The Best Ways to Manage Various Types of Crohn’s Disease

Crohn’s disease is an inflammatory bowel disease. It causes chronic inflammation of the digestive tract. As per a report, it is the most prevalent in Germany and Canada. It affects about 322 out of every 100,000 people in Germany. Whereas in Canada, 319 out of every 100,000 are suffering from it. Crohn’s disease can occur in any part from the mouth to the anus. It appears in patches and can penetrate up to multiple layers in the digestive tract. It is an immune-related disease and most commonly affects the small intestine and the beginning part of the large intestine. There are five types of Crohn’s disease, classified according to the area affected. 

A person may suffer from one or more types of Crohn’s disease. Its treatment varies with the type and severity of the disease. Lifestyle changes, medications, and surgeries can help to manage it. However, research is still going on to find a complete cure. Crohn’s disease follows a cycle of remission and relapse, where symptoms are controlled and flare at other times. As a result, it is essential to know all about it. 

Types of Crohn’s Disease

There are five types of Crohn’s disease. Each has its unique symptoms, which are as follows.

1. Ileocolitis

Ileocolitis is the most common form of Crohn’s disease. It affects the end of the small intestine, known as the terminal ileum, and the large intestine, also called the colon. Around 50% of people with Crohn’s disease are diagnosed with ileocolitis. It is a life-long chronic condition.

Symptoms

• Diarrhoea
• Cramps
• Pain in the lower right or middle abdominal region
• Considerable weight loss
• Fatigue

2. Ileitis

It affects the final part of the small intestine, known as the ileum. It plays an essential role in absorbing vitamin B12 and salts. In severe cases, ileitis may lead to fistulas in the lower right side of the abdomen. Many conditions can cause ileitis, Crohn’s disease being the most common.

Symptoms

• Diarrhoea
• Cramps
• Fistulas
• Considerable weight loss
• Cramping or pain in the abdomen

3. Gastroduodenal Crohn’s Disease

It affects the stomach and the initial part of the small intestine called the duodenum. Gastroduodenal Crohn’s disease is not common – only up to around 5% of people with Crohn’s disease have the condition. 

Symptoms

• Nausea
• Vomiting
• Weight loss
• Loss of appetite

4. Jejunoileitis 

Jejunoileitis causes inflammation in the jejunum (the upper half of the small intestine). It is relatively uncommon and majorly affects the children. 

Symptoms

• Diarrhoea
• Cramps after meals
• Anaemia
• Abdominal pain (this may be very intense)
• Formation of fistulas

5. Crohn’s (granulomatous) Colitis

The word ‘colitis’ means inflammation of the colon lining. Crohn’s Colitis affects the colon part of the large intestine and accounts for around 20% of Crohn’s disease cases. 

Symptoms

• Skin lesions
• Diarrhoea
• Joint pain
• Rectal bleeding

Complications of Crohn’s Disease

1. Fistula

The longer you have Crohn’s disease, the more likely you will develop a fistula. About one in three people with Crohn’s disease will probably generate a fistula. When an ulcer extends entirely through the intestinal wall, it forms an abnormal passage between different body parts. Such a passage is called a fistula. It can form between skin and intestine or between the intestine and another organ. Perianal fistulas are most common.

2. Abscess

An abscess is a pocket of pus caused by a bacterial infection. It can form in the intestinal wall, sometimes causing it to bulge out. Sometimes a fistula may become infected and form an abscess. It may be life-threatening if not treated.

3. Strictures

Scar tissues are a result of long periods of inflammation. Strictures happen when scar tissue builds in the large or small intestine wall. Strictures can cause the colon to become blocked, either partially or entirely, disrupting the movement of food or stool through the intestines. As a result, it leads to constipation or obstipation (complete block of the intestine). It might require surgical intervention when severe to release the blockage.

4. Colon Cancer

Bowel cancer is colon or rectal cancer, depending on where the cancer starts. For example, there may be an increased risk of developing cancer if you have Crohn’s colitis. In addition, the risk increases with the length of time Crohn’s disease is present.

Possible Causes of Crohn’s Disease

A report suggests that immune dysregulation could be a possible cause of Crohn’s disease. Here, a bacteria or virus triggers the immune response. The immune system attacks not just the invading microorganism but also cells in the digestive tract. It leads to the development of Crohn’s disease. Research is still going on to identify the trigger and other factors that contribute to the development of Crohn’s disease.

Risk Factors of Crohn’s Disease

Age

Crohn’s disease can occur at any age. However, a study suggests that 25% of patients get it by 20. Most patients get a diagnosis by the age of 30.

Ethnicity

Research suggests that the prevalence of Crohn’s disease is highest in white people of Europe and North America. However, the cases of Crohn’s disease in African Americans and Asians have been steadily rising over the past decades.

