Crohn's Disease

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What Is Crohn's Disease?

Crohn’s disease is a condition that causes inflammation in your gastrointestinal (GI) tract. Your GI tract is the system of organs that help you eat and digest food. Crohn’s disease is a chronic (ongoing) type of inflammatory bowel disease (IBD) that can cause abdominal pain, diarrhea, and rectal bleeding.

People with Crohn’s disease tend to have flare-ups (periods of severe symptoms) followed by remissions (periods of little to no symptoms). Treatment can help lessen or eliminate how often you experience flare-ups.  

Types of Crohn’s Disease

Gastrointestinal specialists (gastroenterologists) classify the type of Crohn’s disease based on what part of your digestive tract the condition affects:

  • Crohn’s colitis affects only your large intestine (colon).
  • Gastroduodenal Crohn’s disease affects the first part of your small intestine and your stomach.
  • Ileitis affects the lower portion of your small intestine.
  • Ileocolitis affects your colon and the end of your small intestine.
  • Jejunoileitis causes patches of inflammation in the middle and lower portion of your small intestine.

These types of Crohn's disease are also based on complications such as strictures (narrowing of the intestine) and fistulas (abnormal connection between the bowel and other organs or the skin).

Crohn’s Disease Symptoms

The type of Crohn’s disease you have can affect what symptoms you experience. Your gastroenterologist can help you understand what symptoms you’re more likely to have based on your diagnosis. In general, Crohn’s disease may cause a range of symptoms:

  • Blood in your stool
  • Diarrhea
  • Fatigue
  • Rectal bleeding
  • Stomach pain
  • Weight loss

Crohn’s Disease Symptoms Outside the GI Tract

Crohn’s disease can also cause symptoms affecting parts of your body outside the digestive tract:

  • Joint pain during flare-ups
  • Ulcers (sores) inside your mouth and on your skin
  • Painful skin nodules (raised bumps)
  • Inflammation in the spine
  • Eye inflammation
  • Inflammation in the liver
  • Nutritional deficiencies

You may develop sores around the anus as well. These sores can be open wounds, small tears in your skin (anal fissures), or irregular connections in your intestinal walls (anal fistulas). The sores may be painful, red, or swollen.

When to See a GI Specialist

You should see a gastroenterologist if you experience any symptoms of Crohn’s disease or notice changes in your bowel habits. For example, you may suddenly notice differences in the color, consistency, frequency of, or control over your bowel movements. A GI specialist can evaluate you for Crohn’s disease and offer treatments to help you find relief.

Crohn’s Disease Complications

In severe cases, Crohn’s disease can lead to complications:

  • Abscesses (pus-filled pockets in your GI tract)
  • Bowel obstruction (blockage that stops bowel movements)
  • Colon cancer
  • Malnutrition

Crohn’s Disease Causes

Researchers don’t know exactly what causes Crohn’s disease. But people with certain genes are more likely to experience an irregular immune response that causes symptoms. More than 240 genes have been linked to Crohn’s disease, so there isn’t one genetic test to determine whether have the condition.

There’s no way to prevent Crohn’s disease. But learning and avoiding your triggers can help you manage flare-ups.

Crohn’s Disease Risk Factors

There are a few factors that increase your risk of Crohn’s disease:

  • Age—Most people with Crohn’s disease are diagnosed before age 30.
  • Ethnicity—Crohn’s disease is most common among white people, especially those of Ashkenazi Jewish descent. However, Crohn’s disease is becoming more common in other populations.
  • Family history—You’re more likely to have Crohn’s disease if your parent, sibling, or child has it.
  • Medication—Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your chances of Crohn’s disease.
  • Smoking—Cigarette smoking increases your risk of Crohn’s disease and makes management more difficult.

