What is Crohn’s Disease?
Diarrhea is one of those uncomfortable ailments that arrives unexpectedly and sometimes without warning, and we all experience it at one time or another. However, for some people, diarrhea is a daily occurrence – and just one of the many symptoms of Crohn’s disease. Crohn’s disease is a chronic condition that involves swelling and inflammation in the intestines and digestive tract.
It can affect all areas of the gastrointestinal tract from the mouth to the anus, and can even involve the genito-urinary system. It is most commonly the lower part of the small intestine and the first part of the colon that is involved. When swelling occurs in the intestine wall, abdominal pain and cramping is experienced, leading to diarrhea.
Some people may experience only one episode, followed by prolonged remission without any symptoms - while others may have recurring episodes of abdominal pain, diarrhea, fever, and bleeding. While Crohn’s disease is not fatal, it can have life-threatening complications.
Life-long medical care is required, as well as constant monitoring by a physician. With the help of a wide range of treatment options available, Crohn’s sufferers can learn to manage their symptoms and live a productive life.
What Does Crohn’s Disease Affect?
Crohn’s disease affects men and women equally. The disease usually develops at a young age, and research estimates that most people are diagnosed with Crohn’s between the age of 15 and 35. It can affect any ethnic group, but is more prominent amongst whites, especially those of Jewish or European descent.
If you have a family history of Crohn’s, your risk increases dramatically-- especially if the family member is a parent, sibling, or child. You are also placed at risk if you live in an urban or industrialized area, or if you live in the northern climate region. Crohn’s disease increases your risk of developing colon or small bowel cancer, and this is proportional to the length of time you have had the disease and its severity.
Crohn’s disease is very similar to other inflammatory bowel diseases (IBD) such as ulcerative colitis and irritable bowel syndrome, and it can be difficult to make an accurate distinction and diagnosis. Symptoms may be acute or chronic and vary from patient to patient, but commonly includes chronic diarrhea associated with abdominal pain, fever, loss of weight, and a feeling of fullness in the abdomen.
The symptoms and signs of Crohn’s disease include:
Other symptoms outside of the gastrointestinal tract are sometimes associated with Crohn’s disease, including arthritis, eye inflammation, skin problems, osteoporosis, urinary tract infections, and inflammation of the liver. Conversely in children with Crohn’s disease, it is often the non-GIT symptoms that tend to predominate, and this can often lead to a diagnosis of Crohn’s disease being delayed or even overlooked.
Diagnosing Crohn’s Disease
The diagnosis of Crohn’s disease is based on a thorough physical examination and medical history of the patient.
Various tests may be performed which include:
- Blood tests to check for anemia and signs of inflammation. Although these are fairly non-specific tests, they can be a useful adjunct to diagnosis, and can help to establish the extent and severity of the disease.
- Testing a stool sample to determine whether there is bleeding or infection in the intestines.
- Upper GI series or small bowel X-ray to look at the small intestine – the patient drinks a preparation containing barium (a contrast medium) and X-rays are taken to reveal inflammation or abnormality in the lining of the intestine.
- Colonoscopy is a visual exam of the colon. A thin, flexible lighted tube linked to a computer and camera is inserted through to the anus to examine the large intestine.
- Sigmoidoscopy is a similar procedure to the colonoscopy. It examines the lower part of the large intestine, and bleeding or inflammation in this area will be detected during this exam.
- Barium enema is used to test the large intestine by inserting a barium enema into your bowel, followed by an X-ray.
- CT scan (Computerized tomography) is a special X-ray that looks at the entire bowel and checks for complications such as fistulas, abscesses, and partial blockages.
- Capsule endoscopy is performed when all the other diagnostic tests are negative. During this procedure, the patient swallows a capsule that has a camera in it to determine signs of Crohn’s disease. Most diagnoses are made without having to employ this method.
What Causes Crohn’s Disease?
The exact cause of Crohn’s is unknown, but there are several possible theories that suggest the disease may be associated with:
The body’s immune system response is abnormal in people suffering from Crohn’s disease. It attacks bacteria, food, and other substances by mistake, causing white blood cells to accumulate in the lining of the intestines. This leads to chronic inflammation, resulting in ulcers or fissures, as well as a mal-absorption of nutrients. Because the intestinal wall is not absorbing and secreting substances as it should, diarrhea results.
Genetic factors also play a role, and it is estimated that 20 percent of Crohn’s sufferers have a parent, sibling, or child with the disease. Crohn’s disease may be as a result of the genes that the patient has inherited.
Crohn’s disease is more prevalent in people living in urban or industrialized regions, and this has led to speculation that it may linked to a poor diet, low in fiber, as well as environmental pollutants and chemicals.
A number of bacteria have also been implicated in the development of Crohn’s disease, and currently there is much research in this area.
What are Complications of Crohn’s Disease?
There are various complications that can arise in Crohn’s disease and they include:
- Blockage of the intestine: The intestine wall thickens and swells with scar tissue, which narrows the passage and causes the blockage.
- Sores or ulcers: Sores or ulcers may develop and infect the digestive tract, bladder, vagina, anus, rectum, mouth, or skin.
- Fistulas: Fistulas are ulcers that extend through the intestinal wall and open into a different area of the body. It is not uncommon for fistulas to become infected, resulting in abscess formation. A fistula or abnormal connection can occur between different parts of the intestine and other organs, such as the bladder and vagina, and between the intestine and the skin.
