Crohn's Disease

WHAT YOU SHOULD KNOW:

Crohn's disease is a long-term disease of the gastrointestinal (GI) system. This system may also be called the digestive system. The GI system includes the mouth, esophagus, stomach, small and large intestines, and anus (rear end). Crohn's disease causes the lining of the intestines to become reddened, swollen, or bleed. With Crohn's disease, you may have abdominal (stomach) pain or blood in your bowel movements (BMs) that can cause anemia (low blood iron). Children with Crohn's disease may grow more slowly and not get as tall as other children. You may have a fever, loose BMs, or lose weight without trying.

Caregivers do not exactly know what causes Crohn's disease. Possible causes are a weakened immune system or having a family member with the disease. Smoking may increase your risk of having Crohn's disease. Treatment for Crohn's disease may include medicine, diet changes, or surgery.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Untreated Crohn's disease may cause a blockage of your GI tract. If your bowel becomes infected, abscesses could develop. Your bowels may have sores that break through your bowels and burrow into other parts of the intestines or other tissues. This results in abnormal tunnels called fistulas. If a fistula reaches to your skin, especially around your anus, you may have rectal bleeding.
  
  
• With untreated Crohn's disease, swelling of your joints, eyes or mouth may occur. You may also have skin problems, kidney stones, gallstones, spine problems and diseases of your liver and biliary systems. Talk to your caregiver if you have questions about Crohn's disease and your care and treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

You may need to rest in bed. Your caregiver will tell you when it is OK to get out of bed. If you are not allowed out of bed, you can still exercise your legs in bed. Do this by lifting one leg off the bed and drawing big circles with your toes. Then do it with the other leg. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away.

Bowel movements:

This is also called a BM or having a stool. Your BM may often be watery (diarrhea) and may be contain blood. Severe diarrhea may cause you to be dehydrated (not enough water in your body) and anemic (low blood iron). Caregivers will treat the diarrhea, dehydration, and anemia while you are in the hospital.

Intake and output:

Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

Weight:

You may be weighed each day. Caregivers compare your weight from day to day to record how much body fluid you have. You can become dehydrated if you lose too much. You can have shortness of breath or swelling in your legs if you retain too much.

Medicines:

You may need to use any of the following:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Antidiarrheal medicine: This medicine is given to decrease the amount of diarrhea you are having. Some of these medicines coat the intestine (bowel) and make the BM less watery. Other antidiarrheal medicine works by slowing down how fast the intestine is moving.
  
  
• Aminosalicylates: These are also known as 5-ASA. These medicines work by stopping your immune system from releasing substances that can cause swelling.
  
  
• Anti-tumor necrosis factor (anti-TNF) medicine: This medicine blocks inflammation.
  
  
• Immunosuppressants: This medicine may be given to slow down the immune system.
  
  
• Nutritional supplements: Caregivers may give you vitamins or minerals to support your diet.
  
  
• Steroids: This medicine may be given to decrease inflammation.

Tests:

You may have one or more of the following tests:

• Barium studies: These are x-ray pictures of your GI system using a barium solution. Barium is a liquid that will show up in x-rays and help caregivers clearly see your GI system.
  
  
  • Barium enema: A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium is used so that caregivers can see your colon better on the x-ray film.
    
    
  • Barium swallow: This test is an x-ray of your throat and esophagus, the tube connecting your throat to your stomach. This test may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. Follow the instructions of your caregiver before and after the test.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Colonoscopy: A colonoscopy is a test that is done to look at your colon. A tube with a light on the end will be put into your anus, and then moved forward into your colon.
  
  
• Endoscopy: This test uses a scope to see inside your digestive tract, including the esophagus and stomach. Samples may be taken from your digestive tract and sent to a lab for tests. Bleeding may also be treated during an endoscopy.
  
  
• Stool sample: A sample of your stool or bowel movement (BM) is sent to a lab for tests. The stool may show what germ is causing your illness. This helps caregivers learn what medicine is best to treat you.
  
  
• Other tests:
  
  
  • Computerized tomography scan: This test is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your GI system.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. A MRI lets caregivers see inside your body through computerized images using radio waves.
    
    
  • Abdominal ultrasound: This is a test using sound waves to look at your GI system. Pictures of your GI system show up on a TV-like screen.

Treatment options:

Your treatment may change if your Crohn's disease does not get better. You may have one or more of the following treatments:

• Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
  
  

• Diet: No special diet has been proven to prevent or treat Crohn's disease. You may find that your symptoms are made worse by milk, alcohol, hot spices, or foods that contain fiber. Caregivers may change your diet to help decrease your symptoms. Tell caregivers if you use vitamins, minerals, or other nutritional supplements.
  
  
• Surgery: You may need surgery to decrease your symptoms or to correct problems, such as blockage or bleeding. Surgery cannot cure Crohn's disease. Caregivers may remove the diseased part of your intestines and reconnect the healthy parts. You may also need a colostomy to treat Crohn's disease.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Crohn's Disease (Inpatient Care)