Crohn's disease is an ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal (GI) tract. Crohn's disease can affect any area of the GI tract, from the mouth to the anus, but it most commonly affects the lower part of the small intestine, called the ileum. The swelling extends deep into the lining of the affected organ. The swelling can cause pain and can make the intestines empty frequently, resulting in diarrhea.

Crohn's disease is an inflammatory bowel disease, the general name for diseases that cause swelling in the intestines. Because the symptoms of Crohn's disease are similar to other intestinal disorders, such as irritable bowel syndrome and ulcerative colitis, it can be difficult to diagnose. Ulcerative colitis causes inflammation and ulcers in the top layer of the lining of the large intestine. In Crohn's disease, all layers of the intestine may be involved, and normal healthy bowel can be found between sections of diseased bowel.

Crohn's disease affects men and women equally and seems to run in some families. About 20 percent of people with Crohn's disease have a blood relative with some form of inflammatory bowel disease, most often a brother or sister and sometimes a parent or child. Crohn's disease can occur in people of all age groups, but it is more often diagnosed in people between the ages of 20 and 30. People of Jewish heritage have an increased risk of developing Crohn's disease, and African Americans are at decreased risk for developing Crohn's disease.

Crohn's disease may also be called ileitis or enteritis.

Treatment may include drugs, nutrition supplements, surgery, or a combination of these options. The goals of treatment are to control inflammation, correct nutritional deficiencies, and relieve symptoms like abdominal pain, diarrhea, and rectal bleeding. At this time, treatment can help control the disease by lowering the number of times a person experiences a recurrence, but there is no cure. Treatment for Crohn's disease depends on the location and severity of disease, complications, and the person's response to previous medical treatments when treated for reoccurring symptoms.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person's lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.

Someone with Crohn's disease may need medical care for a long time, with regular doctor visits to monitor the condition.

An inflammatory disorder, Crohn's colitis can affect any part of the GI tract but more often affects the terminal ileum and may extend through all the layers of the intestinal wall. It may also involve the lymph nodes and the mesentery, the membranes which attaches the organs to the abdominal wall.

Causes

The exact cause for Crohn's colitis is unknown. Possible causes include allergies, immune disorders and obstruction in the lymph nodes. Genes may also play a role. The disease occurs in individuals in their 20's and their 40's but a second peak incidence can occur in some individuals in between ages 55 and 65.

Symptoms

Clinical effects may vary according to the location of the inflammation and the extent of the involvement. In acute disease, common symptoms include lower right abdominal pain, cramping, tenderness, gas nausea, fever, diarrhea and bleeding, which may be mild or severe.

In chronic cases, diarrhea as frequent as 4 to 6 times per day, right lower quadrant pain, steatorrhea or fatty stools, anorexia, weight loss and weakness are the most common symptoms.

Diagnosis

Laboratory tests - may indicate increased white blood cell count and erythrocyte sedimentation rate, decreased potassium, magnesium, calcium and hemoglobin levels.

Barium enema - will often show the string sign-segments of strictured intestine separated by normal bowel.

Sigmoidoscopy and colonoscopy - may show patchy inflamed areas, which helps rule out ulcerative colitis.

Biopsy - positive results will confirm diagnosis
Upper GI series with small bowel exam will help determine a diseased ileum.

Treatment

Patients are often placed on an NPO diet (nothing to eat) and total parenteral nutrition (the intravenous feeding of a person which bypasses the normal digestive process) to rest the bowel. Dietary modifications like a restricted-fiber diet and elimination of dairy products should be followed. Consumption of irritant fluids like coffee, alcohol, and carbonated drinks which are high in sugar is restricted.

Drugs to combat inflammation include anti-inflammatory corticosteroids and antibacterials like sulfasalazine and 5-aminosalicylic acid. Surgery may be needed to correct bowel perforation, massive bleeding, fistulas, or acute intestinal obstruction.

In severe cases, a colectomy with ileostomy may be done, where the diseased portion of the colon is removed and the ends are stitched back together or an ileostomy is performed to create an opening by bringing the terminal end of the small intestine (ileum) out into the surface of the skin to facilitate the exit of waste.

Understanding Crohn's Colitis Recommended Resources:

Crohn's Diseases Ulcerative Colitis

MUSC Health Digestive Disease Center