Crohn's Disease

Overview

Crohn’s Disease is a type of Inflammatory Bowel Disease (IBD) that can affect any part of the gastrointestinal tract, from the mouth to the anus. The condition is named for Dr. Burrill B. Crohn, who first described the disease in 1932 along with his colleagues, Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer. 

Crohn’s disease is characterized by severe inflammation of the GI tract that can affect the entire thickness of the bowel wall. The disease most commonly affects the end of the small intestine (the ileum) and the colon (the large intestine).

Crohn’s disease can begin at any age, but is most often diagnosed in adults between the ages of 20 and 29. Symptoms usually start gradually, then get worse over time. Many of those diagnosed with IBD have a sibling or parent with the condition, suggesting a genetic component, but it is impossible to predict who may get Crohn’s Disease based on family history alone. Smokers have a significantly higher risk of developing Crohn’s than non-smokers, but the true root cause of the disease is unknown.   

Crohn’s can lead to a variety of symptoms and complications, but often includes recurring episodes of abdominal pain, cramping and diarrhea which may include blood during a bad flare up of symptoms. The inflammation and the symptoms it causes can sometimes go away for a while — called “remission” — but can come back without warning, even after weeks or years. 

The symptoms of Crohn’s disease can sometimes be debilitating, and can have a significant impact on a person’s quality of life, affecting their physical health as well as their mental and emotional wellbeing. Currently, there is no cure for Crohn’s, but long-term remission of symptoms can often be maintained through medication, diet and lifestyle changes. 

Why Hoag for Crohn’s Disease Diagnosis, Management and Care?

Hoag’s Margolis Family Inflammatory Bowel Disease (IBD) Program provides comprehensive, patient-first diagnosis and care for those living with chronic conditions of the bowel, including Crohn’s disease, ulcerative colitis, lymphocytic colitis, collagenous colitis and pouchitis.

Through a team-based, multidisciplinary approach that strives for whole-patient care, we work to help those with Crohn’s disease find the accurate diagnosis, advanced treatment options and personalized recommendations and dietary advice that can help them return to an active lifestyle with less worry about their digestive health.  Meet the Hoag Margolis Family IBD Program Team.

Different Types of Crohn’s Disease

Crohn’s disease is categorized into five types, depending on the part of the gastrointestinal tract it affects:

  • Ileocolitis: Affecting the end of the small intestine (ileum) and the large intestine (colon), ileocolitis is the most common form of Crohn’s disease
  • Gastroduodenal Crohn’s disease: Affects the stomach and the beginning of the small intestine (duodenum).
  • Ileitis: Affects only the end of the small intestine (ileum).
  • Jejunoileitis: Affects only the upper half of the small intestine (jejunum).
  • Crohn’s colitis: Only affects the colon

Symptoms of Crohn’s Disease

The symptoms of Crohn’s disease can vary from patient to patient, and can sometimes go into remission for weeks or years. Digestive symptoms may include:

  • Chronic diarrhea, which may contain blood
  • Abdominal pain and cramping
  • Fever
  • Mouth sores
  • Reduced appetite, causing weight loss
  • Recurring abdominal pain and cramping
  • Nausea and vomiting
  • Constipation, which can lead to bowel obstruction. Learn more about bowel obstructions

GI tract symptoms of Crohn’s Disease may include: 

  • Ulcers, which are open sores that can occur anywhere in the digestive tract
  • Strictures, which are narrow places in the intestine caused by chronic inflammation
  • Fissures, which are small tears in the lining of the anus that may cause bleeding or infections
  • Fistulas, which are tunnels in the intestinal wall that can develop between the intestine and other organs or through the skin. Fistulas near the anus are the most common, and may cause a constant drainage of bowel contents

Non-digestive symptoms may include: 

  • Inflammation of the joints, eyes and skin
  • Anemia
  • Kidney stones
  • Osteoporosis
  • Arthritis
  • Increased risk of colon cancer
  • Liver or gallbladder disease
  • Skin disorders, specifically a condition called hidradenitis suppurativa in which nodules and abscesses can develop in the armpits, groin, under the breasts and in the genital area.
  • Changes to the menstrual cycle caused by malnutrition
Causes of Crohn’s Disease

The exact cause of Crohn’s disease is unknown, but it is believed to result from a combination of genetic, environmental, immune and bacterial factors. It is not considered an autoimmune disease.

