Crohn's Disease and Colitis

Crohn's disease is an inflammatory bowel disease (IBD). It causes inflammation of the lining of your digestive tract, which can lead to abdominal pain, severe diarrhea and even malnutrition. The inflammation caused by Crohn's disease often spreads deep into the layers of affected bowel tissue.

Resources for Chrohn's and Colitis
Crohn's & Colitis Foundation of America


Symptoms

Signs and symptoms of Crohn's disease can range from mild to severe and may develop gradually or come on suddenly, without warning. You may also have periods of time when you have no signs or symptoms (otherwise known as remission).

Signs include:
  • Diarrhea
  • Abdominal pain and cramping
  • Blood in your stool
  • Ulcers in intestinal walls and sometimes in your mouth (like canker sores)
  • Reduced appetite and weight loss
  • Fever
  • Fatigue
  • Arthritis
  • Eye inflammation
  • Skin disorders
  • Inflammation of the liver or bile ducts
  • Delayed growth or sexual development, in children
 

Causes

The exact cause of Crohn's disease remains unknown. Previously, diet and stress were suspected, but now doctors know that although these factors may aggravate existing Crohn's disease, they don't cause it. Now, researchers believe that a number of factors, such as heredity and a malfunctioning immune system play a role in the development of Crohn's disease.
  • Immune system. It's possible that a virus or bacterium may cause Crohn's disease. When your immune system tries to fight off the invading microorganism, the digestive tract becomes inflamed. Currently, many investigators believe that some people with the disease develop it because of an abnormal immune response to bacteria that normally live in the intestine.
  • Heredity. Mutations in a gene called NOD2 tend to occur frequently in people with Crohn's disease and seem to be associated with a higher likelihood of needing surgery for the disease. Scientists continue to search for other genetic mutations that might play a role in Crohn's.


Diagnosis

Your doctor will likely diagnose Crohn's disease only after ruling out other possible causes for your signs and symptoms, including irritable bowel syndrome (IBS), diverticulitis and colon cancer. To help confirm a diagnosis of Crohn's disease, you may have one or more of the following tests and procedures:
  • Blood tests
  • Fecal occult blood test (FOBT)
  • Colonoscopy
  • Flexible sigmoidoscopy
  • Barium enema
  • Small bowel imaging
  • Computerized tomography (CT)
  • Capsule endoscopy


Treatment

Treatment for Chrohn's diease may include medications, surgery, nutrition supplementation, or a combination of these options. The goals of treatment are to control inflammation, correct nutritional deficiencies, and relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding. Treatment for Crohn’s disease depends on its location, severity, and complications.

Treatment can help control Crohn’s disease and make recurrences less frequent, but no cure exists. Someone with Crohn’s disease may need long-lasting medical care and regular doctor visits to monitor the condition. Some people have long periods—sometimes years—of remission when they are free of symptoms, and predicting when a remission may occur or when symptoms will return is not possible. This changing pattern of the disease makes it difficult to be certain a treatment has helped.

Despite possible hospitalizations and the need to take medication for long periods of time, most people with Crohn’s disease have full lives—balancing families, careers and activities.


Daily Management

Diet and Nutrition
  • Ask your doctor about extra vitamins and minerals you may need
  • Eat small amounts of food throughout the day.
  • Drink lots of water (drink small amounts often throughout the day).
  • Avoid fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
  • If your body does not digest dairy foods well, limit dairy products. Try low-lactose cheeses, such as Swiss and cheddar, and an enzyme product, such as Lactaid, to help break down lactose.
  • Avoid high-fiber foods (bran, beans, nuts, seeds, and popcorn).
  • Avoid foods that you know cause you gas, such as beans, spicy food, cabbage, broccoli, cauliflower, raw fruit juices and fruits -- especially citrus fruits.
  • People who have a blockage of the intestines may need to avoid raw fruits and vegetables and other high-fiber foods.
  • Iron supplements (if you are anemic)
  • Calcium and vitamin D supplements to help keep your bones strong
  • Vitamin B12 to prevent anemia
Reduce Stress
  • Exercise
  • Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. You're then taught how to produce these changes yourself. The goal is to help you enter a relaxed state so that you can cope more easily with stress. Biofeedback is usually taught in hospitals and medical centers.
  • Regular relaxation and breathing exercises like yoga and meditation
  • Hypnosis
  • Set aside time every day for any activity you find relaxing — listening to music, reading, playing computer games or just soaking in a warm bath.
Medications
  • Fiber supplements may help your symptoms. You can buy psyllium powder (Metamucil) or methylcellulose (Citrucel) without a prescription.
  • Laxatives
  • Aminosalicylates (5-ASAs)
  • Corticosteroids
  • Medicines such as azathioprine or 6-mercaptopurine quiet the immune system's reaction.
  • Antibiotics may be prescribed for abscesses or fistulas.
  • Biologic therapy is used to treat patients with severe Crohn's disease that does not respond to any other types of medication. Medicines in this group include infliximab (Remicade) and adalimumab (Humira), certolizumab (Cimzia), and natalizumab (Tysabri).
  • Acetaminophen (Tylenol) for mild pain.
  • Drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) may make your symptoms worse.
Surgery
If medicines do not work, a type of surgery called bowel resection may be needed to remove a damaged or diseased part of the intestine or to drain an abscess. However, removing the diseased portion of the intestine does not cure the condition.
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