Family history

People who have a first-degree relative, such as a parent, sibling, or child having Crohn’s disease, have a higher risk. As many as 20% of patients have close relatives suffering from it. Moreover, its risk becomes substantially higher if both parents suffer from it. 

Smoking

Research suggests that smoking increases the risk of Crohn’s disease by more than 200%. In addition, smoking worsens the condition and increases the likelihood of requiring surgery. 

Environmental factors

People in developed countries and urban cities have a higher risk of Crohn’s disease. It is also more common in northern climates than in southern climates.

Diet

People who consume high amounts of fat, omega-6 fatty acids, polyunsaturated fatty acids, and meat in their diet are at higher risk. 

Medications

Consumption of oral contraceptive pills is associated with a higher risk of Crohn’s disease. In addition, nonsteroidal anti-inflammatory medicines can lead to bowel inflammation, triggering Crohn’s disease.

Methods to Diagnose Crohn’s Disease

Crohn’s disease can be hard to diagnose due to its multiple types and similar conditions. A doctor will examine a person’s medical history and existing symptoms. Accordingly, he may prescribe several tests to identify the disease.

Lab tests

• Blood test: It reveals blood counts and helps to check for infections.
• Stool test: It is helpful to find out the presence of microorganisms.

Imaging tests

• MRI: Magnetic resonance imaging or MRI provides detailed images of organs and tissues. It can check for fistulas.
• CT scan: It uses x-rays to provide detailed images of internal organs. It can check the entire bowel as well as tissues outside it.

Endoscopy

• Balloon-assisted enteroscopy: It uses an endoscope along with an overture. It has a tiny camera that could provide a detailed image of the small bowel.
• Capsule endoscopy: It requires swallowing a pill-sized camera. It clicks pictures of the small intestine and transmits them to a recorder. Finally, it exits painlessly on a stool.
• Upper endoscopy uses a lighted tube that provides a detailed view from the oesophagus to the duodenum.
• Colonoscopy: A lighted tube passes through the anus, which helps examine the colon.

Natural Measures to Manage Crohn’s Disease

Modify diet

A patient needs to identify what triggers their flare-ups. It may vary from person to person. Also, it is ideal to consult a dietician as they can help ensure that a person gets sufficient nutrients while avoiding triggering foods. Moreover, it is essential to maintain a proper diet in remission too. Some dietary changes that may help improve symptoms are:

• Limit dairy products: Limiting the consumption of dairy products can help alleviate symptoms such as diarrhoea, abdominal pain, and gas.
• Multiple small meals: It is ideal for eating 5-6 small meals instead of three large meals.
• Keep a check on fluid intake: Drink plenty of water every day. Do not use a straw as you may ingest air by doing so. Avoid caffeinated and carbonated beverages. These can worsen diarrhoea and produce gas.
• Simple meals: As per studies, it is better to eat boiled, grilled, steamed, or poached food.
• Maintain a food journal: It is ideal for checking on foods a person eats and if it causes any symptoms.
• Foods to eat: Include low fibre fruits, lean protein, refined grains, seedless & skinless, non-cruciferous vegetables, etc.
• Foods to avoid: It is advisable to avoid high-fat foods, sugary foods, insoluble fibre, spicy foods, lactose, etc.
• Include Herbs and oils: Herbs such as wormwood, thunder god vine, turmeric, aloe vera, etc., may help reduce symptoms of Crohn’s disease.
• Oils: Oils such as fish oil, lavender oil, peppermint oil, etc., can help reduce inflammation.

Lifestyle Improvements

• Manage stress: Although stress does not cause Crohn’s disease, it can worsen symptoms. Also, it can trigger flare-ups. Therefore, it is advisable to manage stress. Techniques such as breathing exercises, yoga, and biofeedback may be helpful.
• Exercise: Exercise and yoga help reduce stress and regulate bowel function. They can be beneficial to managing Crohn’s disease.
• Quit smoking: Smoking increases the risk of Crohn’s disease. Moreover, it can worsen the symptoms in a patient. However, quitting smoking can have numerous benefits. Also, it may improve digestive health.
• Probiotics and prebiotics: Probiotics and prebiotics promote the growth of good bacteria in the gut. Thus, they help in restoring the natural balance in Crohn’s patients. These include yoghurt, sauerkraut, bananas, artichokes, etc.
• Bowel rest: It is the practice of switching to a liquid diet that helps the digestive system reset. It can last from a couple of days to a few weeks. It is especially beneficial for flare-ups. Doctors’ guidance will ensure that you get all the necessary nutrients.
• Acupuncture: A study suggests that acupuncture and moxibustion may provide therapeutic benefits to the patient. Research is still evaluating its effectiveness in treating Crohn’s disease.

