There is no known cure for Crohn’s disease, but there are ways to treat its symptoms so that the individual who is experiencing this illness can still live a healthy and active life. Those with this kind of condition though, generally go through a period of symptomatic relapse and remission.
Crohn’s disease can range from mild to severe, and its symptoms may change and vary through time. And in some severe cases, it can result in further complications, which can be life-threatening at times.
What are the variations of Crohn’s disease?
This inflammatory disease comes in 6 variations, and they are based on the location of the affected area.
- Gastroduodenal Crohn’s disease- this primarily affects the stomach and the duodenum, which is the 1st part of the small intestine. Only a small percentage (around 5%) of those with this type of Crohn’s disease is affected.
- Jejunoileitis- is experienced in the 2nd section of the intestine called the jejunum, and the same with gastroduodenal, this variation is not very common.
- Ileitis- is an inflammation in the remotest area of the small intestine called the ileum, and this affects around 30% of those with Crohn’s disease.
- Ileocolitis- is the most common type of Crohn’s disease, and about 50% experience this variation. Ileocolitis affects the colon and the ileum.
- Crohn’s colitis- affects only the colon, and around 20% with this disease have this type of variation. Like Crohn’s colitis, ulcerative colitis also only affects the colon, though Crohn’s may affect deeper layers of the intestinal lining.
- Perianal disease- about 30% of Crohn’s disease has this kind of variation, and it usually affects fistulas or abnormal connections between tissues, deep tissue infections, and also sores and ulcers that are found on the outer skin around the anus.
Though what exactly causes Crohn’s disease is not yet known, some factors may influence how you may acquire it. These are:
- Your genes
- Your immune system
- Your environment
According to the Crohn’s and Colitis Foundation, around 20% of those affected with this kind of disease also have a family member/s that have it.
Based on a 2012 study, some factors may affect the degree of your symptoms, and these are:
- If you are a smoker
- Your age
- If the rectum is also affected
- How long you have had the illness
Those who are concerned with Crohn’s disease are prone to developing other complications that may arise if the symptoms become severe. This may occur if intestinal infections coming from bacteria, viruses, fungi, and parasites produces.
Frequently, this disease, along with its treatments, also affect the immune system and makes these infections worse. The most common type that is experienced is a yeast infection, and it usually involves both the lungs and the intestinal tract.
Diagnosing and treating these infections appropriately with antifungal medications are highly essential to avoid further complications.
Diagnosis and Treatment
It is not easy to determine Crohn’s disease, and in fact, making a diagnosis of it requires a process of elimination as the doctor will need to start by eliminating any other possible causes of the symptoms.
The doctor, such as: may require several types of tests
- Blood tests to check for some indicators of the potential problems like anemia and inflammation
- Stool test to help your doctor know if there is blood in your gastrointestinal tract
- Endoscopy, so your doctor may get a better image of the inside of your upper digestive tract
- Colonoscopy, to examine the large bowel
- Some imaging tests that include CT scans and MRI scans as the doctor will be able to see the specific areas of your organs and tissues and are more detailed than the regular X-ray
- The biopsy that will be done during an endoscopy or colonoscopy to get a closer look at your intestinal tract tissue
When the doctor has reviewed all the necessary tests and has eliminated other possible causes, it is only then that Crohn’s disease may be concluded. The doctor may request these tests several times over to find the affected tissue and be able to determine how the illness is progressing.
Treatment for Crohn’s Disease
While there is also no cure yet for Crohn’s disease, its symptoms may be managed through some procedures to lessen its degree and frequency.
The most common types of treatment used for this kind of disease are anti-diarrhea and anti-inflammatory drugs, and the more advanced form of therapy includes biologics, which makes use of the body’s immune system. For the inflammatory drugs, 5- aminosalicylates and corticosteroids are what are usually prescribed.
For mild symptoms with infrequent flares of the disease, anti-inflammatory drugs are the
first medications used to treat the symptoms. And for more severe symptoms, corticosteroids are prescribed, though it should not be taken for an extended time.
