Abdominal pain and diarrhea are symptoms that can appear due to various diseases, such as viruses and infections.
However, Crohn’s disease is nothing like that. Characterized by chronic inflammation, it can cause several losses for patients who suffer from the condition.
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What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory disease of the digestive system and can affect any part of the gastrointestinal tract, from the mouth to the anus.
Formerly it was called colitis , regional enteritis, ileitis and granulomatous ileocolitis, depending on the place it affected. Today, these diseases are colitis and Crohn’s disease, which are classified as Inflammatory Bowel Diseases , or IBD.
Despite this, the region most affected by Crohn’s disease is the terminal ileum (the end of the small intestine and the beginning of the large intestine), which presents inflammation in up to 60% of cases.
In general, it is common for there to be several regions affected by the disease.
It is more frequent in smokers and usually appears between 20 and 30 years of age, but it is not limited to these age groups, and can manifest itself at any point in life.
Even if it is related to the immune system, it is not considered an autoimmune disease.
It is believed to be a genetic condition that can manifest itself in the form of an inappropriate immune system reaction to a threat, such as bacteria or viruses.
The disease causes serious problems for patients, reducing their quality of life.
Among the main symptoms are pain, abdominal discomfort, frequent diarrhea, which may or may not accompany bleeding, in addition to other symptoms, such as loss of appetite.
When it manifests in adolescence or even in childhood, it can be the cause of malnutrition in the patient, impairing development.
The ICD-10 code for Crohn’s disease is K50 .
Crohn’s disease stages
Crohn’s disease can be divided into two phases, acute (or active) and remission.
Active phase (acute)
Acute or active Crohn’s disease, also called Crohn’s disease crisis , is the stage when the disease is causing intestinal inflammation and showing symptoms.
It is in the first active phase that most people discover the disease.
In some cases, the acute phase appears suddenly, surprising the person who until the previous day was fine. However, in other cases, symptoms may appear progressively over the course of a few days.
Remission phase
The remission phase happens when the inflammations are not active. About 95% of people do not show symptoms of Crohn’s disease during remission.
However, it is important to note that there are numerous triggers for a remission to become a crisis, from food to stress , in addition to some that are not known.
The goal of treating Crohn’s disease is to keep the person in remission as long as possible, thereby improving their quality of life.
Causes: What causes Crohn’s disease?
The specific causes of Crohn’s disease are unknown.
However, it is believed that the condition is caused by an overreaction of the immune system to environmental factors – such as infections, hormonal changes or stress, for example. This reaction would be made possible by a genetic alteration.
One of the main suspected triggers of the disease is the presence of a virus or bacteria to which the immune system reacts inappropriately.
Even after the pathogen leaves the body or is eliminated by the immune system, the inflammation reaction does not subside, thus causing Crohn’s disease.
Crohn’s disease is known to cause granulomas, an inflammatory response compatible with fighting fungi and certain types of bacteria.
One suspect is Mycobacterium avium , but it is perfectly possible that other microorganisms are also capable of causing the reaction.
It is important to note that even if Crohn’s disease happens due to infections or any other trigger of the environment, the cause is not this environmental agent, but the way the immune system reacts.
Does stress cause Crohn’s disease?
Years ago, inflammatory bowel diseases like Crohn’s disease were attributed to stress. Today it is known that it does not cause diseases, but it is a factor that can aggravate them when they have already settled.
So when you are in a Crohn’s disease crisis, stress can make your condition worse, and when you are in remission, it can cause a crisis .
Try to relax when possible to avoid crises and worsening of the disease.
Read more: How to control anxiety? 14 tips to avoid crises
Groups of risk
Since the disease is supposed to have genetic roots, it is assumed that people without a predisposition to the disease will not develop it.
However, it is known that there are some factors that increase the risk of developing the condition in those who have the genes for Crohn’s disease.
Smokers
Smokers are more likely to develop the disease than those who do not smoke.
Although tobacco is mainly related to lung problems, it negatively affects the entire body, including the gastrointestinal system.
Family history
As it is a genetic disease, the family history of Crohn’s disease is a risk factor.
Researchers have not found the gene responsible for the disease, but it is known that the chances of developing the condition are greater in those who have family members with it.
In addition, a family history of other inflammatory bowel diseases, such as colitis, also increases the chances of someone developing Crohn’s.