Medical Treatments for Crohn’s Disease

Medications

• Anti-inflammatory drugs: These are the first step in the treatment. These include corticosteroids, 5-aminosalicylates, etc.
• Immune system modifiers: They reduce inflammation by targeting the immune system. These include azathioprine, methotrexate, etc.
• Biologics: Medicines such as natalizumab, vedolizumab, ustekinumab, etc., are used to target the proteins made by the immune system.
• Antibiotics: They help with fistulas and abscesses. They can also reduce harmful bacteria in the intestines. These include ciprofloxacin, metronidazole, etc.
• Other medications: Other medications may include anti-diarrheals, pain relievers, vitamins, supplements, etc.

Surgery

• Resection and Anastomosis: The treatment eliminates the diseased part of the bowel and joins two healthy ends. However, the condition can reoccur after a few years.
• Ileostomy: It is for the diseased rectum. It creates an opening in the skin that discharges waste products.

The Bottomline

Crohn’s disease is a condition that affects the digestive tract. It causes inflammation and can even lead to erosion of digestive parts such as the intestines and bowel. It can vary from mild to severe. Also, it can become life-threatening if not treated on time. Environmental and genetic factors are significant contributors to its development. It can have periods of flare-ups and remission. Accordingly, a person may require modifications in their diets, treatments, etc. It adversely affects the quality of life, but several measures can improve this condition. Apart from medications and surgery, lifestyle and diet changes can also be helpful. But there is no complete cure. Moreover, the state may reoccur even several years after surgery.

Frequently Asked Questions (FAQs)

Q. How do I know if I have celiac or Crohn’s?

A. Celiac and Crohn’s disease both cause inflammation of the intestine. They can have similar symptoms, including abdominal pain, diarrhoea, anaemia, etc. However, these are different conditions with varying complications. Crohn’s disease causes inflammation of the eyes, joints, and bloody stools. If a person is experiencing any symptoms, it is best to consult a doctor. 

Q. What does a Crohn’s flare feel?

A. Crohn’s flare-up may vary from person to person. It can last from a couple of weeks to a few months. It usually causes more severe symptoms like severe diarrhoea, joint pain, abdominal pain, fever, etc. Crohn’s disease is an inflammatory bowel disease, and inflammation can involve different areas of the digestive tract in other people. 

Q. Does Crohn’s make you fart?

A. Crohn’s disease can lead to bacterial overgrowth in the small intestine. As these bacteria break down food, they may produce gas. Thus, bloating and gas are common symptoms of this condition. A person with Crohn’s disease may feel a swollen tummy or bloated after a meal. Foods with high content of bran fibre may help in this.  

Q. Does Crohn’s disease causes a weakened immune system?

A. Crohn’s is due to a dysfunctional immune system. Moreover, certain medications used in treatment, such as immunosuppressants, further weaken the immune system. Crohn’s disease makes the immune system attack healthy body cells due to abnormal regulation of white blood cells (WBC) in their body. The immune system’s strength also depends upon genetic factors, the severity of the disease, flare-ups, etc. 

Q. Is lupus related to Crohn’s?

A. The simultaneous occurrence of lupus and Crohn’s is infrequent. However, some medications used to treat Crohn’s may lead to drug-induced lupus. Therefore, possibly Crohn’s disease may occur before or after diagnosis of lupus. However, Crohn’s disease presence after (systemic lupus erythematosus) SLE is very rare. 

Q. Can you drink alcohol with Crohn’s disease?

A. It is not advisable to consume alcohol with Crohn’s disease. Alcohol impacts the digestive system and may damage organs like the mouth, throat, oesophagus, or liver. However, a person may consume alcohol occasionally and within reasonable limits if it doesn’t affect their symptoms too much.  

Q. Does Crohn’s get worse with age?

A. Crohn’s is a chronic disease that may or may not be progressive. Over time, the symptoms may worsen, lessen, or change. In addition, it depends on how your body responds to this disease and how strong your immune system is. Therefore, it is vital to take proper treatment and suitable measures to manage this condition. 

Q. What happens if you leave Crohn’s untreated?

A. If Crohn’s is left untreated, it can spread throughout the intestinal tract, worsening symptoms. It can lead to multiple complications, hospitalisation, decreased quality of work, etc. In addition, if Crohn’s in the large intestine is left untreated, it can cause colon cancer (in rare cases).  

Q. What foods trigger Crohn’s disease?

A. Alcohol, caffeinated beverages, carbonated beverages, high-fat foods, sugary foods, foods rich in insoluble fibre, corn, butter, mayonnaise, raw vegetables, red meat, pork, etc., are some foods that can act as a trigger. Especially carbonated beverages and dairy products must be avoided as these can worsen the condition. 

Q. Are all Crohn’s patients skinny?

A. Loss of appetite and weight loss are among the common symptoms of Crohn’s disease. A study suggests that as many as 57% of patients witness considerable weight loss before diagnosis. Also, it makes gaining weight more difficult.