How to Test for Crohn’s Disease

Your gastroenterologist uses one or more tests to help diagnose Crohn’s disease:

  • Blood tests—These tests check for anemia (low red blood cell count), infection, or signs of inflammation.
  • Stool tests—You will provide a stool sample for analysis. A stool test can help rule out other causes of digestive symptoms.
  • Colonoscopy—In this procedure, your gastroenterologist will insert a flexible, thin tube with a light and camera (colonoscope) into your rectum. The light and camera on the colonoscope allow them to examine your colon and lower small intestine for inflammation. They may also take a small tissue sample (biopsy) for testing.
  • Imaging tests—You may have a CT scan or MRI to create an image of your bowel. Your gastroenterologist may have you drink a liquid that contains contrast dye. This dye helps your bowel show up more clearly on the imaging scan.
  • Upper endoscopy—Your gastroenterologist will insert a thin tube (endoscope) through your esophagus (tube connecting your throat and stomach) and into your stomach and the first portion of your small intestine. The endoscope has a camera and light that allows examination of your upper GI tract.
  • Capsule endoscopy—You will swallow a small capsule that contains a tiny camera. As the capsule moves through your digestive system, it sends pictures of your GI tract to a small, wearable device. Your gastroenterologist will download and review the images from the device. The capsule leaves your body safely during a bowel movement.

Crohn’s Disease Treatment

There’s no cure or way to prevent Crohn’s disease, but treatment can significantly reduce your flare-ups. The goal is to reduce inflammation so that you experience longer periods of remission, fewer symptoms, and a reduced risk of complications. The goals of treatment are sequential:

  1. Reduce symptoms.
  2. Reduce inflammation.
  3. Heal the bowel.
  4. Obtain a normal quality of life.
  5. Prevent complications.

Crohn’s Disease Medication

Crohn’s disease treatment will usually start with medication. Your gastroenterologist may prescribe a number of medications:

  • Corticosteroids to lower inflammation
  • Immunosuppressants to help your immune system stop attacking healthy tissues
  • Biologics to target proteins your immune system makes that can stimulate inflammation
  • Antibiotics to treat abscesses (infections) or fistulas
  • Antidiarrheals to help reduce diarrhea
  • Pain relievers, such as acetaminophen, to relieve discomfort

Bowel Rest

Your gastroenterologist may instruct you to consume certain liquids for several days without eating or drinking anything else. This helps rest and heal your bowels.

You may complete bowel rest at home, or you may stay in the hospital during treatment. In some cases, you may need a feeding tube or IV (intravenous line) to get the nutrients you need.

Surgery for Crohn’s Disease

If other treatments for Crohn’s disease don’t control your symptoms or if you have certain complications, your gastroenterologist may recommend surgery. Surgery doesn’t cure Crohn’s disease but can reduce your symptoms and lower your risk of further complications.

Surgery for Crohn’s disease may include the following procedures:

  • Small bowel resection—Your surgeon will remove a portion of your small intestine. You may need a small bowel resection to treat an intestinal blockage or to reduce severe symptoms.
  • Large bowel resection—Your surgeon will remove part of your large intestine. You may need this surgery to treat a fistula, bowel obstruction, or severe Crohn’s symptoms.
  • Proctocolectomy and ileostomy—Your surgeon will remove all of your colon and rectum in a proctocolectomy. Then they will perform an ileostomy, bringing the end of your small intestine through a hole in your abdomen. You will wear a pouch outside your body to collect stool from the small intestine. Surgeons reserve this treatment for very severe cases or complications of Crohn’s disease.

What Triggers Crohn’s Disease Flare-Ups?

You could have one or several triggers that cause flare-ups. But you can lessen their impact or avoid some of the most common triggers. 

  • Avoid or limit your consumption of caffeine, alcohol, and carbonated beverages.
  • Drink plenty of water and other hydrating liquids.
  • Keep a food diary to identify specific dietary triggers.
  • Eat a high-fiber diet that is low in sugar, fast food, and processed foods.
  • Consume red meat in moderation.
  • Manage stress with healthy coping techniques.

  • Quit smoking.

Why Choose the IBD Clinic at University of Utah Health?

Our inflammatory bowel disease (IBD) clinic in Gastroenterology Services includes regional and national experts in ulcerative colitis and Crohn’s disease. Physicians throughout the Mountain West region trust our expertise and refer patients with complex needs to our team. We offer the most advanced diagnostic tools and treatments, including clinical trials.

We are a team of gastroenterologists, IBD-trained nurse practitioners and physician assistants, colorectal surgeons, specialized IBD nurse coordinators, dietitians, pharmacists, and IBD research coordinators. There is a lot to know about Crohn’s disease, and we are here to help.

Find a Crohn's Disease Specialist

Schedule an Appointment

You don’t need a referral to schedule an appointment with a gastroenterologist, but it is preferred. You or your referring provider may call 801-213-9797 to request an appointment with our GI Clinic, or you may request an appointment online. We will need medical records and surgical reports from any previous treatments you have had for your condition.