Crohn’s disease, sometimes called regional enteritis or ileitis, is a type of inflammatory bowel disease (IBD).

Crohn’s is a chronic condition that causes parts of the intestine (bowel) to swell up, specifically the small and large intestines.

As a chronic condition, the symptoms will need to be managed for the rest of your life, and while they can go into remission you may suffer flare-ups over the years.

Signs You May Be Suffering from Crohn’s Disease

To understand whether you may be suffering from an IBD such as Crohn’s Disease, it is necessary to look at the causes, signs and symptoms you are experiencing in order to reach a diagnosis.

What Causes Crohn’s Disease?

Despite extensive research, experts still are not entirely sure what causes Crohn’s disease.

Advances in medical research in recent years have been made in many diagnostic areas, specifically genetics.

The new information available suggests that Crohn’s Disease is likely caused by a combination of factors which could include viruses, bacteria, diet, smoking, certain medications, and stress.

There is no hard evidence available to confirm any of these possible causes, and you may like to help with furthering these studies by taking part in one of our clinical trials by clicking here. 

Are There Different Types of Crohn’s Disease?

Crohn’s can be divided up into types based on where in the GI tract the inflammation occurs.

Ileocolitis – end of the small intestine (terminal ileum) and the large intestine (colon)

Ileitis – end of the small intestine (terminal ileum)

Gastroduodenal Crohn’s Disease – stomach and the beginning of the small intestine (duodenum)

Jejunoileitis – areas of inflammation in the upper half of the small intestine (jejunum)

Crohn’s (Granulomatous) Colitis – large intestine (colon)

How is Crohn’s Disease Diagnosed?

Crohn’s disease is diagnosed by a process of elimination, meaning your physician will start with the least invasive tests possible and then progress towards more invasive testing until a clear diagnosis is attained.

Although the causes of Crohn’s are unknown, it is clear that it is often hereditary, so if you have any family history of gastrointestinal problems, it’s recommended to share this with your doctor at your first consultation.

There are a variety of testing options to reach a diagnosis:

Blood Tests/Stool Tests

These are used predominantly to exclude other potential illnesses but do not offer specific Crohn’s indicators.

Colonoscopy

A colonoscopy is a detailed visual examination of the inside of your large bowel, including your rectum using a small camera on a lighted flexible tube, inserted through the anus.

Upper Gastrointestinal (GI) Series

An upper GI series requires you to drink a barium solution that shows up on X-rays to reveal hard-to-reach places in the small intestine, as well as to highlight ulcers and fistulas.

Endoscopy

An endoscopy allows your GI to get a better visual image of the inside of your upper gastrointestinal tract. This can include your stomach, oesophagus, and upper part of the small intestine (duodenum) and is viewed by inserting a thin flexible camera down the oesophagus.

Imaging Tests

Imaging tests like CT scans and an MRI allows for in-depth analysis of specific areas of your tissues and organs that would not be accessible on a normal X-ray.

Once you have been diagnosed with Crohn’s disease, your GI will determine the stage of your disease as well.

This allows for tailored medical assistance based on your needs at each stage of the disease.

Managing Flare-ups

Flare-ups are bound to happen throughout your lifetime, no matter how well you manage your symptoms.

What causes Flare-ups?

As with the unfortunate reality of not knowing what causes Crohn’s disease, to begin with, it is difficult to pinpoint the reasons that one might experience a flare-up.

Typically if you are on a healthcare regimen provided by your GI, the main reason people experience flare-ups is nonadherence to their prescribed medications.

This will seriously disrupt your gut stability and could leave you experiencing severe symptoms.

Symptoms of Crohn’s Disease

Symptoms of Crohn’s Disease can range from mild to severe and will vary over time, based on whether you’re experiencing a flare-up or are heading for remission.

Typically, when these symptoms do present, it develops slowly, however they can occasionally come on more suddenly.

