What Is Chrohn's Disease?

Crohn's disease is a chronic gastrointestinal disorder, or inflammatory bowel disease, that can affect you anywhere between your mouth and anus. It's most commonly involving the lowest end of the small intestine, which is called the ileum. With Crohn's disease, your immune system acts inappropriately, attacking the bacteria that is normally present in your intestines as if it is a foreign substance. It sends white blood cells to your intestines, causing inflammation. The inflammation eventually leads to ulcers, which cause bleeding.

Causes

• According to the National Institute of Diabetes and Digestive and Kidney Diseases, the cause of Crohn's disease is not known. There are some theories, but they are speculative. It's not certain whether the cause is inherited from genes, foreign substances in the environment or from a problem in the immune system. The theory regarding the immune system involves the production of an anti-tumor necrosis factor (TNF) protein that may be the cause of the inflammation.

Symptoms

• Symptoms include abdominal pain, usually in your lower right quadrant, frequent diarrhea, weight loss, rectal bleeding, fatigue, arthritis, skin disorders and fever. In some cases the bleeding can be persistent enough to lead to anemia. Delayed development may occur in children with Crohn's disease. During flares of the disease, you may experience fissures (tears) of your anus. Another complication is fistulas, which are tunnels that may connect one loop of your intestine to another or to another organ, such as your bladder, vagina or skin. Bowel obstruction is a complication that can be life-threatening and may require surgery.

Diagnosis

• Crohn's disease is sometimes difficult to diagnose and a series of tests are needed. Blood tests can indicate anemia and the presence of a high level of white blood cells. An upper GI (gastrointestinal) series may be ordered. For the upper GI you drink a barium solution and x-rays are taken to show abnormalities. A colonoscopy, where the doctor examines your colon, may show inflammation or bleeding. Your doctor can also take biopsies during a colonscopy for examination of the tissue. A capsule endoscopy is sometimes performed, where you swallow a pill that contains a camera. It takes images as it works its way through your digestive system.

Treatment

• Treatment may involve a number of classes of medications including antibiotics, anti-inflammatory drugs (sulfasalazine or mesalamine), corticosteroids (prednisone), immune modifiers (azathioprine or methotrexate), and in some cases, antibiotics. According to the Crohn's and Colitis Foundation of America, the FDA approved the use of infliximab in 1998. Infliximab (Remicade) is the first biologic therapy for Crohn's. It is used for cases where the patient has not responded well to conventional treatments. Other biologic therapy drugs include adalimumab (Humira), natalizumab (Tysabri) and certolizumab pegol (Cimzia). Anti-diarrhea medications, fluid replacements and nutritional supplements may also be used to treat Crohn's.

Surgery

• Surgery sometimes becomes necessary to relieve symptoms or to treat complications such as perforation, obstruction, abscess or bleeding. Removal of the diseased portion of your intestine may offer you some relief but does not cure the disease. Inflammation may return to the area where your surgery took place and subsequent surgeries are not uncommon. According to the National Institute of Diabetes and Digestive and Kidney Diseases, "two-thirds to three-quarters of patients with Crohn's disease will require surgery at some point in their lives."