Crohn’s disease is a lifelong inflammatory bowel disease (IBD).  Parts of the digestive system get swollen and have deep sores called ulcers.  The disease usually is found in the last part of the small intestine and the first part of the large intestine, but it can develop anywhere in the digestive tract, from the mouth to the anus.  Doctors don’t know what causes Crohn’s disease.  You may get it when the body’s immune system has an abnormal response to normal bacteria in your intestine.  Other kinds of bacteria and viruses may also play a role in causing the disease.  Crohn’s disease can run in families.  Your chances of getting it are higher if a close family member has it.  People of Eastern European (Ashkenazi) Jewish family background may have a higher chance of getting Crohn’s disease.  Smoking also puts you at a higher risk for the disease.

          Persistent diarrhea (loose, watery, or frequent bowel movements), crampy abdominal pain, fever, and, at times, rectal bleeding are the hallmark symptoms of Crohn’s disease, but they vary from person to person and may change over time.  Loss of appetite and subsequent weight loss also may occur.  However, the disease is not always limited to the GI tract; it can also affect the joints, eyes, skin and liver.  Fatigue is another common complaint.  Children who have Crohn’s disease may suffer delayed growth and sexual development.  Some patients may develop tears (fissures) in the lining of the anus, which may cause pain and bleeding, especially during bowel movements. Inflammation may also cause a fistula to develop.  A fistula is a tunnel that leads from one loop of intestine to another, or that connects the intestine to the bladder, vagina, or skin. If this complication arises, you may notice drainage of mucus, pus or stool from this opening.  Because Crohn’s is a chronic disease, patients will go through periods in which the disease flares up, followed by times of remission.

          Your treatment will depend on the type of symptoms you have and how bad they are.  The most common treatment for Crohn’s disease is medicine.  Mild symptoms of Crohn’s disease may be treated with over-the-counter medicines to stop diarrhea.  But talk with your doctor before you take them because they may cause side effects.  You may also use prescription medicines.  They help control inflammation in the intestines and keep the disease from causing symptoms.  These medicines also help heal damaged tissue and can postpone the need for surgery.  There are a few steps you can take to help yourself feel better.  Take your medicine just as your doctor tells you to, exercise and eat healthy meals.  Don’t smoke.  Smoking makes Crohn’s disease worse.  The disease makes it hard for your body to absorb nutrients from food.  A meal plan that focuses on high-calorie, high-protein foods can help you get the nutrients you need.  Eating this way may be easier if you have regular meals plus two or three snacks each day.

          Two-thirds to three-quarters of patients with Crohn’s disease will require surgery at some point during their lives.  Surgery becomes necessary in the disease when medications can no longer control the symptoms.  It may also be performed to repair a fistula or fissure.  Another indication for surgery is the presence of an intestinal obstruction or other complication, such as an intestinal abscess.  In most cases, the diseased segment of bowel and any associated abscess is removed; this is called a resection.  The two ends of healthy bowel are then joined together in a procedure called an anastomosis.  While resection and anastomosis may allow many symptom-free years, this surgery is not considered a cure for Crohn’s disease, because the disease frequently recurs at or near the site of anastomosis.  An ileostomy also may be required when surgery is performed for Crohn’s disease of the colon.  After the surgeon removes the colon, he brings the small bowel to the skin, so that waste products may be emptied into a pouch attached to the abdomen.  This procedure is needed if the rectum is diseased and cannot be used for an anastomosis.  The overall goal of surgery in Crohn’s disease is to conserve bowel and return the individual to the best possible quality of life.


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