Diagnosis

There is no single test that is used to diagnose Crohn’s disease.

Patients with suspected Crohn’s Disease are evaluated to exclude other causes of their symptoms, to confirm the diagnosis and severity of Crohn’s Disease.

A combination of tests is used to help confirm a diagnosis of Crohn’s disease, including:

Lab Tests

Blood and stool tests: These tests are not used to make the diagnosis of Crohn’s Disease. These tests rule out other causes of patient symptoms.

Endoscopy

Colonoscopy: This procedure allows a doctor to view the entire colon and the last part of the small intestines using a thin, flexible, lighted tube with a camera at the end.

During the procedure biopsies can be taken for histological analysis, which will aide in making the diagnosis.

Balloon-assisted enteroscopy: This specialised type of endoscopy enables the doctor to look further into the small bowel, which is useful in small bowel Crohn’s Disease.

It is also useful when capsule endoscopy is abnormal, but the diagnosis is still in question.

Small Bowel Imaging

Small Bowel Imaging is ideally performed to help visualise the small bowel disease distribution and extent. An MRI or CT scan can be performed, depending on the availability and expertise.

Capsule Endoscopy

In rare cases, this test may be performed. The patient swallows a capsule that has a camera in it. The camera takes pictures of the small intestine and transmits them to a recorder.

The images are then downloaded to a computer, displayed on a monitor, and checked for Crohn’s disease. This test should not be performed if there is suspicion of an intestinal stricture.

Treatment of Crohn’s Disease

There is currently no cure for Crohn’s disease and there is no single treatment that works for everyone.

Medical treatment is used to reduce inflammation, thereby limiting long term complications, and improving prognosis.

Goals of Treatment

There are a variety of treatments available today for Crohn’s.

The location and severity of your disease, accompanying complications and your response to previous treatment will all influence your Gastroenterologist’s choice of therapy.

There are several important goals of treatment:

• Induce and maintain remission (prevent future flare-ups)
• Heal mucosa (the lining of the intestine)
• Restore and maintain nutrition
• Maintain quality of life as it relates to Crohn’s
• Select optimal timing for those requiring surgical intervention. 

Treatment Options for Crohn’s Disease

Currently available treatments for Crohn’s include:

• Anti-Inflammatory Medication: Some patients, who have Crohn’s Disease, will receive one or more different types of drugs to help control inflammation, depending on the site of their disease. These may include aminosalisylates, such as sulfasalazine and, or corticosteroids.

• Immunosuppressive Medication: These drugs block the body’s immune response, which leads to the inflammatory process. Immunosuppressive medications used to treat Crohn’s include azathioprine, 6-mercaptopurine, methotrexate and, in rare cases, cyclosporine.

• Biologics: The Biologics Infliximab, Adalimumab, Vedolizumab and Ustekinumab are currently registered in South Africa for the treatment of Crohn’s Disease. They are the latest form of therapy for the treatment of Crohn’s disease. See if you qualify for a Clinical Trial here.

• Nutritional Supplements: Nutritional supplements are helpful for people who lose calories and nutrients from diarrhoea or decreased appetite. Supplements can help fuel the body and replenish iron, calcium, other minerals, and vitamins.

• Surgery: If other treatments do not effectively control symptoms and the disease, your Gastroenterologist may recommend surgery.

Other Medications

• In addition to controlling inflammation, some medications may help relieve symptoms. Depending on the severity of the disease your Doctor may prescribe other medication also.

Because of the unpredictability of Crohn’s Disease, you will need medical care for as long as your Gastroenterologist deems necessary, with regular office visits to monitor your condition.

Whatever medications you have been prescribed; it is important to maintain your healthcare regimen even when you’re not suffering from symptoms as this will reduce the risk of future flare-ups.

Lifestyle

Sometimes you may feel helpless when facing Crohn’s disease but changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.

Diet

There is no firm evidence that what you eat causes inflammatory bowel disease, but certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up. A dietician can be consulted if this is the case.

Smoking

Smoking increases your risk of developing Crohn’s disease, and once you have it, smoking can make it worse.

People with Crohn’s disease who smoke are more likely to have relapses and need medications and repeat surgeries.

Stress

Although stress does not cause Crohn’s disease, it can make your signs and symptoms worse and may trigger flare-ups.

Although it is not always possible to avoid stress, you can learn ways to help manage it.

Coping and Support

Crohn’s disease does not just affect you physically – it takes an emotional toll as well. If signs and symptoms are severe, your life may revolve around a constant need to run to the toilet.

Even if your symptoms are mild, gas and abdominal pain can make it difficult to be out in public.  All these factors can alter your life and may lead to depression.

Here are some things you can do:

Be Informed

One of the best ways to be more in control is to find out as much as possible about Crohn’s disease.

Join a Support Group

These can provide valuable information about your condition as well as emotional support.

Group members frequently know about the latest medical treatments or integrative therapies. You may also find it reassuring to be among others with Crohn’s disease.

Talk to a Therapist

Some people find it helpful to consult a mental health professional who is familiar with inflammatory bowel disease and the emotional difficulties it can cause.

Spoke Research is currently recruiting for an Ulcerative Colitis trial – Apply Here