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Alternative Names Return to topInflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis
Definition Return to top
Crohn's disease is a form of inflammatory bowel disease (IBD), which involves ongoing (chronic) inflammation of the gastrointestinal tract. Crohn's-related inflammation usually affects the intestines, but may occur anywhere from the mouth to the end of the rectum (anus).
See also: Ulcerative colitis
Causes Return to top
While the exact cause of Crohn's disease is unknown, the condition is linked to a problem with the body's immune system response.
Normally, the immune system helps protect the body, but with Crohn's disease the immune system can't tell the difference between good substances and foreign invaders. The result is an overactive immune response that leads to chronic inflammation. This is called an autoimmune disorder.
There are five different types of Crohn's disease:
A person's genes and environmental factors seem to play a role in the development of Crohn's disease. The body may be overreacting to normal bacteria in the intestines.
The inflammation related to Crohn's disease frequently occurs at the end of the small intestine that joins the large intestine, but it may occur in any area of the digestive tract. There can be healthy patches of tissue between diseased areas. The ongoing inflammation causes the intestinal wall to become thick.
The disease may occur at any age, but it usually occurs in people between ages 15 - 35. Risk factors include:
Symptoms Return to top
Symptoms depend on what part of the gastrointestinal tract is affected. Symptoms range from mild to severe, and can come and go with periods of flare-ups.
The main symptoms of Crohn's disease are:
Other symptoms may include:
Exams and Tests Return to top
A physical examination may reveal an abdominal mass or tenderness, skin rash, swollen joints, or mouth ulcers. Tests to diagnose Crohn's disease include:
A stool culture may be done to rule out other possible causes of the symptoms.
This disease may also alter the results of the following tests:
Treatment Return to top
Medicines that may be prescribed include:
If medicines do not work, a type of surgery called bowel resection may be needed to remove a damaged or diseased part of the intestine or to drain an abscess. A procedure called anastomosis is done to connect the remaining two ends of the bowel.
According to the Crohn's and Colitis Foundation of America, two-thirds to three-quarters of patients with Crohn's disease will need bowel surgery at some time. However, unlike ulcerative colitis, surgically removing the diseased portion of the intestine does not cure the condition.
Patients who have Crohn's disease that does not respond to medications may need surgery, especially when there are complications such as:
Some patients may need surgery to remove the entire large intestine (colon), with or without the rectum.
No specific diet has been shown to improve or worsen the bowel inflammation in Crohn's disease. However, eating a healthy amount of calories, vitamins, and protein is important to avoid malnutrition and weight loss. Avoid foods that worsen diarrhea. Specific food problems may vary from person to person.
People who have a blockage of the intestines may need to avoid raw fruits and vegetables. Those who have difficulty digesting milk sugar (lactose) may need to avoid milk products.
Support Groups Return to top
The Crohn's and Colitis Foundation of America offers support groups throughout the United States. See http://www.ccfa.org/chapters/
Outlook (Prognosis) Return to top
There is no cure for Crohn's disease. The condition is marked by periods of improvement followed by flare-ups of symptoms.
It is very important to stay on medications long-term to try to keep the disease symptoms from returning. If you stop or change your medications for any reason, let your doctor know right away.
You have a higher risk for small bowel and colon cancer if you have Crohn's disease.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if:
References Return to top
U.S. Food and Drug Administration. FDA Approves New Treatment For Crohn's Disease. Rockville, MD: National Press Office; February 27, 2007: Report P07-30.
Sandborn WJ, Hanauer SB, Rutgeerts PJ, et al. Adalimumab for maintenance treatment of Crohn's disease: results of the CLASSIC II trial. Gut. 2007;56:1232-1239.
Gardiner KR, Dasari BV. Operative management of small bowel Crohn's disease. Surg Clin North Am. 2007;87(3):587-610.
Graham L. AGA Reviews the use of corticosteroids, immunomodulators, and infliximab in IBD. Am Fam Physician. 2007;75(3):410-412.Update Date: 2/20/2008 Updated by: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis, School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.