Here’s what you need to know about Crohn’s disease symptoms and about some of the useful treatment options available.
What is Crohn’s Disease?
Crohn’s disease is defined as a chronic inflammatory disease affecting the digestive tract, mainly the ileum which is the end part of the small intestine .
Swelling and/or inflammation of the digestive tract caused by CD can result in the frequent emptying of the bowel (Diarrhea).
Chronic CD can result in the buildup of scar tissue in the intestine and create a stricture- this reduces the space for food to move through your digestive tract and cause pains/cramps.
Chrons Disease Symptoms
Chrons Disease is often not easy to diagnose and, these are some of the most common Crohn’s disease symptoms:
- Tenesmus – this means pain when passing a stool
- Really bad smelling stools (no jokes please!)
- Abdominal pain
- Loss of appetite – no interest in food
- Gastrointestinal bleeding
- Fatigue – sometimes chronic fatigue
- Abdominal sounds heard over the intestine like a gurgling or splashing sound
- Unintentional weight loss – goes with the loss of appetite
What causes Crohn’s disease?
The actual cause of Crohn’s disease is still unknown, but there are a number of theories. One theory is that infection by certain bacteria may be the cause of Crohn’s disease but up to now there has been no solid evidence to prove this.
Chrons disease is not contagious and diet may affect Chrons disease symptoms in people with the disease but it is unlikely that diet is actually responsible for Crohn’s disease.
Abnormal Immune Response
Normally, the immune system cells and proteins defend the body against harmful bacteria, viruses, fungi, and other invaders. When the immune system becomes activated, it causes inflammation within the tissues where this occurs.
This is an important mechanism of defense used by the immune system and normally only happens when your body is exposed to harmful invaders.
In people with IBD, the immune system is abnormally activated even when there is no invader.
This causes chronic inflammation and ulceration. The susceptibility to this is inherited and so brothers, sisters, children, and parents of people with IBD are more likely to develop these diseases like Crohn’s disease.
A recent discovery has shown that a gene called NOD2 has been identified as being associated with Crohn’s disease . NOD2 is important in determining how the body deals with some bacterial products. People with mutations of NOD2 are more likely to get Crohn’s disease.
Other risk factors of Crohn’s Disease include:
Chrons Disease in Children
Crohn’s Disease affects many children, in fact, recent statistics show that 20% of all cases of Crohn’s disease are diagnosed in children under the age of 15.
Because children have not fully developed yet, one of the main worries is malnutrition which can lead to stunted growth. Many Children with Crohn’s disease take nutritional supplements to help with this problem.
It is also important to remember that children with Crohn’s disease will also have their own unique problems at this important time of their development.
These include the added physical demands placed on their bodies but also the mental aspect where they won’t quite fit in with other children of the same age as their normal routine will be different.
So it is important for a child with Crohn’s disease to have a very good support network of friends, family, and doctor around them.
Not just your physical health…
Whilst Crohn’s is a physical disease, it affects all aspects of the human condition, including your mental state.
It is important to understand that emotion or stress in no way causes Crohn’s disease, however, anyone who has gone through weeks of the physical symptoms of Crohn’s is most likely very stressed and emotional and it is this that can have an added effect on the well-being of the patient.
Different people show varying emotions when faced with the diagnosis of having Crohn’s disease. Some become very angry while others may even feel relieved to finally have a name for what is wrong with them.
A common side effect of being diagnosed with Crohn’s disease is Depression . Coping with a chronic illness is not easy and it soon dawns on the patient that every corner of their life will be affected in some way by this disease.
Counseling can help as well as speaking to others who also suffer from it, especially those with the illness that are coping well.
A real world or online support group can be useful as well as educating yourself as much as possible about the disease.
Crohn’s disease patients usually learn how to prepare and plan for the events in their daily lives and work around the sometimes potentially embarrassing symptoms of the illness.
It is important to remember that life does go on and your depression will pass with time with the help and support from your friends and family.
Living with Crohn’s disease is a real challenge but it is also possible to live a full and productive life with the right attitude.
Crohn’s Disease FACTS
Here are some quick facts about CD:
- The exact cause of Crohn’s disease is still not yet known.
- Chrons disease is a chronic inflammatory disease of the intestines.
