Crohn's Disease

What is Crohn's disease?

Crohn's disease is a long-term inflammatory disease of the gastrointestinal (GI) system. This system is also called the digestive system. The GI system includes the mouth, esophagus, stomach, small and large intestines (colon), and anus (rear end). Crohn's disease causes the lining of your intestines to become swollen or inflamed. The lining of your mouth, esophagus, or stomach may also be affected by Crohn's disease. If the disease is not treated and controlled, you may get rips, sores, or holes in or around your intestines.

With Crohn's disease, you may have times with few or no symptoms. These periods of time are called remissions, or quiet periods. At other times, you may have more signs or symptoms. These periods of time are called relapses, or active periods. Crohn's disease is more common in white people ages 15 to 30 years. There is no cure for Crohn's disease but symptoms can be treated with medicines or surgery.

What causes Crohn's disease?

Caregivers do not exactly know what causes Crohn's disease but the following are possible causes:

• Immune system problems: A weakened immune system may cause Crohn's disease. The immune system is the part of the body that fights infection.
  
  
• Genetic: You are most likely to have this illness if another family member has Crohn's disease.
  
  
• Environmental: Smoking increases your risk of having this disease.
  
  
• Infections: Germs called viruses or bacteria may cause swelling of the digestive tract.
  
  
• Other: The presence of stress may have a role in Crohn's disease as well as regularly consuming dairy foods, such as milk.

What are the signs and symptoms of Crohn's disease?

You may not have all of these signs and symptoms, or you may have different symptoms at different times. Your symptoms may come and go with quiet and active periods. Over time, active periods may occur often and symptoms may be more severe. The most common signs and symptoms of Crohn's disease are:

• Abdominal (stomach) pain: Cramping pain that comes and goes, often felt at the lower right side of your abdomen.
  
  
• Diarrhea: Loose bowel movements that may be dark or tar-colored.
  
  
• Fever: You may start with a mild or low-grade fever. A high fever may occur with problems, such as an abscess.
  
  
• Fatigue: Being more tired than usual.

Other signs and symptoms:

• Blood in your bowel movements (BMs).
  
  
• Feeling nauseated (upset stomach).
  
  
• Joint pain or swelling.
  
  
• Losing weight without trying.
  
  
• Loss of appetite for food.
  
  
• Unusual paleness of the skin.

Children with Crohn's disease may grow more slowly and may not get as tall as they should. Sexual development may also occur slower than expected.

How is Crohn's disease diagnosed?

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 outlines the GI system to help caregivers clearly see it.
  
  
  • 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 the inside of 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. MRI allows caregivers to 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.

How is Crohn's disease treated?

Crohn's disease may be treated and controlled most of the time. You may need one or more of the following treatments:

• Medicines:
  
  
  • 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 nutrition if you have severe Crohn's disease.
    
    
  • Steroids: This medicine may be given to decrease inflammation.
  
  
• Other treatment options:
  
  
  • 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 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 to have a colostomy to treat Crohn's disease.

What else can be done to feel better?

Crohn's disease cannot be prevented but you can reduce your symptoms. The following may help you feel better:

• Do not smoke.
  
  
• Take your medicines exactly as your caregiver has instructed. Doing this may keep your disease in remission. Always ask your caregiver before using vitamins, nutritional supplements, or other medicines.
  
  
• Eat a healthy diet. Keep a record about what food and drinks make your symptoms worse. Drink 8 to 10 (eight ounce) cups of water daily. Do not drink alcohol.
  
  
• Ask your caregiver about exercising and other healthy ways to manage stress, such as deep breathing. Regular exercise and managing your stress may keep your symptoms from getting worse.

Where can I find support and more information?

Crohn's disease is a life-changing illness for you and your family. Accepting that you have Crohn's disease may be hard. You and those around you may feel scared, confused and anxious. These feelings are normal. Talk to your caregiver, family or friends about your feelings. You may also want to join a support group with other people who have Crohn's disease. Contact the following for more information:

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda , MD 20892-3570
  Phone: 1- 800 - 8915389
  Web Address: www.digestive.niddk.nih.gov
  

• Crohn's and Colitis Foundation of America, Inc.
  386 Park Avenue S, 17th Floor
  New York , NY 10016-8004
  Phone: 1- 800 - 932-2423
  Web Address: http://www.ccfa.org
  

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.

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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.

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