What is Crohn’s Disease?
Crohn's disease is a chronic type of inflammatory bowel disease (IBD) that causes swelling and irritation of the tissues, called inflammation, in the digestive tract.
Crohn’s disease is a chronic disease in which abnormal reactions of the immune system cause inflammation in your digestive tract. Most commonly, Crohn’s disease affects your small intestine and the beginning of your large intestine. However, Crohn’s disease can affect any part of your digestive tract, from your mouth to your anus.
This is a lifelong condition that can’t be cured. However, treatments typically help manage your symptoms and allow you to live an active life.
What Causes Crohn’s Disease?
There’s no known single cause of Crohn’s disease, but it’s related to a dysfunctional immune response. A person’s immune system will switch into attack mode to destroy foreign invaders like bacteria, viruses, fungi, and other microorganisms. During a normal immune response, cells travel out of the blood to the intestines and produce inflammation. Inflammation is a sign that your body’s fighting the germs. Once the threat is gone, your immune system calms and the inflammation disappears.
An autoimmune response happens when your immune system launches into overdrive and attacks your body’s own cells. For example, your immune system may launch an inappropriate attack on bacteria normally found in your gut, causing Crohn’s-related inflammation in your intestines. These harmless bacteria are mistaken for foreign invaders and the immune system mounts a response. The inflammation caused by the immune response does not go away. This leads to chronic inflammation, ulceration, thickening of the intestinal wall, and, eventually, symptoms of Crohn’s disease.
Crohn’s disease can develop in people of any age or race, but is more likely to develop in people who:
are between the ages of 15 and 35
have a family member, most often a sibling or parent, with IBD
are of Jewish descent
smoke cigarettes
Recent research suggests hereditary, genetic, and environmental factors contribute to Crohn’s disease development.
Genetic Factors
Crohn’s disease tends to run in families, so if you or a close relative has the disease, your family members have an increased chance of developing Crohn’s. Studies have shown that between 5% and 20% of people with IBD have a first-degree relative, such as a parent, child, or sibling, who also has one of the diseases.
Environmental Factors
Where you live appears to play a role in the development of Crohn’s disease.
Here’s where Crohn’s disease is more common:
Developed countries, rather than undeveloped countries
Urban cities and towns, rather than rural areas
Northern climates, rather than southern climates
Symptoms
Crohn’s is a chronic disease, which means patients will likely experience periods when symptoms are active, known as flares, followed by periods of remission when you may not notice any symptoms at all.
Symptoms of Crohn's disease typically include:
Persistent diarrhea
Urgent need to move bowels
Sensation of incomplete bowel evacuation
Belly pain and cramping.
Fever
Fatigue
Blood in the stool / Rectal bleeding
Mouth sores
Reduced appetite and weight loss
Pain or drainage near or around the anus due to inflammation from a tunnel into the skin, called a fistula
Crohn’s Disease Complications
Crohn’s disease may lead to complications that develop over time. Complications may include:
anemia, a condition in which you have fewer red blood cells than normal. Approximately 1 in 3 people with Crohn’s disease have anemia. Crohn’s disease may lead to more than one type of anemia, including iron-deficiency anemia, anemia of inflammation or chronic disease, or vitamin B12 deficiency anemia.
bone problems. Crohn’s disease and corticosteroids used to treat the disease may lead to low bone mass, known as osteopenia or osteoporosis.
problems with growth and development in children. Problems may include gaining less weight than normal, slowed growth, short stature, or delayed puberty.
malnutrition, a condition in which you don’t get enough of the vitamins, minerals, and other nutrients you need to be healthy.
The inflammation of Crohn’s disease may lead to serious complications, which are:
Bowel obstruction, a partial or total blockage of the movement of food, fluid, air, or stool through your intestines. Obstructions can develop when scar tissue forms or abnormal narrowing called strictures occur.
Fistulas, an abnormal tunnel-like opening that connects two body parts that don’t normally connect. Fistulas may become infected. For example, with Crohn’s disease, fistulas sometimes cause an opening between your rectum or anal canal inside your body and the skin surrounding your anus outside your body (anal fistula).
Abscesses, infected pus-filled pockets that form in your digestive tract or abdomen, which are painful.
Anal fissures, which are small tears in your anus. Anal fissures may cause itching, pain, or bleeding.
Ulcers, or open sores in your mouth, intestines, anus, or perineum.
· Crohn’s disease can also increase your risk of colon cancer and blood clots.
Diagnosis
Doctors typically do not use a single test to diagnose Crohn’s disease. You may need a combination of tests.
Most people diagnosed with Crohn’s first see a healthcare provider because of ongoing diarrhea, belly cramping or unexplained weight loss. As part of your workup, you may need to see a doctor who specializes in digestive diseases, called a gastroenterologist.
Your provider will consider your medical history, including your symptoms, and family history. They’ll perform a physical exam to see if you have signs of Crohn’s like swelling or tenderness in your belly. They may perform a series of tests to rule out other conditions before making a diagnosis.
Lab tests
Lab tests check a sample of fluid or tissue for microscopic signs of disease.
Blood test: A blood test checks your blood cell counts and blood chemistry for signs of Crohn’s. A high white blood cell count may indicate inflammation or infection. Low levels of red blood cells indicate anemia, common with Crohn’s disease. A protein your liver makes called the C-reactive protein (CRP) may be elevated if there’s active inflammation.
Stool test: This test checks a stool (poop) sample for bacteria or parasites. It can rule out infections that cause chronic diarrhea. For example, a calprotectin fecal test measures inflammation in your intestines.
Imaging procedures
Your provider may order imaging tests to take pictures of your digestive tract, such as:
Computed tomography (CT) scan: A CT scan creates images of your digestive tract using X-rays. It tells your healthcare provider how severe the inflammation is. You may need a CT enterography, which involves drinking a solution that highlights your small intestine so it stands out more in the images.
Magnetic resonance imaging (MRI): An MRI uses a large magnet and radio waves to create images of the inside of your body. It’s especially useful in showing fistulas around your small intestine and anus. You may need to drink a special contrast fluid before the procedure to clarify the images (MRI enterography).
Endoscopy
An endoscopy sends a thin tube with a light and camera (endoscope) into your digestive tract to take images or show videos of areas with inflammation. You’ll be sedated for these procedures.
Colonoscopy: During this procedure, a provider uses an endoscope to examine the inside of your colon and lower small bowel (ileum). They may remove a tissue sample (biopsy) to test for white blood cells.
Upper endoscopy: A provider passes an endoscope through your mouth and into your throat. An attached camera allows your provider to see inside, from your mouth to the start of your small intestine.
Capsule endoscopy: You swallow a small plastic capsule with a light and a camera that takes pictures as it moves through your digestive tract.
What is the life expectancy of a person with Crohn’s disease?
Crohn’s disease isn’t fatal, and people with Crohn’s disease can live just as long as people without it. Still, managing your condition to prevent complications is important since Crohn’s can increase your risk of certain conditions.
References
https://medlineplus.gov/crohnsdisease.html#:~:text=What%20is%20Crohn's%20disease%3F,beginning%20of%20your%20large%20intestine. Assessed and Endorsed by the MedReport Medical Review Board