Crohn's Disease

What Is Crohn's Disease?

Crohn's disease is a condition that causes parts of the intestine (bowel) to get red and swollen. It's a chronic condition, which means it lasts a long time or constantly comes and goes.

Crohn's disease is an inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract from mouth to anus (where poop comes out). It's most commonly found at the end of the small intestine and the beginning of the large intestine. The inflammation of Crohn's disease damages the entire bowel wall.

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

The most common symptoms of Crohn's disease are belly pain and diarrhea. Other symptoms include:

• blood in the toilet, on toilet paper, or in the stool (poop)
• nausea or vomiting
• fever
• low energy
• skin tags, sores, or drainage around the anus
• mouth sores
• weight loss

Because Crohn's disease damages the whole bowel wall, there can be scarring, narrowing of the bowel, and fistulas. A fistula (pronounced: FISS-chuh-luh) is an abnormal connection that links the bowel to the skin, bladder, vagina, or other loops of bowel. A fistula may leak stool (poop), pus, or blood.

Crohn's disease can cause other problems, such as rashes, eye problems, joint pain and arthritis, and kidney stones and gallstones.

What Causes Crohn's Disease?

The exact cause of Crohn's disease is not clear. It is probably a combination of genetics, the immune system, and something in the environment that triggers in the gastrointestinal tract. Diet and stress may make symptoms worse, but probably don't cause Crohn's disease.

Crohn's disease tends to run in families. But not everyone with Crohn's disease has a family history of IBD. Crohn's disease can happen at any age, but is usually diagnosed in teens and young adults. People who smoke are more likely to get Crohn's disease.

How Is Crohn's Disease Diagnosed?

Doctors diagnose Crohn's disease with a combination of blood tests, stool (poop) tests, and X-rays. They also might do imaging tests, such as CT scans and MRIs.

Doctors can look at the colon using an endoscope, a long, thin tube with a camera attached to a TV monitor:

• In a colonoscopy, the tube goes in through the anus.
• In an upper endoscopy, the tube passes down the throat.

The doctor can see inflammation, bleeding, or ulcers in the esophagus, stomach, small intestine and on the wall of the colon. During the procedure, the doctor might do a biopsy, taking small tissue samples for testing in a lab.

How Is Crohn's Disease Treated?

Crohn's disease is treated with medicines, changes in diet, and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems and flare-ups, and possibly heal the inflamed intestines.

Your doctor may recommend:

• anti-inflammatory drugs to decrease the inflammation
• immunosuppressive agents to prevent the immune system from causing more inflammation
• biologic agents to block proteins that cause inflammation
• nutrition therapy to give the bowel a chance to heal

Surgery may be necessary if:

• the bowel gets a hole
• the bowel becomes blocked
• a fistula forms
• bleeding can't be stopped
• symptoms don't respond to treatment

Nutrition therapy is a way to treat Crohn’s disease with a special diet. A person with Crohn’s disease gets a drinkable formula instead of eating regular food. This diet can reduce inflammation and help heal the intestines. Sometimes, nutrition therapy is used instead of medicine. A doctor or registered dietitian can create these diets.

Doctors may prescribe antibiotics to prevent or treat infections. People with Crohn’s disease should always check with their doctor before using antidiarrheal medicine.

Because some medicines make it harder to fight infections, it's important to get tested for tuberculosis and have all the recommended vaccines before starting treatment.

Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for someone with the condition to get the calories and nutrients they need. Be sure to eat a variety of foods, get plenty of fluids, and avoid foods that make your symptoms worse. Some teens may need supplements, like calcium or vitamin D. Someone who isn't growing well may need other nutrition support.

What Else Should I Know?

Dealing with the symptoms of Crohn's disease can be a challenge. But many people with Crohn’s disease can stay well and have few symptoms for long periods of time. Talk to your doctor about ways you can feel better during flares. Because stress can make symptoms worse, it’s important to get enough sleep and manage stress in positive ways. Yoga, meditation, breathing and relaxation techniques, music, art, dance, writing, or talking to a friend can help.

If you feel sad or anxious about your symptoms, talk to your doctor, parent, or other trusted adult. It may also help to talk to a therapist or other mental health provider.

As you get older, you can take on more responsibility for managing your health care. Getting treatment for Crohn's disease, managing your symptoms, and keeping a positive attitude can help get you back on track.

You also can find more information and support online at:

• The Crohn's and Colitis Foundation
• ImproveCareNow