Crohn’s disease is a disorder that causes inflammation (swelling, irritation) of the wall of the bowel (intestines). Nutrients and vitamins in food may not be easily absorbed.
Most people have this disorder throughout life, but with treatment most people can often live a normal life. It can occur at any age but is most commonly diagnosed before age 30 and is slightly more common in whites. It is not contagious and cannot be prevented.
The cause is unknown. It’s thought to be an autoimmune disease, which means that the body’s immune system reacts against its own tissues. It seems to run in families.
Common symptoms include middle or lower abdominal (belly) pain (may be worse after eating), and diarrhea (sometimes bloody). Other possible symptoms are joint pain, eyelid redness and swelling, skin lesions, mouth sores, weight loss, tiredness, and fever.
Many complications, such as bowel blockages, can occur. Fistulas (abnormal passages) and fissures (cracks in the skin) in and around the anus and rectum can form and lead to infections.
The health care provider uses symptoms, blood tests, and abdominal CT to make a diagnosis and exclude other causes. The health care provider may suggest seeing a digestive disease specialist (gastroenterologist).
Colonoscopy is used to examine the inside of the large intestine (colon). In colonoscopy, the gastroenterologist inserts a flexible tube (which holds a scope and camera) into the rectum and then up into the intestine. During this test, the doctor takes a sample of tissue (biopsy) for study with a microscope.
The goals of treatment are to relieve symptoms, control inflammation, and prevent complications. People without symptoms need no treatment. Mild diarrhea is controlled with medicine and dietary fiber. Severe symptoms need antiinflammatory drugs such as prednisone. Antibiotics may help infections when present. Pain relievers are given for abdominal pain and cramping; vitamin and mineral supplements, for malnutrition. Diet changes such as adding some fiber also help. Medications that suppress the immune system may be necessary to control symptoms. High-nutrition liquid formulas may be used during severe symptoms to rest the intestines.
About 70% of people need surgery for symptoms. During surgery, part of the intestine is removed. In some cases, intestines are temporarily connected to a pouch attached outside the body (ileostomy pouch), which allows going to the bathroom while allowing another part of the intestines to heal.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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