- Anal fissures: Small tears or cracks called fissures may develop in and around the anus causing painful bowel movements.
- Nutritional complications: A deficiency of proteins, calories, and vitamins can cause malnutrition. Because of the inflamed bowel wall in Crohn’s disease, as well as the symptoms such as diarrhea, abdominal pain and cramping, there is often mal-absorption of nutrients.
- Other health hazards: Crohn’s disease can also cause other health complications such as arthritis, osteoporosis, colon cancer, inflammation in the eyes or mouth, gallstones, kidney stones, liver diseases or bile system problems.
How Does Crohn’s Disease Affect Pregnancy?
The course of fertility, pregnancy, and delivery is not usually affected in women with inactive Crohn’s disease. Women who have active Crohn’s disease during pregnancy are at increased risk of going into preterm labor or miscarriage. Crohn’s disease may worsen during the first trimester or post-partum. Most women can have a normal delivery, but depending on the severity of the disease and the size of the baby, a Caesarian section may be necessary.
Antibiotics and immunoregulators should be avoided during pregnancy because of the increased risk of birth defects. Women with Crohn’s disease who want to become pregnant should discuss their options and the precautionary measures involved with their physician. Women in remission at the time of conception may experience possible flare-up symptoms during their third trimester. After giving birth, women may also experience flare-ups.
Help for Crohn’s Disease
Crohn’s disease is a life-long, unpredictable condition, and often it is difficult to gauge when treatment has been successful. The aim of treatment is to relieve the symptoms of diarrhea, abdominal pain, and rectal bleeding, as well as to reduce the underlying inflammation.
The disease varies from patient to patient, with treatment depending on the severity and location of the disease as well as the response to treatment. There may be times where the patient experiences long periods of remission, and at other times, repeatedly recurring symptoms. Complications such as obstructions, abscesses and fistulas can also occur; therefore constant medical supervision is of the utmost importance.
Conventional medical treatment approaches to control Crohn’s disease tend to be non-specific, and are aimed at reducing the inflammation and diarrhea. The following treatments are most commonly prescribed:
- Anti-inflammatory drugs
- Immune system suppressants
- Cortisone or steroids are often used to treat acute attacks of the disease
- Antibiotics are often given to treat a suspected bacterial cause or trigger
- Anti-diarrhea agents together with fluid-replacement therapy
- Nutritional supplements such as high-calorie liquid formulas
- Surgery, such as a partial or total removal of the affected part of the bowel, is sometimes used as a last resort in severe cases. However, this just relieves the symptoms and is not curative. It is quite common for the disease to re-occur in the adjacent areas of the bowel, often where the bowel has been surgically rejoined.
- Candidiasis (or an overgrowth of candida in the digestive system) has also been suggested as a possible cause or associated condition in some individuals
It is important to note that many of these drugs can cause serious side effects such as nausea, vomiting, and increased susceptibility to infection. There may be some trial and error involved before the best treatment solution for the individual is found. However, people suffering from Crohn’s can enjoy a normal, productive life if various treatment options are explored and symptoms are controlled.
There are various natural and alternative treatment options that can address the symptoms of Crohn’s disease and provide welcome relief. These treatments improve the overall physical, mental, and emotional well-being of the individual.
Treatment options that are therapeutic and have a positive effect include:
- Naturopathy -- multidisciplinary approach that uses the healing power of natural resources to allow the body to heal itself
- Relaxation techniques such as yoga, massage, floatation therapy, and deep breathing
- Herbalism and homeopathy
- Nutritional therapy
Herbal and homeopathic remedies address the underlying cause of the illness and are aimed at restoring the body’s self-healing mechanism and reducing the inflammatory response. They can help to provide a supportive platform and restore harmony and equilibrium in the affected body systems. These remedies are specifically tailored to the patient’s needs, not the symptoms.
Some examples of herbal remedies used in the treatment of Crohn’s disease include Matricaria recutita, Filipendula ulmaria, Ulmus fulva and Sutherlandia frutescens. These or other herbs may be recommended alone or in combination – depending on individual needs-- and can help to strengthen digestive health and address the problems associated with Crohn’s disease, without many of the side effects associated with the prescription drugs.
No matter which treatment options you choose, it is important to monitor the condition carefully and to stick to treatment regimes as directed by your health care practitioner.
More Information for Crohn’s Disease
Tips for Coping with Crohn’s Disease
Crohn’s disease has both physical and emotional effects. This disease will have a definite impact on overall functioning, relationships, and feelings of well-being.
Here are some coping strategies that will prove to be helpful:
- Educate yourself as much as possible about Crohn’s disease – from your physician, reading material, the internet, and support groups.
- Develop healthy eating patterns and consult a dietician about significant changes that need to be made to your diet (this may vary from individual to individual).
- Avoid caffeine and sugar-laden snacks, and include fiber and plenty of water into your diet.
- Avoid dairy products, as they commonly trigger attacks.
- Plan and prepare in advance - if you are visiting or going to public places like the movies, restaurants or gym, take extra underwear or toilet tissue with you in case of a potentially embarrassing accident.
- Practice various relaxation techniques such as autogenic training and guided imagery to reduce stress.
- Establish a regular exercise program.
- Create an open, honest relationship with your physician.
- Keep the lines of communication open and accept support from family and friends.
- Join a support group where you can meet other people with the same problem.
- Stay positive and maintain a sense of humor.
- Take one day at a time and learn acceptance.