What is Crohn's disease?
Crohn's disease is a chronic (long-term) inflammation of the bowel
(intestines). Areas of inflamed tissue are often separated by areas of
normal tissue.
The large intestine is inflamed in 65% of the people who have
Crohn's disease. The small intestine is inflamed in 35% of people with
the disease. Crohn's disease generally occurs in young adults.
How does it occur?
The cause of Crohn's disease is unknown.
In Crohn's disease, the inflammation occurs in all the layers of
the small or large intestine as well as nearby tissues and lymph
nodes. The sores and swollen areas may thicken and eventually block
the intestines. The inflammation can cause holes and sores in the
bowel walls. Because the inflammation also affects the outer
intestinal walls, the loops of bowel may attach to each other.
What are the symptoms?
Symptoms of Crohn's disease include:
- abdominal pain or cramping
- diarrhea
- fever
- fatigue
- weight loss
- rectal fistula (abnormal opening at or near the anus)
- rectal fissure (a painful crack in the mucous membrane of the
anus).
How is it diagnosed?
To diagnose Crohn's disease, your doctor will review your symptoms
and examine you. The exam usually includes a sigmoidoscopy or
colonoscopy (a procedure in which the doctor uses a scope to look at
the inside of your intestine or colon). Often the doctor will take a
small piece of bowel tissue for testing. The doctor may also want a
sample of your stool (bowel movement) for testing.
Other tests may include a blood test and a barium x-ray study to
examine the colon and small bowel (particularly the end section of the
bowel).
How is it treated?
There is no cure for Crohn's disease. The best treatment is
frequent checkups with your doctor to control the disease. The doctor
will probably prescribe one or more medications for you to take.
If you have diarrhea, avoid certain foods that have a laxative
effect, such as raw fruits and vegetables and concentrated fruit
juices. You can rest your bowel by not eating solid foods for a while.
Drink just clear fluids frequently during the day (electrolyte or
rehydrating fluids are best). It is important to drink often so that
you do not become dehydrated. When an attack of diarrhea is over, eat
small frequent meals. Return to your normal diet gradually.
Limit or avoid food additives and stimulants such as caffeine (in
coffee, tea, or chocolate). Avoid eating or drinking milk products.
Enzyme supplements may help if you develop an intolerance to lactose
(a sugar in dairy products). Ask your doctor if you should reduce the
amount of roughage in your diet.
If you have cramps or abdominal pain, it may help to put a hot
water bottle or electric heating pad (set on low) on your abdomen.
If your condition is more serious, hospital treatment may include:
- intravenous feeding (into a vein) to replace lost nutrients and
fluids
- blood transfusions to restore lost blood
- use of medications such as antibiotics and steroids to reduce
inflammation
- nasogastric suction (through a tube passed through the nose to
the stomach) to drain out acidic digestive juices.
If the disease is not kept under control you may get sores, tears,
or abnormal openings in and around your intestines. In this case you
may need surgery.
How can I take care of myself?
It is important to follow your doctor's instructions. If your
symptoms persist or if you develop new symptoms, tell your doctor. In
addition, you can:
- Be aware of the possibility of the symptoms coming back.
Otherwise a recurrence may make you feel discouraged, anxious,
fearful, or tense.
- Keep a healthy, positive attitude.
- Learn to use relaxation techniques such as mental imaging,
muscle relaxation exercises, and deep breathing.
- Talk with a mental health professional about how to manage
events in your life that trigger anxiety.
- Develop a positive support system (family, friends) for talking
about the normal stresses of daily life.
- Follow a balanced, nutritious diet, but avoid raw fruits and
vegetables and milk products.
- Exercise 20 minutes at least three times a week.
- Get enough rest even if you cannot sleep.
- Allow time each week for play and recreation.
- Take the full course of treatment your doctor prescribes.
For more information you may also want to write or call:
Crohn's and Colitis Foundation of America
444 Park Avenue South
New York, New York 10016
