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Crohn’s Disease

Crohn's disease is a type of inflammatory bowel disease (IBD). It usually starts slowly — often in your 20s — and gets worse over time.

Symptoms of Crohn's disease include stomach pain, diarrhea, and weight loss. There's no cure, but doctors can treat your symptoms with medicine, diet changes, and surgery.

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What Is Crohn's Disease?

Crohn's disease is a severe, chronic inflammatory bowel disease. It causes inflammation, ulcers, and bleeding in the digestive tract.

It often affects the end part of the small intestine, called the ileum. But Crohn's disease can affect any part of the digestive tract, from the mouth to the anus.

The cause of Crohn's disease isn't known, but like other inflammatory bowel diseases, it seems to run in some families.

Some research links Crohn's disease to an overactive immune response to bacteria in the intestine, causing damage to the intestines.

What are the types of Crohn's disease?

There are 5 types of Crohn's disease, based on where patches of inflammation occur:
  • Crohn's (granulomatous) colitis. Affects the colon (large intestine).
  • Ileitis. Only affects the ileum, the last and longest section of the small intestine.
  • Ileocolitis. The most common type of Crohn's disease. It affects the very end of the small intestine (terminal ileum) and the colon.
  • Gastroduodenal Crohn's disease. Affects the stomach and where the small intestine begins (duodenum).
  • Jejunoileitis. Affects the upper half of the small intestine (jejunum).

What causes Crohn's Disease?

Doctors aren't sure what causes Crohn's disease.

It may happen when the immune system overreacts to normal bacteria in the digestive system.

Chron's also runs in families, so genes may play a role.

Some foods, alcohol, and caffeine can trigger a flare-up of Crohn's symptoms. These triggers may differ by the person. For many people with Crohn's disease, fatty or spicy foods cause issues.

Stress doesn't cause Crohn's disease, but it can make flare-ups worse.

What are Crohn's disease risk factors and complications?

Crohn's disease risk factors

Certain factors may increase your risk of getting Crohn's disease. They include:

  • A high fat diet.
  • Smoking.
  • Taking birth control pills or antibiotics.
  • Using nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.

Complications of Crohn's disease

If not treated, Crohn's disease can lead to:

  • Abscesses.
  • Anal fissures.
  • Colon cancer.
  • Fistulas.
  • Inflammation in other parts of your body.
  • Intestinal obstruction.
  • Malnutrition.
  • Ulcers.

What Are the Symptoms and Signs of Crohn's Disease?

Common symptoms of Crohn's disease include:

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

What is severe Crohn's disease?

Severe Crohn's disease has symptoms that have a major impact on your daily life.

These include:

  • Issues like an abscess or intestinal blockage.
  • High fever.
  • Intense abdominal pain.
  • Muscle loss.
  • Constant vomiting.
  • Severe intestinal lining disease.
  • Severe weight loss.

How Do You Diagnose Crohn's Disease?

To diagnose Crohn's disease, your doctor will ask you about your symptoms and health history and do a physical exam.

They'll also run tests, which may include:

  • Blood tests.
  • Stool exam.
  • Barium x-rays.
  • CT or MRI scans.
  • Flexible sigmoidoscopy.
  • Colonoscopy.
  • Upper endoscopy/enteroscopy.
  • Biopsy.

How Do You Treat Crohn's Disease?

UPMC offers treatment options to help control or prevent how severe Crohn's disease symptoms are.

Medicines for Treating Crohn’s Disease

Many types of medicines can treat Crohn's disease, such as:

  • Aminosalicylate medicines.
  • Antibiotics/probiotics.
  • Corticosteroids.
  • Immunomodulators.
  • TNF-inhibitors.
  • Other biologic treatments.

Diet changes

Your doctor may suggest that you avoid foods that cause symptoms.

These foods differ for each person, but may include:

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

When is surgery for Crohn's disease necessary?

Very severe Crohn's disease may not improve with medicine and can cause issues like:

  • A stricture.
  • An obstruction.
  • Fistulas. This is when the intestine connects in an odd way to organs or tissues like the bladder, vagina, or skin.

In these cases, bowel resection surgery may be an option. Your surgeon will remove the diseased section of your intestine and join the two healthy ends that remain.

At UPMC, we do bowel resection for Crohn's disease using a few techniques.

  • Open surgery. A traditional surgery where doctors make a cut of 6 to 8 inches in your belly. It's often necessary with emergency surgeries.
  • Laparoscopic surgery. This technique uses small cuts to the belly and a tiny lighted tube to allow doctors to see internal organs. Laparoscopic surgery tends to lead to a faster recovery with less discomfort than open surgery.
  • Robotic surgery. Like laparoscopic surgery, but surgeons don't need to put their hands in the abdominal cavity. Instead, they control robotic instruments that do the surgery. This cutting-edge technique allows for greater precision and faster recovery.

Other types of surgery for Crohn's disease include:

  • Abscess drainage, to help heal an abscess.
  • Colectomy, to remove the entire colon.
  • Fistula removal, to heal abnormal openings between organs.
  • Ostomy surgery, to create an opening in the body for stool to pass through.
  • Protocolectomy, to remove both the colon and rectum.
  • Strictureplasty, to open narrowed sections of the intestine.

How long is recovery from colorectal surgery?

Colorectal surgery is a major operation.

You'll stay in the hospital for up to a week. If you have post-op problems, you may need to stay longer.

Recovery at home will take about 6 weeks.