There also might be periods when you have no signs and symptoms, this is called remission and is the end goal of treatment for the disease.

The most common symptoms of Crohn’s disease involve the digestive tract and can include:

Pain

Most commonly, the pain will be felt at the lower-right side of the abdomen. However, it varies between individuals and can be linked to the type of Crohn’s disease you have.

Mouth Sores

Ulcers are quite commonly experienced from time to time.

Diarrhoea

This can range from mild to severe. Heavy intestinal cramping also can contribute to runny stools.

Fatigue

Many people experience fever-like symptoms, usually due to inflammation or infection. It’s also common to have no energy and feel tired.

Reduced Appetite and Weight Loss

Abdominal pain and cramping can affect both your urge to eat and your ability to digest and absorb food properly.

Arthritis

Arthritis usually affects the larger joints and is most often found when bowel symptoms are also present.

Anal Pain and Stool Blood

The most common problems include fissures (tears), ulcers, fistulas, bloody stools, and infected areas of the skin. These may occur as a singular experience or together.

Treatments Available

Currently, there are a variety of drug therapy treatments available for Crohn’s.

These can be supplemented by overall health and wellness in your lifestyle, or potentially in conjunction with a surgical procedure.

Drug therapies currently available in SA include the following.

Anti-Inflammatory Medication

One or more different types of drugs may be to help control inflammation, depending on the site of their disease and the stage of inflammation. These can include aminosalisylates, such as sulfasalazine and, or corticosteroids.

Immunosuppressive Medication

Immunosuppressive medications used to treat Crohn’s include azathioprine, 6-mercaptopurine, methotrexate and, in rare cases, cyclosporine. These drugs work by blocking the body’s immune response from initiating the inflammatory process.

Biologics

The Biologics drug treatment options are the latest form of therapy for the treatment of Crohn’s disease. Infliximab, Adalimumab, Vedolizumab and Ustekinumab are the three options currently registered in South Africa.

See if you qualify for a Clinical Trial to participate in the forefront of medical research here.

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.

Surgery

If drug therapy treatments in conjunction with overall health and lifestyle wellness do not effectively control symptoms and the disease, your Gastroenterologist may recommend surgery. 

Lifestyle

You can support and strengthen the drug therapies prescribed by your doctor for Crohn’s disease by making some changes in your diet and lifestyle.

There are no scientific studies to prove the impact this makes, but it may help control your symptoms and lengthen the time between flare-ups by striving for overall health and wellness.

Diet

There is no hard evidence that what you eat causes inflammatory bowel disease or inflammation, but certain foods and beverages can aggravate your digestive tract and hasten a flare-up.

This could simply be a food allergy that is worsened by the presence of Crohn’s disease, in which case avoiding that particular food would lessen discomfort.

It is always recommended that you consult a dietician before making any major changes to your eating habits, and they can also guide you to a diet that suits your needs.

Smoking

Studies indicate that smokers are at higher risk of developing Crohn’s disease, and once you have it, smoking can make the symptoms worse.

Smoking also increases the likelihood of having a relapse once you have reached a state of remission, as well as needing more medical and surgical interventions.

Stress

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

Unfortunately, it in itself can also be a symptom of the disease.

Crohn’s disease does not just affect you physically – it takes an emotional toll as well. If the symptoms are severe, you may find that you need to excuse yourself often to use the toilet.

This can be difficult or uncomfortable until you find a way to manage the situation.

Finding a support structure, through family and friends or support groups of your peers, is necessary to find ways to manage stress and mitigate symptoms.

Moving Forward

As with any chronic illness, Crohn’s disease will require you to stay on top of your health, with the assistance of a qualified medical practitioner to guide you, at all times.

It is possible to live an almost entirely normal life, with little to no interference from symptoms along the way.

To learn more about our practice and how we can assist you on this journey to gut health, contact us here.

If you’d like to take part in a clinical trial for Crohn’s, join us here.