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Crohn's Disease

About Crohn's Disease

Crohn's Disease is a form of inflammatory bowel disease, or inflammation of the colon. It is similar to Ulcerative Colitis, but can affect any part of the gastrointestinal tract – from the mouth to the anus. The inflammation tends to have specific patterns and may affect one area more than others. It is associated with varying degrees of severity. Many patients with Crohn's Disease ultimately require surgery at some point in their life, and surgery is often done to treat complications related to the disease. It requires care of a specialized physician trained in the disease. The most common symptoms associated with ulcerative colitis include:

  • blood in the stool
  • recurring rectal discomfort, pain, or feeling of incomplete evacuation of stool
  • abdominal pain
  • diarrhea

Crohn's Disease can be associated with other conditions outside the intestine. These include:

  • Lupus
  • arthritis
  • Uveitis (inflammation in a part of the eyes)
  • Sclerosing cholangitis (inflammation of the bile ducts)
  • Skin conditions and rashes
  • Perianal fistulas, fissures or skin tears, and skin tags

Diagnosis

The diagnosis and evaluation of Crohn's Disease usually requires a colonoscopy, upper endoscopy or EGD, and evaluation of the small intestine using contrast studies. A colonoscopy uses a small scope to visually examine the inside of the colon and rectum for disorders of the lining. A colonoscope is a thin, flexible tube, with a tiny fiber-optic video camera and a light inside its tip. It is about the thickness of an adult finger. The tube is flexible and can be maneuvered to investigate the interior surface of the colon. The camera sends magnified images of the colon to a television screen. Multiple biopsies or samples of tissue are usually taken to examine under the microscope. This helps your doctor determine the severity of the disease and the most appropriate treatment options.

Treatment for Crohn's Disease

Crohn's Disease patients are treated with medication that calms down your body's inflammatory response which is the reason for the disease. There are several different types of medications including steroids (such as prednisone), oral medications (including 5-ASA agents such as mesalamine and immunomodulators such as 6-MP or azothiaprine), and intravenous or intramuscular medications called biologics that suppress your immune system (for more severe disease). Surgery is reserved complications arising from disease or to remove certain aspects of diseased intestine.
Surgery involves removal of a limited section of intestine where the disease is most severe. One of the problems with surgery is that it will not cure the disease (unlike ulcerative colitis). A patient may develop a recurrence requiring future surgery. Surgery may also involve opening up a narrowed segment of intestine or removal of an abnormal connection between two loops of bowel. Surgery may also be required on the anus to help drain areas of infection that develop.

For additional information on Crohn's Disease, visit the American Society of Colon and Rectal Surgeons website: https://www.fascrs.org/patients/disease-condition/crohns-disease-expanded-version  

Related video: https://www.fascrs.org/video/inflammatory-bowel-disease-0

 

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