By Anish A. Sheth, M.D.
Crohn’s disease is a type of inflammatory bowel disease that affects more than half a million people in the United States, according to the National Institutes of Health.
Often beginning gradually, Crohn’s can become worse over time and cause serious health complications.
At the Center for Digestive Health at Penn Medicine Princeton Medical Center, patients with Crohn’s disease and other common and complex gastrointestinal disorders have access to high-quality screening, testing and treatment.
Inflammation and Irritation
A chronic disease, Crohn’s causes inflammation and irritation in your digestive tract. Most commonly, Crohn’s affects your small intestine and the beginning of your large intestine, but it can affect any part of the digestive tract, including your mouth and your anus.
While doctors are unsure what exactly causes Crohn’s disease, it is believed to be an autoimmune reaction in which the bacteria in your digestive tract mistakenly trigger your immune system, resulting in inflammation associated with Crohn’s.
Additionally, genetics are suspected of playing a role Crohn’s with research showing that if you have a parent or sibling with Crohn’s, you may be more likely to develop the disease.
Other risk factors may include:
- The use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen, antibiotics and birth control pills
- A high-fat diet
The most common symptoms of Crohn’s disease are:
- Cramping and abdominal pain
- Weight loss
Other symptoms include:
- Joint pain or soreness
- Nausea or loss of appetite
- Skin changes
- Eye redness or pain
Symptoms may vary depending on the location and the severity of the inflammation. If you experience symptoms of Crohn’s, talk with your doctor. He or she may refer you to a gastroenterologist for an accurate diagnosis and treatment plan.
Risk of Complications
While Crohn’s cannot be cured, it can be managed to prevent symptoms and reduce the risk of complications, such as:
- Intestinal obstruction. Inflammation from Crohn’s can cause the wall of your intestines to thicken and narrow, which can lead to a partial or complete blockage of your bowels.
- A gastrointestinal fistula is an abnormal opening in your digestive tract that can cause fluids to seep through the lining of your intestines and result in infection.
- Painful, swollen pus-filled pockets of infection in your digestive tract can be caused by inflammation associated with Crohn’s.
- Anal fissures. Small tears in your anus may case itching, pain or bleeding.
- Ulcers or open sores can occur anywhere along your digestive tract, including your mouth and intestines.
- Crohn’s can prevent your body from getting the vitamins, minerals and nutrients it needs to stay healthy.
- Inflammation in other areas of your body, such as your joints, eyes and skin.
Additionally, if Crohn’s occurs in your large intestine, you may be more likely to develop colon cancer.
Diagnosis and Treatment
Diagnosing Crohn’s disease involves a combination of tests including a physical exam, lab tests and imaging tests such as X-rays and CT scans to look for inflammation.
If your doctor suspects the problem is in the small intestine, a video capsule endoscopy may be recommended, allowing your doctor to see inside your digestive tract through a tiny camera contained in a small capsule you can swallow.
Video capsule endoscopy, offered at PMC’s Center for Digestive Health, does not require anesthesia, and patients are able to leave the doctor’s office after swallowing the capsule.
As the capsule makes it way through the digestive tract, the camera records and transmits images to a small receiver device that you wear. When the recording is finished, your doctor can download and review the images. The camera leaves your body through a bowel movement and can be safely flushed down the toilet.
In cases where the large intestine is affected, a colonoscopy is typically required to confirm the diagnosis. Because colon cancer is a complication of Crohn’s, people with Crohn’s should talk to their doctor about how often they should have a colonoscopy. When detected early, colon cancer can often be cured.
Treatment for Crohn’s depends on its severity and may include medication, bowel rest, surgery or a combination of all three.
For people with mild symptoms, medications can help decrease inflammation and prevent flare-ups.
For people with more severe symptoms, surgery is often necessary to treat Crohn’s. In fact, according to the NIH, one study found that 60 percent of people had surgery within 20 years of having Crohn’s disease.
Though Crohn’s disease a chronic disease that cannot be cured, with the proper diagnosis and treatment it can be managed to alleviate symptoms, with periods of remission that can last for years.
To learn more about PMC’s Center for Digestive Health or to make an appointment, call 609.853.7272 or visit www.princetonhcs.org.
Anish Sheth, M.D., is board certified in gastroenterology. He is Chief of Gastroenterology at the Princeton Medical Center and Co-Medical Director of the Princeton Medical Center for Digestive Health.