Crohn's/Colitis

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What is Crohn's disease?

Crohn's disease is a serious inflammatory disease of the gastrointestinal (GI) tract. It predominates in the intestine (ileum) and the large intestine (colon), but may occur in any section of the GI tract. Crohn's disease usually causes diarrhea, crampy abdominal pain, often fever, and at times rectal bleeding. Loss of appetite and subsequent weight loss also may occur. Symptoms may range from mild to severe, but in general people with Crohn's disease can lead active and productive lives.

Crohn's disease is chronic. We don't know its cause. Medication currently available decreases inflammation and usually controls the symptoms, but does not provide a cure. Because Crohn's disease behaves similarly to ulcerative colitis, from which it may be difficult to differentiate, the two disorders are grouped together as inflammatory bowel disease (IBD). Unlike Crohn's disease, in which all layers of the intestine are involved, and in which there can be normal healthy bowel in between patches of diseased bowel, ulcerative colitis affects only the innermost lining (mucosa) of the colon in a continuous manner. Depending on where the involvement occurs, Crohn's disease may be referred to as Ileitis, regional enteritis, or colitis, etc. To lessen the confusion, the term Crohn's disease can be used to identify the disease wherever it occurs in the body (ileum, colon, rectum, anus, stomach, duodenum, etc.). It is referred to as Crohn's disease because Burrill B. Crohn was the first name in a three-author landmark paper published in 1932, which described the disease.

Is Crohn's disease inherited?
We know that Crohn's disease tends to run in families. Studies have shown that about 20 to 25 percent of patients may have a close relative with either Crohn's or ulcerative colitis. There does not seem to be any clear-cut pattern to this familial clustering. Research actively continues in an attempt to establish a link to specific genes governing its transmission. At this time, there is no way to predict which, if any, family members will develop Crohn's disease.

What are the symptoms of Crohn's disease?
In Crohn's disease, abdominal pain and diarrhea are often the earliest signs. The pain is primarily at or below the navel in the abdomen. These symptoms follow a meal. Loss of appetite and weight, joint pains, and fever are common early signs of Crohn's disease can include sores in the anal area, including skin tags mimicking hemorrhoids, fissures (cracks), fistulas (abnormal openings connecting the bowel to the skin surface near the anus), and abscesses.

How is Crohn's disease diagnosed?
The diagnosis is suggested by the history (signs and symptoms). Additional testing to help make the diagnosis may include barium x-rays of the upper and lower GI tract, flexible sigmoidoscopy, and sometimes colonoscopy. (The last two tests permit a direct examination of the colon with a lighted tube inserted through the anus. During these tests, biopsies may be obtained to help make a diagnosis.) Laboratory tests are so helpful and include evaluation of the blood and stool.

Because Crohn's disease often mimics other conditions and symptoms may vary widely, the correct diagnosis of Crohn's disease may take some time.

Is nutrition important in Crohn's disease?
Good nutrition is essential in any chronic disease but especially in this illness, which is characterized by reduced appetite, poor absorption, and diarrhea, all of which rob the body of fluids, nutrients, vitamins, and minerals. Restoration and maintenance of proper nutrition is a vital part of the medical management of Crohn's.

While foods appear to play no role in causing the disease, soft, bland foods may cause less discomfort than spicy or high-fiber foods when the disease is active. Except for restricting milk in lactose intolerant patients, most gastroenterologists try to be flexible in planning the diets of their Crohn's patients.


What causes Crohn's disease?
Researchers do not know what causes this disease. They do not believe it is caused by emotional stress or by food, or that it is transmitted directly from person to person.

Research has shown that in IBD the body's defenses are operating against some substances in the body, perhaps in the digestive tract, which they recognize as foreign. These foreign substances (antigens) may themselves cause the inflammation, or may stimulate the body's defenses to produce an inflammation that continues without control.