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Crohn’s disease

Crohn’s disease: Symptoms, diet, causes, diagnosis and more

May is awareness month for Crohn’s Disease and Ulcerative Colitis. These are inflammatory bowel diseases of the gastrointestinal tract. Crohn’s commonly affects the colon and small intestine, but can occur anywhere throughout the digestive tract. Ulcerative Colitis commonly affects only the colon.

man in abdominal pain

What is Crohn’s and inflammatory bowel disease?

Inflammatory Bowel Disease (IBD) describes auto-inflammatory conditions of the gastrointestinal tract (GI tract). There are two forms of IBD, Crohn’s disease and ulcerative colitis. IBD usually presents fairly early, between the ages of 15 and 30, and it is a lifelong disease. Currently 100,000 Australians live with IBD, which may be classified as mild, moderate or severe.

The GI tract (or digestive tract) includes the gut and other organs that work to break down and absorb food. The digestive tract starts from the mouth and continues all the way to the anus.

Crohn’s disease can affect any part of the gastrointestinal tract from mouth to anus, but most commonly affects the small and / or large intestine. It may involve the whole thickness of the gastrointestinal wall.

Ulcerative colitis most is limited to the large intestine (colon or large bowel). Ulcers (sores) can develop on the bowel lining, which may bleed or produce mucus.

Common symptoms of Crohn’s

Signs and symptoms of Crohn’s disase can differ between each person, and can range from mild to serious. Symptoms can be made worse by chronic inflammation, which impacts the body’s ability to absorb nutrients from food. Common symptoms include:

  • Abdominal pain.
  • Tiredness and fatigue.
  • Loss of appetitite and weight loss.
  • Frequent diarrhoea, which can include blood and mucus.
  • Anemia.

Less common symptoms are likely to develop during flare ups and can include:

  • Mouth ulcers (sores).
  • Inflammation of the eyes or liver.
  • Joint pain.
  • Skin rashes.
Crohn's disease patient in pain in their abdomen

Causes of Crohn’s

Medical professionals believe Crohn’s disease can be caused by a virus or bacteria that activates an immune system response – but it’s not known why the immune system activates in some people and not others.

Genetics play a major role. If you have family members with IBD, your risk of developing Crohn’s disease is increased. But you may also develop an IBD with no family history. Factors such as stress and diet may aggravate the symptoms, but they are not known causes of Crohn’s disease.

Lifestyle factors may contribute to Crohn’s disease, but this has not been definitely proven. However, it is known that cigarette smoking can increase the risk of developing IBD.

Getting a Crohn’s diagnosis

As people with Crohn’s disease may experience symptoms similar to other conditions, they will need to undergo different tests for a doctor to make an accurate diagnosis. Your doctor will want to rule out an infection or Irritable Bowel Syndrome (IBS) being the cause of your symptoms, and also work out which part/s of your bowel are being impacted. This can also help determine treatment options.

A Crohn’s diagnosis will most likely be made after a number of tests, which may include:

  • Blood test to determine if inflammation is present, and if you are anemic or lacking in nutrition.
  • Stool tests to determine whether your symptoms are caused by an infection. A stool test known as a faecal calprotectin test, can detect inflammation levels.
  • Endoscopy to view the digestive tract with a camera, and take a tissue sample (biopsy). Your doctor will decide whether one or a combination of endoscopies are needed. An upper GI tract endoscopy investigates your throat, stomach and the start of the small intestine (via the mouth). A colonoscopy will examine the large intestine and end of the small intestine (via the anus). And a sigmoidoscopy will examine the recum and lower part of the large intestine (via the anus).

It’s important to remember that Crohn’s disease can change over time. Your doctor may order different tests at different times, to monitor your disase and assess whether your current treatment is working. This is particularly the case if you experience flare ups of your symptoms.

Crohn’s treatments

There is currently no cure for Crohn’s disease. Treatment for Crohn’s disease can vary, depending on your symptoms and their severity. For most people with Crohn’s disease, it can be well managed through a combination of medication and lifestyle changes. In some cases, surgery may be needed.

Treatment for Crohn’s disease aims to reduce symptoms, control inflammation and heal the GI tract and/or bowel. As each person experiences Crohn’s disease differently, their doctor will work with them to determine the most effective treatment options. As Crohn’s disease can change over time, treatment may also need to adapt to ensure it remains effective.

