort, and pain.
There are some cases when this disease affects only the last segment of the small intestine (ileum). There are also other cases when this disease is confined to the colon which is part of the large intestine. The most common areas affected by Crohn’s disease are the last part of the small intestine and the colon.
In general, the signs and symptoms of the Chron’s disease can range from mild to severe. They usually develop gradually, but there are cases when they suddenly become severe. You may also have periods of time when you have no signs or symptoms (remission).
When the disease is active, the following signs and symptoms are the most common:
- Abdominal pain and cramping
- Blood in your stool
- Mouth sores
- Reduced appetite and weight loss
- Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
Other signs and symptoms
In the cases when the Crohn’s disease is more severe, people may also experience:
- Inflammation of skin, eyes and joints
- Inflammation of the liver or bile ducts
- Delayed growth or sexual development, in children
The scientists were unable so far to discover the causes of the Chron’s disease. One of the causes that they suspect are diet and stress. However, the doctors have found so far that these factors can aggravate the disease, but not cause its appearance. A number of factors, such as heredity and a malfunctioning immune system, likely play a role in its development.
- Immune system. It’s possible that a virus or bacterium may trigger Crohn’s disease. When your immune system tries to fight off the invading microorganism, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.
- Heredity. Crohn’s is more common in people who have family members with the disease, so genes may play a role in making people more susceptible. However, most people with Crohn’s disease don’t have a family history of the disease.
The following risk factors have been discovered so far to trigger the Crohn’s disease:
- Age. Crohn’s disease can occur at any age, but you’re likely to develop the condition when you’re young. Most people who develop Crohn’s disease are diagnosed before they’re around 30 years old.
- Ethnicity. Although Crohn’s disease can affect any ethnic group, whites and people of Eastern European (Ashkenazi) Jewish descent have the highest risk. However, the incidence of Crohn’s disease is increasing among blacks who live in North America and the United Kingdom.
- Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn’s disease has a family member with the disease.
- Cigarette smoking. Cigarette smoking is the most important controllable risk factor for developing Crohn’s disease. Smoking also leads to more-severe disease and a greater risk of having surgery. If you smoke, it’s important to stop.
- Nonsteroidal anti-inflammatory medications. These include ibuprofen, naproxen sodium, diclofenac sodium and others. While they do not cause Crohn’s disease, they can lead to inflammation of the bowel that makes Crohn’s disease worse.
- Where you live. If you live in an urban area or in an industrialized country, you’re more likely to develop Crohn’s disease. This suggests that environmental factors, including a diet high in fat or refined foods, may play a role in Crohn’s disease.
Crohn’s disease may lead to one or more of the following complications:
- Bowel obstruction. Crohn’s disease affects the thickness of the intestinal wall. Over time, parts of the bowel can scar and narrow, which may block the flow of digestive contents.
- Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).
- Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind.
- Anal fissure. This is a small tear in the tissue that lines the anus or in the skin around the anus where infections can occur. It’s often associated with painful bowel movements and may lead to a perianal fistula.
- Malnutrition. Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. It’s also common to develop anemia due to low iron or vitamin B-12 caused by the disease.
- Colon cancer. Having Crohn’s disease that affects your colon increases your risk of colon cancer. General colon cancer screening guidelines for people without Crohn’s disease call for a colonoscopy every 10 years beginning at age 50.
- Other health problems. Crohn’s disease can cause problems in other parts of the body. Among these problems are anemia, skin disorders, osteoporosis, arthritis, and gallbladder or liver disease.
- Medication risks. Certain Crohn’s disease drugs that act by blocking functions of the immune system are associated with a small risk of developing cancers such as lymphoma and skin cancers. They also increase risk of infection.
The diet is very important when you suffer from Chron’s disease, especially if you are a child. Most patients with Crohn’s disease say that the following foods can increase diarrhea and cramping:
- bulky grains
- dairy products
- spicy foods
When a doctor recommends a specific treatment, his aim is to control the inflammation, correct nutritional problems, and relieve symptoms. As we mentioned above, there is no cure for Crohn’s disease, but some treatments can help by reducing the number of times a patient experiences recurrences.
Crohn’s disease treatment depends on:
- where the inflammation is situated
- the severity of the disease
- the patient’s response to previous treatment for recurring symptoms
Medication for Crohn’s disease
- Anti-inflammation drugs – the doctor will most likely start with mesalamine, which helps control inflammation.
- Cortisone or steroids – corticosteroids are drugs containing cortisone and steroids.
- Immunosuppressant drugs – these drugs reduce the patient’s immune response. The doctor may prescribe 6-mercaptopurine or a related drug, azathioprine. Side effects include vomiting, nausea, and a weaker resistance to infection.
- Infliximab – this blocks the body’s inflammation response.
- Antibiotics – fistulas, strictures, or prior surgery may cause bacterial overgrowth. Doctors will generally treat this by prescribing ampicillin, sulfonamide, cephalosporin, tetracycline, or metronidazole.
- Anti-diarrheal and fluid replacements – when the inflammation subsides, diarrhea usually becomes less of a problem. However, sometimes the patient may need something for diarrhea and abdominal pain.
The majority of Crohn’s disease patients may need surgery at some point. When medications no longer control symptoms, the only solution is to operate. Surgery can relieve symptoms that did not respond to medication, or to correct complications, such as abscess, perforation, bleeding, and blockage.
Removing part of the intestine can help, but it does not cure Crohn’s disease. Inflammation often returns to the area next to where the affected part of the gut was removed. Some Crohn’s disease patients may require more than one operation during their lives.
In some cases, a colectomy is needed, in which the whole colon is removed. The surgeon will make a small opening in front of the abdominal wall, and the tip of the ileum is brought to the skin’s surface to form an opening called a stoma. Feces exit the body through the stoma. A pouch collects the feces. Doctors say that a patient who has a stoma can carry on leading a normal and active life. If the surgeon can remove the diseased section of the intestine and then connect the intestine again, no stoma is needed.
What is very important to understand is that most people with Crohn’s disease can live normal and active lives, hold jobs, raise families, and function successfully.