The type of medications to be recommended depending on several factors like the person’s symptoms, the history of the illness, the severity of the condition, and how the individual’s body reacts to the 1st set of treatment.
An inflammation that results in the symptoms of Crohn’s disease may be due to an overactive immune system. So to decrease the inflammatory response as well as to limit the immune system’s reaction, a drug called immunomodulators are used to regulate the immune system.
Antibiotics are also used to treat symptoms of this disease as they are said to reduce drainage and heal fistulas. They fight off any harmful bacteria as well that may be present in your gut that contributes to the inflammation.
If your symptoms are severe, you may be prescribed with biologic therapy. This is because biologic drugs can block some specific proteins that may be encouraging the inflammation.
When you are already diagnosed with Crohn’s disease, your doctor might recommend you to see a registered dietitian so that he or she can help you how food may affect your symptoms and what kind of diet may help you.
The diet is different for each individual as the disease can involve different areas of the gastrointestinal tract.
You may have to:
- Adjust your intake of fiber- some may need a high- fiber and high- protein diet, while others may require a low- fiber one.
- Limit your intake of fat- because excess fats will pass from the small intestines to the colon, which can result in diarrhea.
- Limit your intake of dairy products- because of this condition. Your body can develop difficulty in digesting certain dairy products, which can result in an upset stomach, abdominal cramps, or diarrhea.
- Drink water- your body’s ability to absorb water from your digestive tract may also be affected by Crohn’s disease, which can lead to dehydration. This may most especially happen when you have diarrhea or bleeding.
Consider alternative sources of vitamins and minerals
Since Crohn’s disease may alter your intestines’ ability to absorb other nutrients from food properly, your doctor may recommend a multivitamin that will work best for you. While your nutritionist will help you with your dietary limitations and guidelines for a well- balanced diet.
Should lifestyle changes and less invasive treatment procedures do not work out and improve your symptoms, surgery may be required. According to the Crohn’s and Colitis Foundation, around 75% of those affected with this condition go through surgery at some point in their lives.
There are different types of surgery for Crohn’s. One is by removing the damaged areas of the digestive tract then reconnecting the healthy neighborhoods, another is by repairing the damaged tissue or managing the scar tissue or treating deep infections.
Doing surgery is the last option for those with Crohn’s disease, but this will only be done if all other treatments did not work to improve the symptoms or if they have become too severe.
Some types of surgeries are:
- Strictureplasty- attempts to reduce the effects of scarring or to cause further damage to the tissue by widening or shortening the intestines
- Bowel resection- sections of the damaged pipe are removed, while the healthy ones are stitched together to reform the intestines
- Ostomy- is creating a hole through which your body can eliminate waste. This procedure can be temporary or permanent depending on your doctor’s evaluation
- Colectomy- is removing portions of the colon that are damaged
- Proctocolectomy- this procedure requires the removal of the colon and the rectum
Risks of having Crohn’s
Some of the complications that may arise from this condition are the following:
- Bowel obstruction
- Anal fissure
- Malnutrition due to your inability to eat properly as it causes diarrhea, abdominal pain, and cramping
- Colon cancer
- Other health issues like anemia, skin disorders, osteoporosis, arthritis, gall bladder or liver disease
- Medication risks as some drugs used for this treatment may cause other side effects like lymphoma, skin cancer or increased risk for infection
When to seek medical attention
Some early signs of Crohn’s disease are:
- Abdominal cramps
- Blood in the stool
- Loss of appetite
- Weight loss
- Feeling like bowels aren’t empty after a bowel movement
- Feeling the need to do a bowel movement frequently
These symptoms may also possibly be mistaken for other conditions, which is why it is best to see your doctor when these signs persist.
The symptoms may become severe as the condition progresses, and some of the signs are:
- Having perianal fistula
- Inflammation of the skin and the joints
- Shortness of breath
Though it does not have a cure, early detection can help in preventing further complications and will allow you to treat the symptoms as soon as possible.
Table of Medications
- Entocort EC