Treatments may include:

  • Medication.
  • Dietary changes.
  • Surgery.

There is also a range of complementary treatments that can be beneficial for people with Crohn’s disease. As there is a known connection between gut health and mental health for example, improving your psychological health can positively affect your gut health and reduce the symptoms of Crohn’s disease.

Commonly Asked Questions about Crohn’s.

These are some of the commonly asked questions about Crohn’s disease.

What are the first signs of Crohn’s?

Common first signs and symptoms of Crohn’s disease can include abdominal pain or cramps, frequent diarrhoea with blood or mucus present.

Is Crohn’s disease serious?

Crohn’s disease is a chronic, lifelong auto-inflammatory condition for which there is currently no known cure. However, treatments can very effectively manage the disase and its impacts. You may experience flare ups and periods of remission, during which you are free of symptoms.

If you experience any new symptoms or a worsening of symptoms, it is important to speak with your doctor.

What does it feel like to have Crohn’s?

People with Crohn’s disease experience symptoms differently. However common experiences includes physical symptoms such as abdominal pain (like severe cramping), frequent diarrhoea and extreme fatigue. This can be exhausting to experience and manage, so it is important to go gently on yourself and avoid stressful situations as much as possible.

What foods can trigger Crohn’s?

Diet does not cause Crohn’s disease. As it is experienced differently by each person, dietary changes for people with Crohn’s disease are not generally recommended. If you notice that some foods, such as alcohol or caffeine, make your symptoms worse it is best to modify your diet so you can avoid flare ups.

Crohn's disease patient with a stoma

How do you test for Crohn’s?

Testing for Crohn’s disease is detailed above under Getting a Crohn’s diagnosis, and may include a combination of blood tests, stool tests and endoscopic examination. If you are concerned about your digestive or bowel health, or are experiencing signs and symptoms of Crohn’s disease, it important to speak with your doctor.

What triggers a Crohn’s flare up?

The triggers for Crohn’s disease flare ups can be specific to each person. However, the most common triggers of flare ups include:

  • Non-adherence with your treatment protocol (for example, not taking your medication).
  • Certain non-steroidal anti-inflammatory medicines (NSAIDs) such as aspirin or ibuprofen.
  • Eating particular foods that your bowel has trouble absorbing.

How are you diagnosed with Crohn’s?

This is detailed above under Getting a Crohn’s diagnosis, and may include a combination of blood tests, stool tests and endoscopic examination. If you are concerned about your digestive or bowel health, or are experiencing signs and symptoms of Crohn’s disease, it important to speak with your doctor.

How severe is Crohn’s pain?

The severity of abdominal pain or other pain associated with Crohn’s disease can vary from person to person, and whether you are in remission or experiencing a flare up. It also very much depends on where in the GI tract the inflammation is occuring. Abdominal pain tends to be crampy and in the lower right abdomen. People with Crohn’s disease can also experience mild to severe joint pain.

What is the difference between Crohn’s and colitis?

Crohn’s disease and Ulcerative Colitis are both forms of inflammatory bowel disease (IBD).

Crohn’s disease can affect the full thickness of the intestinal or bowel wall, and can occur in any part of the GI tract (from the mouth to the anus).

Ulcerative Colitis commonly causes inflammation of the inner lining of the large bowel (colon and rectum).

Can a Crohn’s flare-up go away on its own?

A Crohn’s flare up can last from a few days to a few months, depending on the severity of symptoms. It can go away on its own or continue for months and require a change of treatment, including a situation that may need surgery. It is important to let your doctor know of any changes to your symptoms, particularly if they get worse.

What is the safest treatment for Crohn’s?

The safest treatment for Crohn’s disease very much depends on your own particular symptoms and experience. Your doctor will advise you on the safest and best treatment plan for you.

Can you heal inflammatory bowel disease?

There is currently no cure for Crohn’s disease or inflammatory bowel disease. People with IBD will experience periods of remission (when the disease is inactive), but this does not mean they are healed of the disease. Treatment, such as medication, can reduce inflammation and increase the number of length of remission periods.

Crohn's disease patient in pain

Can colitis turn into Crohn’s disease?

Ulcerative Colitis and Crohn’s disease are two different forms of IBD. One will not turn into the other, though the different diseases can progress and change over time.

Why is Crohn’s not an autoimmune disease?