- Chrons disease usually causes you to have ulcers in your small intestine, colon, or both.
- If you have Crohn’s disease in the small intestine it may cause an obstruction of the intestine.
- The symptoms of Crohn’s Disease are abdominal pain, diarrhea, vomiting, fever, and weight loss.
- People with Crohn’s disease often have reddish, tender skin nodules, and inflammation of their joints, spine, eyes, and liver.
- Treatment for people with Crohn’s disease depends on the location and severity of the disease.
- Crohn’s disease treatments include drugs for decreasing inflammation or the immune system, antibiotics, and as a last resort surgery.
- The most common ways to diagnose Crohn’s disease is by barium enema, barium x-ray of the small bowel, and colonoscopy.
Crohn’s Disease and Fistulas
What is a Fistula and what can be done to help?
What is a Fistula?
A fistula is an abnormal growth or tunnel that connects two body cavities, for example, the rectum and the vagina or a fistula can connect a body cavity to the skin, for example connecting the rectum to the outside of the body .
How are Fistulas Created?
One way a fistula may form is from an abscess which is a pocket of pus. This abscess may constantly be filled with body fluids like stools or urine. This then stops the body from healing and ultimately the fistula breaks through to another body cavity, an organ or to the skin.
Crohn’s Disease and Fistulas
Statistically more fistulas are found in people who have Crohn’s disease than with people who have ulcerative colitis and about one in 4 patients who have Crohn’s disease eventually also get fistulas.
Different types of Fistulas:
Most fistulas seem to occur near the anus and the genital area and there are four types of fistulas:
1) Enteroenteric or Enterocolic Fistulas: This type of fistula involves the large or small intestine.
2) Enterocutaneous Fistulas: Are fistulas that go from the intestine to the skin . It is important to note that an enterocutaneous fistula may cause complications in surgery.
3) Enterovaginal Fistulas: go to the vagina.
4) Enterovesicular Fistulas: go to the bladder and often result in urinary tract infections or the passage of gas from the urethra during urination.
What are the symptoms of a Fistula?
The symptoms of fistulas can depend on what type of fistula you have, but generally, they often include pain, fever, tenderness, and itching.
Fistulas may also drain pus or a foul-smelling discharge and may depend on the severity and location of the fistula.
If you have Crohn’s disease or any other form of IBD and you have cause to feel that you may have a fistula , as always it is best to seek out professional medical advice – go see your doctor!
Folic Acid & Chrons Disease in Children
A link between Folic Acid and Crohn’s Disease as well as another form of IBD, Ulcerative Colitis in Children has been found.
Children with either form of IBD have been shown to have low levels of Folic Acid in their blood .
So what does this mean?
Folic acid is vital for the proper functioning of the brain and plays a crucial part in a person’s mental and emotional health.
It helps with the production of DNA and RNA, the body’s genetic material, and is especially important when cells and tissues are growing rapidly, like infancy, adolescence, and pregnancy.
Folic acid also works closely with vitamin B12 to regulate the formation of red blood cells and to help iron function properly in the body.
What is Folic Acid?
Vitamin B9 also called folate or folic acid is one of 8 B vitamins . Folic acid is the synthetic form of B9, found in supplements and fortified foods, while folate occurs naturally in foods.
B vitamins aid the body to convert Carbohydrates into glucose for energy. They also help metabolize fats and protein. Other benefits of B complex vitamins include their ability to help improve your skin, hair, eyes, and liver health. They also improve the functioning of the nervous system.
The researchers from the University of California in San Francisco believe that IBD in children may be different from the IBD that affects adults.
They made this discovery when they measured the folate levels in the blood of 78 children and what they discovered was that nearly half of whom had recently been diagnosed with IBD while the remainder were healthy controls.
Folate levels were nearly 20 percent higher in the IBD group, the researchers found, even though the controls were ingesting around 18 percent more folate from their diet.
Foods rich in Folic acid
Folate is found in many leafy vegetables, for example, spinach, turnip greens, lettuces, dried beans and peas, fortified cereal products, sunflower seeds, and certain other fruits and vegetables are rich sources of folate.
