Crohn’s Disease: Causes, Symptoms, & Treatments

Crohn’s disease is a lifelong gastrointestinal disorder that causes painful swelling and redness inside the digestive tract¹. This inflammation can lead to symptoms including abdominal pain and diarrhoea².

Inflammation is how the body protects itself from foreign invaders such as viruses and bacteria². This immune response is usually “turned off” once these invaders are destroyed, however with Crohn’s disease, a problem with the immune system causes the inflammation to continue and damage the walls of the gastrointestinal tract².

Crohn’s disease and ulcerative colitis are often collectively known as inflammatory bowel disease (IBD).

What’s the difference between Crohn’s disease and ulcerative colitis?

Crohn’s disease and ulcerative colitis are both inflammatory bowel diseases, however, they affect the digestive tract in different ways:

• Crohn’s disease can affect any part of the gastrointestinal tract, but usually affects the last section of the small bowel (the ileum) and/or the colon². Inflammation can extend into the entire thickness of the bowel wall.
• Ulcerative colitis only affects the large bowel (colon and/or rectum) and inflammation is just in the inner lining².

What are the symptoms of Crohn’s disease?

Everyone responds differently to Crohn’s disease – the severity of symptoms tends to vary from time to time and from person to person³. Common symptoms include:

• Abdominal pain
• Weight loss
• Diarrhoea (sometimes with blood and mucus)
• Tiredness
• Constipation
• Malnutrition
• Nausea
• Delayed or impaired growth in children

IBD is not progressive and doesn’t necessarily get worse over time³. “Flare-ups” can range from mild to severe and back to mild again, with periods of relief from symptoms in between these attacks for some people.

What causes Crohn’s disease?

The cause of Crohn’s disease is unknown, but it is thought to be a combination of genetic, environmental, and immunological factors¹. It can develop at any age, but usually first appears between 15 and 30 years of age². Crohn’s disease is becoming much more common in children under the age of nine.

From a genetics perspective, you are slightly more likely to develop Crohn’s disease if you have a close relative with it². Certain ethnic groups are also more likely to develop the condition.

Crohn’s disease is more common in people living in Australia, Western Europe and America than in developing countries². Researchers suspect that the modern Western lifestyle may play some role in causing Crohn’s disease in susceptible people.

During a flare-up, exposure to an environmental trigger such as viruses or bacteria prompts the immune system to switch on its standard defence mechanism (inflammation) against a foreign substance¹.

In most people, this immune response subsides once the foreign material is destroyed, but with some people, the immune system fails to switch off, so the inflammation continues¹. Over time, prolonged inflammation damages the walls of the gastrointestinal tract and causes the symptoms of inflammatory bowel disease (IBD).

How common is Crohn’s disease?

Crohn’s disease and ulcerative colitis are an emerging global disease, with Australia having one of the highest rates of prevalence in the world¹. More than 80,000 Australians live with inflammatory bowel disease, with this number expected to grow to more than 100,000 by 2022.

How is Crohn’s disease diagnosed?

Doctors use a variety of tests to diagnose Crohn’s disease as no single test can definitively diagnose it². These tests might include blood tests, stool samples, x-rays, colonoscopy and gastroscopy. Other types of imaging (such as an x-ray) are sometimes used to help in the diagnosis and to help rule out other diseases²..

How is Crohn’s disease treated?

There is no cure for Crohn’s disease, but treatment may help minimise the impact the condition has on someone’s life. People with the condition can lead normal lives most of the time³.

Treatment might include:

• Medication: Crohn’s disease involves periods of relapse where the inflammation in the bowel flares up, and periods of remission where the inflammation subsides². Medication can be used to control inflammation during a flare-up to give the bowel a chance to heal, help maintain remission, improve general wellbeing and prevent complications from developing.
• Surgery: surgery can remove or widen sections of the bowel that are severely affected by Crohn’s disease². A stoma (an artificial opening in the stomach that diverts faeces or urine into a bag) is sometimes required if the disease is very severe.

Can changing my diet help with Crohn’s disease?

Diet and food allergies do not cause Crohn’s disease, however, adjusting your diet can help you to manage your symptoms². Some dietary changes that may assist include:

• Low-fibre diet: most people find that a bland, low-fibre diet helps to ease cramping and diarrhoea
• Low-fat diet: those with difficulty digesting fats may benefit from a low-fat diet
• Low-lactose diet: some people with Crohn’s disease lack the enzyme lactase, which breaks down the milk sugar lactose
• Liquid diet: a person with severe Crohn’s disease may need a nutritionally balanced liquid diet
• Plenty of water: people with Crohn’s disease should drink plenty of fluids to prevent dehydration

What’s the difference between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)?

Inflammatory bowel disease (IBD) is different from irritable bowel syndrome (IBS). People with IBD may also have IBS, but they are two separate conditions.

• IBD is an autoimmune disorder where the immune system mistakenly attacks your own body tissues¹ – in the case of Crohn’s disease, your gastrointestinal tract.

• IBS does not cause inflammation or damage to the bowel. The digestive system looks normal but doesn’t work as it should¹. Stress, infection and some foods can aggravate the condition.

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Sources:
1. https://www.crohnsandcolitis.com.au/about-crohns-colitis/
2. https://www.healthdirect.gov.au/crohns-disease
3. https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/crohns-disease-and-ulcerative-colitis