Age
Crohn’s disease usually manifests between 20 and 30 years of age. However, it is possible that it happens in other age groups.
Especially when it occurs in childhood or adolescence, it can cause developmental problems due to malabsorption of nutrients.
Diet
Your eating habits can affect the way your gut reacts.
Certain diets, with many fats or industrialized products , are believed to be the reason why cases of Crohn’s disease are more common in cities and developed countries.
History of gastroenteritis
It is common for Crohn’s disease to arise after gastroenteritis , which is an intestinal inflammation caused by a virus, parasite, fungus or bacteria. Most cases are due to viral infection.
Symptoms
The symptoms of Crohn’s disease dramatically reduce the patient’s quality of life. Are they:
Severe diarrhea
Due to inflammation within the intestine, one of the main symptoms of Crohn’s disease is diarrhea.
The intestine is the place where most of the nutrients are absorbed and where the fecal cake is effectively transformed into feces.
It turns out that when the intestine is inflamed, the affected region temporarily loses its function. This means that the inflamed portion is not able to absorb nutrients and the fecal cake passes directly through it.
This can be a cause of diarrhea, which causes certain portions of the stool to be eliminated very quickly and with a lot of fluid.
Abdominal pain
The intestine performs specific movements to make the stool pass through its entire length. The problem with Crohn’s disease, in this case, is that when there is inflammation, the intestine is still moving.
Do you know when you have an inflamed wound and touching it hurts? Abdominal pain happens for a similar reason.
The inflamed region makes strong contractions with the intention of pushing the fecal cake and the result is severe pain.
Arthritis
There are greater numbers of joint diseases, such as arthritis, in people who have inflammatory bowel diseases. The arthritis is also an inflammatory disease that affects the joints.
Inflamed eyes
The patient’s eyes can also become inflamed. It is a sign that can appear just before a Crohn’s disease crisis, with symptoms such as redness of the eyes and sensitivity to light.
Skin rashes
Crohn’s disease can also manifest itself with rashes on the skin, often on the legs. This symptom usually goes away when the intestine is treated.
Low fever
Inflammation often comes with a fever , which is stronger depending on the bacteria that causes the initial infection.
In the case of Crohn’s disease, there is no bacterium that is causing it, but fever is still common.
In general, the fever is low and does not usually exceed 38ºC, but it is long lasting.
Nausea and vomiting
Nausea and vomiting are symptoms related to gastrointestinal problems. Inflammation in the digestive system caused by Crohn’s disease can cause this problem.
Canker sores
Canker sores are ulcers located in the lining of the mouth and can be caused by several factors. Problems in the digestive system, such as inflammation, are one of them.
Vomiting, which can also be caused by Crohn’s disease, can also cause thrush.
Read more: Ointment or pill? What is the best cold sore medicine?
Abdominal swelling
Due to inflammation of the digestive system, there may be abdominal swelling. The inflamed region itself may swell, and in addition, these minor swellings can cause blockages of the intestine.
Gases can build up in the organ because of blockages, which further increases abdominal swelling.
Weight loss and appetite reduction
Crohn’s disease causes reduced appetite, which in turn can lead to considerable weight loss due to a lack of nutrients.
In addition, the disease reduces the absorption of nutrients carried out by the intestine, so even what the patient eats is not used properly.
Therefore, the disease can cause growth problems.
Children and adolescents, who are in the development phase, need a lot of nutrients, but a possible Crohn’s disease can greatly reduce the use of food. The result is weight loss and the risk of underdevelopment.
Flatulence
The accumulation of gases that can be caused by Crohn’s disease causes flatulence, in addition to the inflammation being responsible for a greater production of gases on the part of the intestine. This greater production, in addition to facilitating accumulation, increases the release of gases.
Anal lesions
Inflammation caused by Crohn’s disease often leads to anal lesions such as anal fissure (a small wound in the area of the lining of the anus), hemorrhoids (swelling of anal veins) and anal fistula (creating a muscle opening in the anus, which becomes infected) .
Frequent evacuation
The Crohn’s disease patient needs to go to the bathroom very often as the fecal bolus passes through the intestine very quickly due to inflammation in the region.
How is the diagnosis made?
The diagnosis of Crohn’s disease can be made in a few different ways. The professional responsible is the gastroenterologist .
Colonoscopy and endoscopy
A colonoscopy is the most effective method for the identification of Crohn’s disease.