How to classify IBD is part of an evolving medical conversation. IBD describes auto-inflammatory conditions of the GI tract and includes both Crohn’s disease and ulcerative colitis. Crohn’s disease occurs when a person’s immune system overreacts to foreign organisms that are harmless in people without IBD. This overreaction can cause inflammation in a person’s gastrointestinal tract.

Use of language can be confusing, as there is ongoing medical discourse as to whether autoimmune disease or autoimmune disorder can be used to classify IBD. Regardless of its official classification, people with Crohn’s disease experience symptoms ranging from mild to severe, in which their body’s immune system overracts to harmless foreign organisms, resulting in inflammation in the gastrointestinal tract.

If you are particularly concerned with terminology, it’s best to raise this with your doctor.

Is Crohn’s autoimmune or auto-inflammatory?

As above, the terminology classifying inflammatory bowel diseases, including Crohn’s disease, is a part of an evolving medical conversation. IBD describes auto-inflammatory conditions of the gastrointestinal tract and includes both Crohn’s disease and ulcerative colitis.

Use of language can be confusing, as there is ongoing medical discourse as to whether autoimmune disease or autoimmune disorder can be used to classify IBD. Regardless of its official classification, people with Crohn’s disease experience symptoms ranging from mild to severe, in which their body mistakenly attacks healthy cells, resulting in inflammation.

If you are particularly concerned with terminology, it’s best to raise this with your doctor.

Does Crohn’s give you a weak immune system?

If you are diagnosed with Crohn’s disease, it does not automatically mean you have a weak immune system. A weak immune system is a general term describing the body’s lack of appropriate response to fighting disease and organisms such as virus and bacteria. Having a weak immune system can occur for many reasons, including medication, recent surgery, age, genetics or chronic illness. People with Crohn’s disease can have a weak immune system because of these factors. But not all people with Crohn’s disease have a weak immune system.

Does Crohn’s make you more susceptible to Covid-19?

It is not considered that people with Crohn’s disease are more susceptible to Covid-19. Further, a person with Crohn’s disease is likely to experience Covid-19 in the same way as someone without the condition.

People with IBD who are on immunosuppressive medication due to their condition may be more susceptible to Covid-19 compared with the general population, as are those with comorbidities such as cardiovascular disease, chronic pulmonary disease, diabetes or cancer.

If you have any concerns about Crohn’s disase and Covid-19, it’s best to speak with your doctor.

doctor treating a Crohn's disease patient

What autoimmune disease goes with Crohn’s?

People with IBD do have an increased risk of developing an autoimmune disease. This risk seems to increase with the number and severity of Crohn’s symptoms a person experiences.

Autoimmune diseases that may be experienced by people with IBD include:

  • Arthritis, particularly Rheumatoid Arthritis, which is where an overactive immune system attacks the lining of joints.
  • Psoriasis, where an overactive immune system causes skin cells to grow more quickly than normal, leading to raised patches of dry, cracked and itchy skin.
  • Multiple sclerosis, where the immune system attacks the coating around the nerves of the brain and spinal cord.

How many medications are there for Crohn’s?

There are a range of medications used to treat Crohn’s disease, and they are mainly used to reduce inflammation. A person’s particular need for and response to a medication is relevant only to them and their doctor.

The main types of medication for Crohn’s disease include:

  • Aminosalicylates, which reduce inflammation of the gut lining.
  • Corticosteroids, used to treat moderate-to-severe Crohn’s disease by blocking the body’s inflammatory response. They are most effective for short-term control of the disease, during flare ups.
  • Immunosuppressants, used to suppress the body’s immune response, which in turn decreases inflammation.
  • Biologics, which are given through injection under your skin and or intravenous infusion, and work to reduce inflammation.
  • Antibiotics, which may be needed to treat your abscesses or fistulas and after surgery.

It is important to always discuss your particular medical needs with your doctor, particularly if you experience any change in symptoms while taking a prescribed medication.

DOCTO can help with your bowel health.

Good management of IBD, both Crohn’s and colitis, is important for improving your quality of life. This includes accessing all the relevant health information you can, and having a trusted specialist medical team to help manage and understand your diagnosis.

If you have any concerns about your bowel, digestive or gut health, please contact Docto and seek a referral to one of our gastroenterologists. Find out more at docto.com.au today!