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Crohn's Disease: Types, Symptoms, Causes, Treatment

An inflammatory bowel disease (IBD), Crohn's disease causes inflammation of your digestive tract, which can lead to fatigue, abdominal pain, diarrhoea, malnutrition and weight loss. It is a chronic condition and is also termed as ileitis or enteritis. The affected areas in the digestive tract can vary in different people [1] .

Crohn's disease usually affects the very last segment of the small intestine, but may also affect other places in the intestinal tract. It is slightly more common in women than men [2] . According to studies, the incidence of Crohn's disease in India is 7 per 100000 population with a male to female ratio of 3.2:1.

Read on to know more about the inflammatory bowel disease.

Types Of Crohn's Disease

The inflammatory bowel disease is classified into six types, depending on the location affected by Crohn's disease.

Ileitis: This type of inflammation affects the last part of the small intestine. 30 per cent of people with Crohn's disease has ileitis [3] .

Ileocolitis: It is the most common variation of the disease and affects not only the ileum but also the colon. Almost 50 per cent of people with Crohn's disease has ileocolitis [4] .

Jejunoileitis: This affects your jejunum and is rarely reported.

Gastroduodenal Crohn's disease: This variant of the condition affects the duodenum and your stomach. About 5 per cent of people with Crohn's disease has gastroduodenal Crohn's disease [4] .

Crohn's colitis: This variant affects only the colon and is found in about 20 per cent of people with Crohn's disease. Like ulcerative colitis, Crohn's colitis also impacts the colon but on a more severe level.

Perianal disease: This type of Crohn's disease can be painful as it causes deep tissue infections, as well as sores and ulcers on the outer skin around the anus. Around 30 per cent of people with Crohn's disease has the perianal disease [5] .

Symptoms Of Crohn's Disease

The signs of the condition develop only gradually and can become worse over time. In some extremely rare cases, the symptoms may arise suddenly. Likewise, the symptoms vary depending on the part affected [6] .

The common symptoms of Crohn's disease are as follows [7] :

  • Urgent bowel movements
  • Blood in your stool
  • Diarrhoea
  • Abdominal cramps
  • Fatigue
  • Weight loss
  • Fever
  • Painful sore near your anus
  • Lack of appetite
  • Mouth sores
  • Stomach pain
  • Anaemia

Some of the other (less common and severe) symptoms are as follows [7] :

  • Delayed growth or sexual development, in children
  • Inflammation of the liver or bile ducts
  • Inflammation of skin, eyes and joints
  • Arthritis

Causes Of Crohn's Disease

Studies have revealed that one possibly develops Crohn's disease from an abnormal reaction in the immune system. However, there is a lack of clarity as to exactly why the condition develops. Diet and stress were previously thought to be the cause of the condition [8] .

Some of the possible causes of Crohn's disease are as follows [9] :

Immune system: Virus or bacterium may trigger Crohn's disease and when this occurs your immune system tries to fight off the invading micro-organism, which in turn attacks the digestive tract cells.

Heredity: The condition is commonly found in people who have family members with the disease. Due to this, it has been ascertained that the genes of an individual may play a role in causing the disease.

Environmental factors: It has also been pointed out that certain environmental factors such as substances from something you've eaten, cigarette smoke and microbes may trigger the condition.

Detoxing Your Home: Understanding And Eliminating Environmental Toxins

Risk Factors Of Crohn's Disease

The factors that pose a risk to the condition are as follows [10] :

  • Ethnicity
  • Age
  • Family history
  • Smoking habit
  • Nonsteroidal anti-inflammatory medications
  • Place of residence

Complications Of Crohn's Disease

The following complications may arise due to Crohn's disease [11] [12] :

  • Ulcers
  • Fistulas
  • Bowel obstruction
  • Anal fissure
  • Malnutrition
  • Colon cancer
  • Medication risks
  • Anaemia
  • Skin disorders
  • Arthritis
  • Osteoporosis
  • Liver diseases

Diagnosis Of Crohn's Disease

The doctor will start the diagnosis by checking the symptoms. Apart from a physical examination, the following tests will help the doctor diagnose the condition [13] .

  • A faecal occult blood test
  • Blood test for anaemia and infections
  • Biopsy
  • Colonoscopy
  • Sigmoidoscopy
  • MRI
  • Balloon-assisted enteroscopy
  • Endoscopy
  • CT scan

Treatment For Crohn's Disease

For each individual, the treatment differs as there is no specific treatment or a specific cure for the condition. The treatment methods aim to manage and control the symptoms of Crohn's disease, especially inflammation [14] .

Medications: Antidiarrhoeal and anti-inflammatory drugs are commonly used. Immune system suppressors, antibiotics, pain relievers, iron supplements, vitamin B-12 shots and calcium and vitamin D supplements are also prescribed.