Liver and liver products also contain high amounts of folate, as does baker’s yeast. Some breakfast cereals (ready-to-eat and others) are fortified with 25% to 100% of the recommended dietary allowance (RDA) for folic acid.
Crohn’s Disease Treatments
The Different Treatments available to people who suffer from Crohn’s
There are a number of different ways to treat Crohn’s disease. When most people are first diagnosed with Crohn’s, steroids and other medicines are used to reduce inflammation in their gut.
These are usually administered in pill form and taken through the mouth, but can also be taken as an enema if the lower part of your colon or rectum has the Crohn’s disease.
Steroids used in the treatment of Crohn’s Disease
If your chrons disease symptoms are severe, you may have to be put onto steroids (corticosteroids) for a few weeks . In about 70% of cases, the symptoms will improve within four weeks.
And then as you improve the dosage of steroids you’re given be given will be reduced. Because of the long-term side effects, steroids are not used as a long-term treatment for Crohn’s disease.
Antibiotics and immunosuppressants
If you do not respond well to steroids or 5-aminosalicylate medicines, you may be put onto antibiotics that will help fight the infection caused by the Crohn’s.
Immunosuppressive medicines such as methotrexate, antibody therapy (infliximab), or a combination of these treatments may be used.
5-aminosalicylate medicines & Crohn’s
Again if you do not respond to the steroids, 5-aminosalicylate medicines can be used mainly only with mild cases of Crohn’s disease.
These include sulfasalazine, mesalazine, olsalazine, and balsalazide. These drugs are not always effective and switching back to steroids may be the only option.
Crohn’s Disease Diet
People who have really bad symptoms of Crohn’s disease, and those that cannot be controlled using medicines, may have to follow a really strict diet customized for Crohn’s.
In the majority of cases, people who follow the diet closely show significant improvement after a few weeks and then you can slowly return to a normal diet.
It is thought that some foods, like dairy products, may start the symptoms of Crohn’s disease, but the exact reasons are not yet fully understood.
Crohn’s Disease Surgery
Surgery is only used as the last option with Crohn’s disease patients and the affected part of your gut will be removed.
Crohn’s Disease Treatment Naltrexone
A drug that treats people with addictions could help people with Crohn’s Disease Symptoms.
Now you may think that a drug (Naltrexone) that has been approved for treatment of alcohol and narcotic addiction, is a strange choice for a chrons disease treatment?
A Gastroenterologist at Penn State Milton S. Hershey Medical Center, Jill Smith, M.D says that the drug Naltrexone also seems to reverse the inflammation in the intestines caused by Crohn’s disease and on top of that it also seems to help with the healing of ulcers .
These findings were part of a study she carried out on the effects of a low dose of naltrexone. This study was conducted on Seventeen people who had moderate to severe cases of Crohn’s Disease.
For people suffering from alcohol or narcotic addiction, the usual dosage of naltrexone is 50 mg. The people with Crohn’s disease in the study were only given 4.5 mg that were taken once a day for three months.
Of these patients, 89 percent of them responded to the low-dose medication and 67 percent had their chrons disease symptoms go into remission. The response to the test was that they also said that their quality of life was greatly improved.
What about side effects?
Seven of the Crohn’s disease patients reported sleep disturbance whilst taking the drug. There were also reports of Nausea, hair thinning, blurred vision, irritability, mood swings, and mild disorientation.
Because of the positive results from this study, a larger study is being implemented at the Hershey Center. So there might be some good news ahead for Crohn’s disease sufferers!
Advanced Crohn’s Disease Surgeries
About four out of every five patients with Crohn’s disease are having to undergo some sort of surgery at some point during their lives. It only stands to reason that any advancement in the techniques of Crohn’s disease surgery will make a real difference.
Below are a few examples of some new advancements in surgery related to Crohn’s disease:
Another new innovation in surgery for people with Crohn’s disease is known as Laparoscopic surgery which involves minimally invasive techniques requiring only a small incision and leaves very little external scarring .
Laparoscopic surgery can take longer to perform than conventional surgical techniques but leads to shorter stays in hospital, which not only saves money but also gives them a relief from the long periods of time they usually spend in hospitals.
Those who’ve had a fistula will know how painful and dangerous it can be as it has the potential to cause the contents of your intestines to diverge from the anal canal.
