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What is Crohn's disease?

Crohn's disease is an inflammatory bowel disease (IBD) that causes inflammation or ulceration of the digestive tract. It can affect any part of your digestive tract, but it is most common in the last part of the small intestine (ileum) and the large intestine (colon).

Crohn's disease affects the deepest layers of the lining of the digestive tract, causing deep sores called ulcers.

Crohn's disease and ulcerative colitis (which affects the colon and rectum) are the most common types of inflammatory bowel disease, with ulcerative colitis being more common.

What causes Crohn's disease?

The cause of Crohn's disease is not known. It sometimes runs in families, suggesting a genetic link. The immune system may overreact to normal intestinal bacteria and cause inflammation. Disease-causing bacteria and viruses also may play a role in triggering the condition, and smoking increases the risk of Crohn's disease.

Increasingly, researchers think environmental factors play a role in causing Crohn's disease.

What are the symptoms?

The main symptoms of Crohn's disease are abdominal pain, rectal bleeding, and diarrhea. Constipation, fever, and loss of appetite may also occur.

Crohn's disease also may cause:

Sores in the mouth.
Nutritional deficiencies, such as lowered levels of vitamin B12, folic acid, iron, and fat-soluble vitamins, because the intestines may not be able to absorb nutrients from food.
Bowel obstruction.
Anal tears (fissures) or openings (fistulas), abscesses, or skin tags that may resemble hemorrhoids.
Joint aches and fatigue.
Sometimes complications develop elsewhere in the body (systemic), including the eyes, liver, blood, and bones. These systemic symptoms suggest immune system involvement.

How is Crohn's disease diagnosed?

Crohn's disease is diagnosed through a medical history and physical exam, imaging tests to look at the intestines, and laboratory tests.

Crohn's disease can be difficult to diagnose. Early symptoms, or its only symptoms, may consist of joint aches and a general feeling of fatigue. The condition may go undiagnosed for years because symptoms usually develop gradually.

Tests that may be done to diagnose Crohn's disease include:

Barium X-rays of the small intestine or colon, in which a white liquid is used to coat the inside of the intestine so that it can be seen more clearly on an X-ray.
Colonoscopy or flexible sigmoidoscopy, in which a lighted viewing instrument is used to examine the inside of the colon.
Biopsy, in which tissue is taken from the affected area and tested to distinguish between Crohn's disease and other conditions such as cancer.
Stool analysis to look for blood and signs of infection.
How is it treated?

Crohn's disease can usually be controlled with medications that reduce inflammation and cure infection, keeping the disease from producing symptoms (known as being in remission). However, while it can be managed, Crohn's disease cannot be cured.

Mild symptoms of Crohn's disease may be treated with antidiarrheal medications. Talk with your health professional before taking them, though, because they may cause side effects. Prescription medications also may be used to treat mild symptoms and keep Crohn's disease in remission.

More severe symptoms may require treatment with one or more prescription medications. You may also need to follow a special diet if you are not able to absorb nutrients properly.

If your symptoms are severe or do not get better with initial medications, you may need more aggressive treatment with intravenous (IV) medications and possibly surgery. Surgery is usually done only when severe symptoms don't respond to medication or when complications develop, such as bleeding or developing a blockage (obstruction) in the intestine. Crohn's disease tends to come back after surgery.

How will Crohn's disease affect my life?

Crohn's disease is a chronic condition that may flare up throughout your life. You may have only mild symptoms or long periods without symptoms. A few people have persistent, severe symptoms.

People who have only mild symptoms that respond to home treatment cope well with the disease. But for some others, Crohn's disease can be a frustrating condition. The persistent diarrhea that often occurs may make you feel as if your life revolves around the bathroom. You may feel isolated, be embarrassed by the symptoms, and have a poor body image. These feelings may keep you from participating in work, social, and sexual activities.

However, most people with the condition live high-quality, productive lives using medications to control inflammation and treat symptoms.

Crohn's disease can cause stress, which in turn may affect the course of the disease. Help is available if you are struggling with the condition. Seek support from family, friends, clergy, or a professional counselor. A strong social network may reduce stress and make the disease less active. 1

Frequently Asked Questions

Learning about Crohn's disease:
What is Crohn's disease?
What causes Crohn's disease?
What are the symptoms of Crohn's disease?
What determines the severity of Crohn's disease?
What are the types of inflammatory bowel disease?
Who is affected by Crohn's disease?

Being diagnosed:
What tests are used to diagnose Crohn's disease?
What other conditions have symptoms similar to Crohn's disease?
What happens during a medical history and physical exam?
How can a colonoscopy be used to diagnose Crohn's disease?
How can a stool analysis be used to diagnose Crohn's disease?
How does a barium enema show Crohn's disease?

Getting treatment:
How is Crohn's disease treated?
What medications are used to treat Crohn's disease?
What types of surgery can be used to treat Crohn's disease?
What other treatments are available?

Ongoing concerns:
Can I prevent flare-ups of Crohn's disease?
When should I see a doctor?
What can I do at home to treat symptoms?

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