Crohn’s Disease: What is it and how to treat it

Highlights

• Crohn’s disease is a fairly common, chronic form of inflammatory bowel disease that causes pain and inflammation along the digestive tract.
• Crohn’s symptoms may be constant or ebbing and flowing, and largely target the digestive system, causing abdominal pain, diarrhea, weight loss, fever, and fatigue.
• A team of practitioners including physicians (like gastroenterologists), nutritionists, pharmacists, and holistic health providers can help manage Crohn’s over the long term.
• There is no cure for Crohn’s disease, but medications and complementary treatments like acupuncture and behavioral therapy can help address symptoms.

For most people, unpleasant digestive symptoms like abdominal pain and diarrhea are temporary and easily resolved with medication. For some, these symptoms are severe and unrelenting, which can prompt a person to visit their primary healthcare provider to seek out a diagnosis.

An investigation may uncover Crohn’s disease, a severe, chronic inflammation of the intestinal wall or any portion of the gastrointestinal tract.

Crohn’s disease is a lifelong form of inflammatory bowel disease (IBD). IBD, including ulcerative colitis and Crohn’s, is a group of disorders that cause chronic pain and inflammation in the digestive tract (the path food travels from the mouth to the anus).

Crohn’s can occur anywhere in the digestive tract, and its location can result in one of five specific types of Crohn’s disease:

• Gastroduodenal Crohn’s: Inflammation in the stomach and the start of the small intestine (duodenum)
• Jejunoileitis: Inflammation in the middle part of the small intestine (jejunum)
• Ileitis: Inflammation in the last section of the small intestine (ileum)
• Ileocolitis: Inflammation in the end of the small intestine and a portion of the large intestine (colon)
• Crohn’s (granulomatous) colitis: Inflammation only in the colon. Note ulcerative colitis also affects the colon but it is different from Crohn’s colitis in that it only impacts the top layer of the intestinal wall and is a continuous inflammation with no pockets of healthy tissue.

Each inflammatory disease subtype has a distinct clinical presentation and typical course of treatment, so it’s important to work with a primary healthcare provider to get an accurate diagnosis for Crohn’s disease.

How many people have Crohn’s disease?

According to the National Institutes of Health, as many as 700,000 Americans are affected by Crohn’s disease, with an equal distribution in men and women.

While the condition can occur at any age, it is most common among adolescents and young adults between the ages of 15 and 35, with approximately 25% diagnosed by age 20. Disease in adults between 60 and 80 years of age are the second most commonly diagnosed group.

It is hypothesized that Crohn’s is an autoimmune disease and that those with a family history of Crohn’s are more likely to develop it. Genetic factors as well as environmental factors (e.g. smoking, eating a high-fat diet, using nonsteroidal anti-inflammatory drugs) may increase the risk of developing Crohn’s as well.

Symptoms of Crohn’s disease

Each person experiences Crohn’s differently, depending on where the intestinal inflammation is located. However, common symptoms often include: 

• Diarrhea (sometimes bloody)
• Abdominal pain (usually starting 1-2 hours after meals)
• Fever
• Fatigue 
• Weight loss
• Rectal bleeding and anal fissures

These symptoms may be constant, or they may come and go (known as “relapsing and remitting”). Some people with Crohn’s disease can identify the exact moment they began feeling symptoms, usually triggered by trauma, illness or stress. But more often, symptoms build slowly over time with no identifiable triggering event.

How is Crohn’s disease diagnosed?

There’s no single diagnostic test for Crohn’s disease. Instead, your healthcare provider may begin by first ruling out other conditions, such as an infection or parasites. If definitive testing rules out those causes, other procedures may be ordered to observe the condition of the gastrointestinal tract.

These can include, but are not limited to:

• Blood test
• Colonoscopy
• Biopsy
• Endoscopy
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)

How serious is Crohn’s?

Crohn’s disease can be uncomfortable. It can also present a lot of challenges for day-to-day life. But when managed well, Crohn’s disease is not life-threatening. Getting Crohn’s under control through traditional and complementary therapies is the ultimate goal.

That’s why it’s important to work with a healthcare team that includes a primary care physician, nutritionist, pharmacist, and holistic healthcare providers such as acupuncturists.

When left untreated, Crohn’s can lead to life-threatening complications. According to Johns Hopkins School of Medicine, Crohn’s disease is associated with complications that may be more problematic than the bowel disease itself. These can include:

• Malnutrition due to difficulty absorbing nutrients in the intestine.
• Colitic arthritis, or joint pain, swelling, and stiffness in the knees, ankles, hips, wrists, and elbows.
• Pericholangitis, a liver disease that inflames the bile ducts.
• Kidney stones, or calcium oxalate deposits that block urine flow. 
• An abnormal growth (known as a “fistula”) between the inflamed bowel and the urinary bladder, leading to infection.
• Perforation of the intestinal wall as a result of chronic inflammation weakening the tissue.
• A higher risk of developing colorectal cancer, especially in people who’ve had Crohn’s disease for a decade or more.

Is there a cure for Crohn’s disease?

Although there is no cure for Crohn’s disease, several options are available to slow the progression of the disease and alleviate symptoms. Medications such as steroids and immunosuppressants are the main treatment for Crohn’s disease. Alternative treatments may also be helpful when used alongside traditional medical treatment.

Acupuncture has been shown to improve quality of life in people with Crohn’s disease, and mental health treatment to manage stress and anxiety may help reduce the frequency and severity of symptoms.

People with Crohn’s may also find it helpful to work with a registered dietitian or nutritionist to identify the foods that trigger inflammation and develop a nutrition plan to keep their symptoms at bay. Once you’ve identified foods that cause your symptoms to flare, you can choose either to avoid them or to learn new ways of preparing them that will make them tolerable.

If these treatments for Crohn’s disease aren’t effective, a patient may require surgery. According to the Crohn’s and Colitis Foundation, there are several different types of surgery for Crohn’s disease, depending on the location of the disease in your GI tract and the complications a person is suffering.

Surgery is often seen as a last resort, used in life-threatening situations or when all other options have been exhausted.

Can I live a normal life with Crohn’s disease?

Yes: It’s entirely possible to live a normal life with Crohn’s disease symptoms. Even though Crohn’s is a lifelong illness, it is a manageable one.

A team of professionals, including a primary care provider, nutritionist, therapist, and/or acupuncturist can help you to live comfortably with Crohn’s disease.

If you think you may be experiencing Crohn’s disease, the right provider can help you build a personalized plan to support your wellbeing. Connect with a credentialed expert who serves your area here.