Crohn's Disease: A Serious Inflammatory Bowel Disease

If you were just diagnosed with Crohn's disease, a potentially serious inflammatory bowel disease, the news may still be sinking in. On the one hand, you may be relieved to have an explanation for why you've felt so sick. But on the other, you may feel helpless. You may worry about what a future with inflammatory bowel disease holds.

On top of the pain and the other symptoms, the uncertainty of life with Crohn's disease can be hard to deal with. It's an unpredictable condition. Some people go without symptoms for years, while others have more regular -- and severe -- flares. Some people do fine with little or no treatment. Others need medicines every day and get multiple surgeries.

But don't give into the fear and the worry. You will feel better again. While no treatment can cure Crohn's disease, there are a lot of treatments that help control it.

You also have a key role in keeping yourself healthy and regaining a feeling of control. Remember that most people who have Crohn's disease live pretty normal lives: They go to school, they have jobs, and they raise families. By learning about the disease, getting treatment, and planning ahead, you can, too.

What is Crohn's disease?

Crohn's disease is a type of IBD -- inflammatory bowel disease. It can develop anywhere in the digestive tract, the 30 foot expanse between your mouth and your rectum. However, Crohn's disease most often develops in two areas: the lower part of the small intestine, called the ileum, and part of the large intestine, the colon. Much less often, it develops in other areas, like the stomach or esophagus.

Crohn's disease often causes inflammation along certain spots in the lining of the intestines. This inflammation can be severe and painful. Crohn's disease results in diarrhea, one of the most common symptoms of Crohn's disease. Symptoms may not be constant. People may go through long periods without any problems and then suffer a flare, during which symptoms appear. Some have ongoing symptoms, like diarrhea, even when they are not having a flare.

Doctors still aren't sure what causes Crohn's disease. A leading theory is that Crohn's disease is caused by a problem with the immune system.

Your immune system is supposed to fight off harmful viruses and bacteria. However, some researchers think that in people with Crohn's disease, the immune system overreacts to harmless substances. It mistakes food and normal bacteria for dangerous invaders and attacks them. The result is that levels of white blood cells -- one of the body's defenses -- build up in the intestines. This leads to inflammation and destruction of intestinal tissue.

What are the symptoms of Crohn's disease?

Some symptoms of Crohn's disease are:

• Cramps and pain in the abdomen, usually in the lower right side
• Diarrhea
• Blood in the stool
• Weight loss
• Joint pain
• Fatigue
• Skin problems
• Fever
• Anemia as a result of internal bleeding

Children who have Crohn's disease may have development problems and stunted growth.

Who is at risk for Crohn's disease?

Crohn's disease is equally common in men and women. While it can develop at any age, it's most frequently diagnosed in people between 20 and 30. There are some ethnic and racial differences. Jewish people are a little more likely to get it and African-Americans a little less.

There's also a genetic connection. Up to 30% of people with Crohn's disease have a blood relative with either this condition or another form of IBD.

How do I know if I have Crohn's disease?

The symptoms of Crohn's disease are similar to other conditions like irritable bowel syndrome (IBS) and ulcerative colitis. So it can be hard to diagnose.

Your doctor will want to do a thorough examination. You'll probably need blood work, a stool sample, and a special type of X-ray.

You may also need a sigmoidoscopy or a colonoscopy. During these procedures, a narrow tube with a camera is inserted into the rectum. A sigmoidoscopy only goes as far as the lower part of the large intestine. A colonoscopy goes all the way through the large intestine. The doctor will look for signs of damage and take samples of any abnormal tissue.

What problems are linked to Crohn's disease?

Crohn's disease can cause

• Intestinal blockages. These are some of the most common complications. As the intestinal walls become inflamed and scar tissue builds up, the passage gets smaller and smaller. Sometimes it completely closes. Digested food may not be able to pass through the intestine. Intestinal blockages may need to be treated with surgery.
• Fistulas. These are ulcers that develop in the intestinal wall and can scar into an adjacent intestinal wall. These ulcers can tunnel into tissues surrounding them, including other parts of the intestines, the bladder, the vagina, and skin. Fistulas may become infected. They sometimes require surgery, especially if they cause persistent symptoms.
• Abscesses. These are little pockets of pus caused by infection with bacteria; they can develop in the intestinal wall. Abscesses can cause pain, sometimes fever, and less often may cause a rupture in the intestines. Abscesses may need to be drained and treated with antibiotics.
• Nutritional problems. Because people with Crohn's disease may not be able to digest and absorb nutrients properly, it can be harder for them to get the nutrition they need. Plus, the illness itself can take away appetite. Doctors may recommend that a person with Crohn's disease increase the calories they eat, especially during flare-ups.
• Other conditions, like arthritis, skin problems, inflammation of the eyes and in the mouth, kidney stones, gallstones, and liver disease. Crohn's disease also increases the risk of colorectal cancer, although the overall danger is still low.

What can I do about Crohn's disease?

The good news about Crohn's disease is that there are a lot of treatments that can help. They include:

• Medicines that can reduce inflammation, suppress the immune response, and fight infections.
• Good nutrition can help you feel better and help maintain your health.
• Surgery to resolve complications and to remove areas of diseased intestine that do not improve with medication.

Most people with Crohn's disease need all of these treatments at one time or another.

Living with Crohn's disease is not easy. It can make you feel out of control of your own life. To be frank, there may be times where you feel like your whole life revolves around your toilet. You can feel terribly trapped and alone.

But treatments can make a difference. If you take charge of your health -- and work closely with your doctor -- you can feel better again.

SOURCES: National Digestive Diseases Information Clearing House web site" "Crohn's Disease." American Academy of Family Physician's familydoctor.org web site: "Crohn's Disease." American Gastroenterological Association: "Inflammatory Bowel Disease." Crohn's and Colitis Foundation of America web site: "Surgery for Crohn's Disease" and "Diet and Nutrition." Warner, A. and Barto, A. 100 Questions and Answers about Crohn's Disease and Ulcerative Colitis: A Lahey Clinic Guide, Jones and Bartlett, 2007. Sabil, F. Crohn's Disease and Ulcerative Colitis: Revised Edition, Firefly, 2003.