Crohn's disease is a chronic inflammatory process primarily involving the intestinal tract from the mouth to the anus. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum).
Crohn's disease is a chronic condition and may recur at various times over a lifetime. Some people have long periods of remission, sometimes for years, when they are free of symptoms. There is no way to predict when a remission may occur or when symptoms will return.
The exact cause is not known, but doctors believe it comes from a mix of different factors. The main contributing factors are the immune system response, genes and family history, environmental triggers, and smoking. An x-ray study of the small intestine may be used to diagnose Crohn's disease.
Symptoms
- Cramping and abdominal pain.
- Diarrhea.
- Fever.
- Weight loss.
- Bloating.
- Anal pain or drainage.
- Skin lesions.
- Rectal abscess.
- Fissure.
- Joint pain.
Who does it affect?
Any age group may be affected, but the majority of patients are young adults between 16 and 40 years old.
Crohn's disease and a similar condition called ulcerative colitis are often grouped together as inflammatory bowel disease. The two diseases afflict an estimated 1.6% of the U.S. adult population.
Treatment
There is no "cure" for Crohn's disease, but medical therapy with one or more drugs provides a means to treat early Crohn's disease and relieve its symptoms. The most common drugs prescribed are corticosteroids, immunosuppressants and biologics to quiet the immune response and heal the intestinal lining.
Surgery
In more advanced or complicated cases of Crohn's disease, surgery may be required in 70% to 80% of all patients. Surgery is not "curative," although many patients never require additional operations. Surgery often provides effective long-term relief of symptoms and frequently limits or eliminates the need for ongoing use of prescribed medications. Surgical therapy is best conducted by a physician skilled and experienced in the management of Crohn's disease.
A conservative approach is frequently taken, with a limited resection of intestine (removal of the diseased portion of the bowel) being the most common procedure. Emergency surgery is sometimes necessary when complications, such as a perforation of the intestine, obstruction (blockage) of the bowel, or significant bleeding occur with Crohn's disease. Other less urgent indications for surgery may include abscess formation, fistulas (abnormal communications from the intestine), severe anal disease or persistence of the disease despite appropriate drug treatment.
Not all patients with these or other complications require surgery. This decision is best reached through consultation with your gastroenterologist and your colon and rectal surgeon.
Note: The materials presented in this section are for general information and do not substitute for medical advice. Patients have the right to receive accurate, easily understood information about their health plans, professionals, and facilities, and to a choice of health care providers sufficient to ensure access to appropriate high-quality health care.