Crohn's Disease for Patients

Crohn’s disease is a type of inflammatory bowel disease (IBD) in which your immune system recognizes the lining of your intestine as foreign. This causes the immune system to attack the intestinal epithelium, causing inflammation. Crohn’s disease usually follows a pattern of repeating cycles of intermittent flares in which the condition worsens and symptoms are present, and then a period of remission in which inflammation is controlled, and symptoms are absent. The symptoms can range from mild to severe and can be disabling.

Signs and Symptoms:

• Abdominal pain

• Diarrhea

• Fatigue

• Unintentional weight loss

• Anal pain

• Arthritis: Typically in the larger joints and is most active when bowel symptoms are active.

• Mouth sores: Usually found between the gums and lower lip, or along the sides of the tongue.

• Eye inflammation (uveitis or scleritis): Can cause eye pain, blurry vision, and sensitivity to light.

Diagnosis: Crohn’s disease is confirmed through an intestinal biopsy. The specimen is studied microscopically for specific histological features, namely clusters of inflammatory cells called granulomas.

Treatment: The first step of treatment is to manage Crohn’s with medications. Anti-inflammatory medications (e.g. corticosteroids, 5-aminosalicylates, sulfasalazine), can help to counteract and prevent inflammation. Immunomodulators (e.g. azathioprine, methotrexate, and 6-mercaptopurine), as well as biologic response modifiers, (infliximab, adalimumab, certolizumab), can reduce the immune response to attack the intestines. 

If medications are not able to control symptoms, or complications arise from Crohn’s disease, such as fistulas, strictures, or obstructions, surgery may be recommended. Surgery may result in massive resection and short bowel syndrome. In this case, an intestinal transplant evaluation may be warranted.