Crohn’s is more common in people who have a close relative with the disease, suggesting a genetic component. About 1 in 5 people who have Crohn’s have a sibling or parent with the disease, but most people with Crohn’s disease don’t have a family history of the condition. 

Crohn’s affects both men and women equally. It’s not known why, but Crohn’s disease is most common in Caucasians, with those of Eastern European (Ashkenazi) Jewish descent particularly at risk. In recent years, however, rates have increased among African-Americans and migrants to the U.S.

Another known risk factor is smoking. Studies show people who smoke tobacco have a significantly higher risk of developing Crohn’s disease. Smokers also have a higher risk of developing severe complications including fistulas, strictures and intestinal blockages. Smoking has also been shown to increase the risk of developing symptoms beyond the GI tract, including osteoporosis, arthritis and skin disorders.   The increased risk can persist for years even if a person stops smoking. 

How Is Crohn’s Disease Diagnosed?

If you visit the doctor with symptoms that might suggest Crohn’s disease, your physician will likely talk to you about your medical history, including any relatives who might have Inflammatory Bowel Disease (IBD), and the symptoms you’re experiencing, followed by a thorough physical exam.

During the physical exam, the physician may check your abdomen for bloating, use a stethoscope to listen for sounds in the abdomen that may suggest the disease, and tap or press on your abdomen to check for tenderness or pain. 

Depending on the outcome of the physical exam, you may be asked to submit to more tests, including: 

  • Blood tests to see if your have anemia or an elevated white blood cell count that may suggest inflammation or infection
  • Stool tests
  • Colonoscopy, in which the doctor uses a long, flexible camera called an endoscope to visually inspect your rectum and colon
  • Upper GI endoscopy, which involves inserting the endoscope down the throat so the esophagus and stomach can be examined 
  • A capsule study, which involves swallowing a pill containing a tiny camera, which relays images of the inside of the digestive tract 
  • An upper GI series, in which images are taken of the upper gastrointestinal tract, including the esophagus, stomach and duodenum 
  • imaging tests such as CT scans or MRI
Advanced Imaging Technology for Those With Bowel Disorders, at Hoag

At Hoag, we know it’s not enough to just give a diagnosis. We need to find the right diagnosis for each individual patient, based on their condition, symptoms and their best path to healing. That’s why we’re committed to utilizing the latest tools and techniques, including the most advanced imaging options available. 

Among the imaging options available for those with chronic conditions of the bowel:  

Management and Treatment Options for Crohn’s Disease

There is currently no cure for Crohn’s Disease, but various treatment options can help patients manage symptoms and prevent flare-ups. Treatment and management options for Crohn’s include:

  • Medication, which may include:
    • Anti-inflammatory drugs
    • Corticosteroids
    • Immune system suppressors
    • Biologic therapies that target specific proteins created by the immune system that may contribute to inflammation
    • Pain medications
    • Medications to help control diarrhea
  • Bowel rest, which involves only drinking liquids while not eating anything else. During bowel rest, patients may be given special nutrients to drink, or may be given nutrition through a feeding tube or IV
  • Surgery to improve symptoms or treat complications, including internal bleeding, fistulas, or to remove a damaged portion of the GI tract 
Next-Generation Treatment, Surveillance and Management Options for Chronic Bowel Disorders at Hoag

Hoag is committed to offering the latest and most promising treatment and management options for those facing chronic issues involving the GI tract. Among the advanced techniques available at Hoag: 

Ways to Reduce Your Risk of Developing Crohn’s Disease

Currently, there’s no known way to definitely prevent yourself from developing Crohn’s Disease. However, there are certain ways you might be able to reduce your risk of developing the disease or having flare ups, including: 

  • Don’t smoke tobacco, and quit if you do smoke. Studies have shown that smoking is both a major risk factor for Crohn’s, and causes more severe symptoms for those who already have the disease. 
  • Eat a healthy diet rich in fruits, vegetables and whole grains to help maintain a healthy digestive system.
  • Get regular exercise, as regular physical activity can potentially help keep your digestive system healthy

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