Crohn's disease

What is Crohn's Disease?
Crohn's disease is an Inflammatory Bowel Disease (IBD). It causes chronic inflammation of the digestive tract.

Key Difference: Unlike Ulcerative Colitis, which only affects the colon, Crohn's can affect any part of the digestive tract from mouth to anus. It also penetrates deep into the tissue layers, causing severe pain and strictures.

Symptoms

Symptoms vary depending on which part of the gut is inflamed. They can range from mild to severe and may develop gradually or suddenly:

• Abdominal Pain & Cramping: Often severe due to swelling and scar tissue (strictures).
• Diarrhea: The intestine cannot absorb water efficiently.
• Weight Loss: Due to pain while eating and inability to absorb nutrients.
• Blood in Stool: From ulcers bleeding in the intestine.
• Fatigue & Fever: Signs of active inflammation or infection.
• Mouth Sores: Ulcers similar to canker sores.

Causes

The exact cause is unknown, but it is likely a combination of:

• Immune System Malfunction: The body attacks healthy bacteria in the gut, causing inflammation.
• Genetics: It runs in families (genes like NOD2 are linked to it).
• Environment: Smoking is a major risk factor and makes the disease worse.

Complications

Because Crohn's affects the deep layers of the tissue, it causes unique structural problems:

• Strictures (Bowel Obstruction): Chronic inflammation causes scar tissue to build up, narrowing the bowel and blocking the flow of food.
• Fistulas: Ulcers can tunnel completely through the intestinal wall, creating an abnormal connection to the skin, bladder, or vagina. This is a serious complication requiring surgery.
• Malnutrition: Difficulty absorbing iron (anemia) and Vitamin B-12.

Diagnosis

Doctors use a combination of tests to rule out other infections (like IBS):

• Colonoscopy: The gold standard. It allows the doctor to see the entire colon and the end of the small intestine (ileum).
• Capsule Endoscopy: You swallow a camera pill to visualize the small intestine, which a standard scope cannot reach.
• CT/MRI Enterography: Specialized scans to look for fistulas and thickening of the bowel wall.

Treatment

There is no cure, but modern therapies can bring about long-term remission.

1. Biologics (The Gold Standard)

These drugs target specific proteins in the immune system (like TNF) to stop inflammation at the source. They are often given via injection or IV infusion.

• Infliximab (Remicade)
• Adalimumab (Humira)
• Certolizumab (Cimzia)

2. Immune Suppressors

Older drugs that lower the immune system's activity overall. Used for long-term maintenance.

• Azathioprine (Imuran)
• Methotrexate

3. Corticosteroids

Drugs like Prednisone or Budesonide. These are fast-acting but used only for short-term "flares" due to severe side effects (bone loss, diabetes, infection risk).

4. Surgery

Up to 75% of Crohn's patients eventually need surgery to repair a stricture, drain an abscess, or remove a damaged section of bowel. Note: Unlike Colitis, surgery does not cure Crohn's; the disease can return in the healthy tissue next to the incision.

5. Diet & Nutrition

While food doesn't cause Crohn's, it helps manage symptoms.

• Low Residue Diet: Eating low-fiber foods during a flare to prevent blockage.
• Vitamin B-12 & Iron: Supplements are often needed due to malabsorption.
• Enteral Nutrition: In severe cases, liquid nutrition is used to let the bowel rest.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.