This can often progress to anal incontinence, abscesses and in the most serious cases systemic infection.
There are now certain surgical procedures that can drain the fistula tract but for more difficult lesions there is a new surgical anal plug which is made from grafted porcine tissue and is then placed over the fistula .
This fistula plug then is the catalyst for the growth of fibrotic tissue in the area that will then close off the fistula passage.
The technique of Strictureplasty has completely changed bowel surgery as the technique allows the surgeon to leave the disease affected the length of bowel in place but widen it , which is kind of like letting out the seams on a pant-leg.
This saves bowel tissue while “restructuring” it so that intestinal contents can safely pass through. Before Strictureplasty, surgeons would have to cut out whole sections of bowel affected with Crohn’s disease, shortening the organ which leads to the limiting of the gastrointestinal tract.
6 Tips for a better life with Crohn’s
1) Chew your food to a pulp!
If you have strictures (i.e., narrowed portions of the intestine), it’s important to avoid getting a blockage. One simple thing that can help is to chew your food to a pulp and to discreetly spit out into a napkin anything that cannot be chewed to a pulp.
2) Overcome fatigue
A large percentage of Crohn’s patients experience fatigue. Exercise can help improve stamina, strengthen bones and muscles, and elevate mood (thanks to the endorphin rush).
The key to regular exercise is to develop a routine, and you may want to leave yourself a daily reminder to exercise.
Having home exercise equipment will make it easier to exercise when you’re short on time. Supplements and diet also can help battle fatigue.
People with Crohn’s can be deficient in vitamin B-12, and vitamin B-12 deficiency can contribute to fatigue, so start taking your daily dose.
It’s best to avoid coffee because it can be pro-inflammatory, and if you want, you can get a caffeine boost from green tea (including a lightly-caffeinated green tea extract supplement).
Sugars and other simple carbs also contribute to fatigue, so try to avoid them as much as possible during the day.
Of course, getting a good night’s sleep can also help prevent fatigue.
3) Minimize stress.
Many Crohn’s patients find that stress exacerbates their symptoms. Make it a high priority to identify the sources of stress in your life (e.g., work, relationships, health), and brainstorm ways to minimize your stress.
There are many self-help books that are useful, and therapy can also be quite helpful. For many, anti-anxiety medication can also do wonders (and can improve sleep, as well).
The bottom line is that you should not just accept stress (especially high levels of stress) as a normal part of your life — take steps to minimize your stress.
4) Be kind to your bottom.
Many Crohn’s patients have fissures and find it very painful to have a bowel movement.
Lubricating the irritated area with Vaseline immediately in advance of the bowel movement can make the experience much less painful and can help avoid further irritation (allowing the area to heal).
In addition, the use of flushable wet wipes instead of toilet paper is also helpful for cleaning the area thoroughly without causing irritation. Both Vaseline and flushable wipes can be purchased in travel-friendly sizes.
5) Strive for bathroom regularity.
Crohn’s patients typically are plagued with bathroom irregularity. Eating a bowl of oatmeal each morning can help with that. If oatmeal doesn’t work for you, try experimenting with other food items until you find something that works for you.
For constipation, external stimulation of your intestine via heating pads and gentle manual pressure (i.e., massaging your belly) can also help to get things moving along, and (in a pinch) laxatives may be of help.
6) Protect your immune system.
Crohn’s patients may start out with a weakened immune system or might develop a weakened immune system as a side effect of the medication.
It is important to take this into account. For example, people experience a dip in their immune system when they are tired.
It is therefore important for Crohn’s patients to get adequate rest and not to push themselves too hard to work through fatigue. Air travel can be taxing even to a strong immune system, and so Crohn’s patients should take precautions when traveling.
For example, when possible, travel in the morning when fully rested, rather at the end of a long day. And try not to travel two days in a row; rather, give your immune system a chance to bounce back.
There is an interesting and discrete (albeit unusual) product — nasal filters — that can help minimize the number of germs inhaled during a flight.
There are some reports that vitamin C may also be helpful. There is also some truth to the old wives’ tale — you can catch a cold if you let your body get cold, so bundle up when the temperatures drop.
How do you cope with Crohn’s?
Please share your experience and tips in the comments below.