Nutrition therapy: In some cases, the individual will be recommended a special diet given via a feeding tube. It can also be done by injecting nutrients into a vein.

Surgery: In the case of the other treatment measures not working, the doctor will suggest surgery. Surgery for treating Crohn's is relatively common.

Diet For Crohn's Disease

Changing your dietary habits may help in managing the symptoms of the condition. However, the diet that may work for one individual may not work for the other [15] .

  • Manage the fibre intake
  • Control consumption of fatty food
  • Limit your dairy consumption
  • Consider alternative sources of vitamins and minerals
  • Avoid spicy foods, alcohol and caffeine

Some of the other dietary shifts are, eating small meals, drinking plenty of water and talking to a dietician.

View Article References
  1. [1] Torres, J., Mehandru, S., Colombel, J. F., & Peyrin-Biroulet, L. (2017). Crohn's disease. The Lancet, 389(10080), 1741-1755.
  2. [2] Feagan, B. G., Sandborn, W. J., Gasink, C., Jacobstein, D., Lang, Y., Friedman, J. R., ... & Adedokun, O. J. (2016). Ustekinumab as induction and maintenance therapy for Crohn’s disease. New England Journal of Medicine, 375(20), 1946-1960.
  3. [3] Cleynen, I., Boucher, G., Jostins, L., Schumm, L. P., Zeissig, S., Ahmad, T., ... & Brant, S. R. (2016). Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study. The Lancet, 387(10014), 156-167.
  4. [4] Pascal, V., Pozuelo, M., Borruel, N., Casellas, F., Campos, D., Santiago, A., ... & Vermeire, S. (2017). A microbial signature for Crohn's disease. Gut, 66(5), 813-822.
  5. [5] Gomollón, F., Dignass, A., Annese, V., Tilg, H., Van Assche, G., Lindsay, J. O., ... & Rieder, F. (2016). 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. Journal of Crohn's and Colitis, 11(1), 3-25.
  6. [6] Colombel, J. F., Sands, B. E., Rutgeerts, P., Sandborn, W., Danese, S., D'haens, G., ... & Parikh, A. (2017). The safety of vedolizumab for ulcerative colitis and Crohn's disease. Gut, 66(5), 839-851.
  7. [7] De Cruz, P., Kamm, M. A., Hamilton, A. L., Ritchie, K. J., Krejany, E. O., Gorelik, A., ... & Bampton, P. A. (2015). Crohn's disease management after intestinal resection: a randomised trial. The Lancet, 385(9976), 1406-1417.
  8. [8] Monteleone, G., Neurath, M. F., Ardizzone, S., Di Sabatino, A., Fantini, M. C., Castiglione, F., ... & Rogai, F. (2015). Mongersen, an oral SMAD7 antisense oligonucleotide, and Crohn’s disease. New England Journal of Medicine, 372(12), 1104-1113.
  9. [9] Akobeng, A. K., Zhang, D., Gordon, M., & MacDonald, J. K. (2016). Oral 5‐aminosalicylic acid for maintenance of medically‐induced remission in Crohn's disease. Cochrane database of systematic reviews, (9).
  10. [10] Gevers, D., Kugathasan, S., Knights, D., Kostic, A. D., Knight, R., & Xavier, R. J. (2017). A microbiome foundation for the study of Crohn’s disease. Cell host & microbe, 21(3), 301-304.
  11. [11] Quévrain, E., Maubert, M. A., Michon, C., Chain, F., Marquant, R., Tailhades, J., ... & Lequin, O. (2016). Identification of an anti-inflammatory protein from Faecalibacterium prausnitzii, a commensal bacterium deficient in Crohn’s disease. Gut, 65(3), 415-425.
  12. [12] Lim, W. C., Wang, Y., MacDonald, J. K., & Hanauer, S. (2016). Aminosalicylates for induction of remission or response in Crohn's disease. Cochrane Database of Systematic Reviews, (7).
  13. [13] Kugathasan, S., Denson, L. A., Walters, T. D., Kim, M. O., Marigorta, U. M., Schirmer, M., ... & Crandall, W. V. (2017). Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study. The Lancet, 389(10080), 1710-1718.
  14. [14] Casteele, N. V., Khanna, R., Levesque, B. G., Stitt, L., Zou, G. Y., Singh, S., ... & Rutgeerts, P. J. (2015). The relationship between infliximab concentrations, antibodies to infliximab and disease activity in Crohn's disease. Gut, 64(10), 1539-1545.
  15. [15] Colombel, J. F., Panaccione, R., Bossuyt, P., Lukas, M., Baert, F., Vaňásek, T., ... & Travis, S. (2017). Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. The Lancet, 390(10114), 2779-2789.

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