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Definition

Crohn's disease is a severe, chronic inflammatory bowel disease. It causes inflammation, ulcers, and bleeding in the digestive tract. It usually affects the end portion of the small intestine called the ileum. However, any part of the digestive tract can be affected, from the mouth to the anus.

Small Intestine

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Causes

The cause of Crohn's disease is not known. Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease, seem to run in some families. Some researchers think that it is due to a reaction to a virus or bacteria. The immune system overreacts and causes damage to the intestines.

Risk Factors

People of Jewish heritage are more likely to get Crohn's disease. Your risk may also be increased if you have family members with inflammatory bowel disease.

Symptoms

Symptoms include:

  • Diarrhea
  • Abdominal cramps and pain
  • Rectal bleeding
  • Weight loss
  • Fatigue, weakness
  • Nausea
  • Fever
  • Mouth sores
  • Sores, abscesses in the anal area
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids, tissues, and waste products may need to be tested. This can be done with:

Pictures of your bodily structures may need to be taken. This can be done with:

Your rectum and colon may need to be examined. This can be done with:

Treatment

Treatment may include:

Dietary Changes

Your doctor may advise that you avoid foods that trigger symptoms. These foods are different for each person. They may include:

  • Dairy foods due to lactose intolerance
  • Highly seasoned foods
  • High-fiber foods
Medications

There are many types of medications that are used to treat Crohn's disease. Examples of these medications include:

  • Aminosalicylate medications such as sulfasalazine, mesalamine, and olsalazine
  • Anti-inflammatory medications such as prednisone, methylprednisolone, and budesonide
  • Immune modifiers such as azathioprine, 6-mercaptopurine, and methotrexate
  • TNF inhibitors such as infliximab, adalimumab, and certolizumab
  • Antibiotic medications such as metronidazole, ampicillin, and ciprofloxacin
Surgery

Very severe Crohn's may not improve with medications. You may be advised to have the diseased section of your intestine removed. The two remaining healthier ends of the intestine are then joined together. You are still at high risk for the disease returning.

Surgery may also be done if you have an obstruction or fistulas.

Untreated Crohn's disease may lead to:

  • Fistulas—Abnormal connections between the intestine and other organs or tissues, such as the bladder, vagina, or skin
  • Intestinal obstruction
  • Arthritis
  • Eye inflammation
  • Liver disease
  • Kidney stones
  • Gallstones
  • Skin rashes
  • Osteoporosis
Prevention

Women may be able to reduce their risk of Crohn's disease through exercise. Talk to your doctor about an exercise program that is best for you.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org

Crohn's and Colitis Foundation of America
http://www.ccfa.org

CANADIAN RESOURCES:

Crohn's and Colitis Foundation of Canada
http://www.ccfc.ca

Health Canada
http://www.hc-sc.gc.ca

References:

Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/index.aspx. Updated January 10, 2013. Accessed January 6, 2014.

Hou JK, Abraham B, El-Serag H. Dietary intake and risk of developing inflammatory bowel disease: a systematic review of the literature. Am J Gastroenterol. 2011;106(4):563-573.

Inflammatory bowel disease. American Gastroenterological Society website. Available at: http://www.gastro.org/patient-center/digestive-conditions/inflammatory-bowel-disease. Accessed January 6, 2014.

What is Crohn's disease? Crohn's and Colitis Foundation of America website. Available at: http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/. Accessed January 6, 2014.

10/2/2009 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: FDA approves new drug to treat psoriasis. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm183851.htm. Published September 25, 2009. Accessed January 6, 2014.

11/25/2013 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Khalili H, Ananthakrishnan A, et al. Physical activity and risk of inflammatory bowel disease: prospective study from the Nurses' Health Study cohorts. BMJ 2013;347:f6633.



Last reviewed December 2013 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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