After the patient is anesthetized, a small camera is inserted through the anus and doctors can observe the internal state of the large intestine, as well as the final 20 centimeters of the small intestine.
It is also possible to use endoscopy , which is the insertion of a camera through the patient’s mouth, to observe the stomach and duodenum (beginning of the small intestine) – since Crohn’s disease can affect any part of the digestive system.
During these tests, signs of inflammation are sought.
Biopsy
Biopsy is the visual study under a microscope of a part removed from the patient’s body.
A small sample of the inflamed regions is analyzed to identify how the inflammatory process is happening, in addition to excluding the possibility of confusion between Crohn’s disease and other conditions.
The test is also used to identify intestinal cancers, for example, or to search for bacteria and other microorganisms that may be causing the inflammation, which would differentiate the condition, since Crohn does not need microorganisms for the inflammation.
Bloodtests
Blood tests can identify the presence of anemia (which can indicate bleeding from the intestines).
In addition, they serve to find out if there is an infectious process in progress, since in that case white blood cells in high numbers can be found in the blood.
These tests are mainly used to raise the suspicion of Crohn’s disease or to eliminate it.
Contrast tomography
Contrast tomography is an image exam used to identify certain situations that Crohn’s disease can cause, such as the formation of intestinal blocks or adhesion of the intestinal walls.
For the exam, the patient ingests a liquid mixed with barium , a substance that is not absorbed by the body, and X-rays are taken from the digestive system.
Barium appears extremely clearly on X-rays and, with that, it is possible to know details of the path that food takes in the intestine, in addition to identifying blockages and changes.
This test is never used alone for Crohn’s identification since it is common to point out false negatives (when the disease is present, but the test is not able to identify it).
Is Crohn’s disease curable?
No . Crohn’s disease has no cure. What is possible is treatment to maintain remission .
It is a disease that works in separate phases of crises (acute phase) and remission. When you are in crisis, there are inflammations in the digestive system, but when these inflammations are controlled, you go into remission.
Can Crohn’s disease kill?
Although Crohn’s disease is not considered fatal, it is possible that its complications cause death.
That’s because inflammations can open wounds that are at risk of becoming infected inside the intestine, which can lead to death.
There is also a danger that intestinal blockages will occur, causing fecal matter not to pass.
The blockage of the intestine is a great danger because it can rupture, releasing bacteria and feces into the abdominal cavity.
In addition, Crohn’s disease can prevent the patient from eating or absorbing nutrients. This can lead to death from malnutrition.
However, with appropriate treatment, it is possible that the patient has quality of life.
What is the treatment?
Treatment for Crohn’s disease depends on several factors, such as the affected region, the stage of the disease (acute or remissive) and other specifications.
One of the main intentions of the treatment is to control inflammation, thereby reducing symptoms. This is done during crises of the acute phase of the disease.
Once controlled, we seek to maintain control. That is, to ensure that the disease remains in remission.
Most patients with Crohn’s can live with a good quality of life, some even without restrictions as long as specific care is taken to prevent attacks.
Medication
The treatment of the acute phase of Crohn’s disease is done mainly with medications.
Corticosteroids can be used in newly diagnosed patients to quickly relieve symptoms, but this can only be done for a short period of time as this type of medication has several side effects.
Other medications can be used to reduce seizures.
Aminosalicylates are used to control inflammatory bowel diseases, for example. Immunosuppressants can also be administered to reduce the effects of patients’ immune systems.
Bacterial infections can be common in people with Crohn’s disease as inflammations can open the way for them, so antibiotics can also be used in treatment.
Antidiarrheals (medicines to prevent diarrhea), analgesics (reduce pain) and vitamin supplements can also be used to control symptoms and keep the disease under control.
Cannabis oil
Cannabis oil has been shown to significantly reduce the symptoms of patients with Crohn’s disease in tests, and during the test, 65% of patients achieved remission after 8 weeks of using the drug.
The anti-inflammatory effects of cannabis are already known, but during this test, it was found that the reduction in symptoms was not due to these effects, since the endoscopic and blood tests did not show a reduction in intestinal inflammatory markers.
It is not known exactly how the effect of cannabis reduces the symptoms of Crohn’s disease.
Surgery
In some cases, surgery may be necessary and, although it is an option that doctors prefer to avoid, it is inevitable in some cases.
Crohn’s disease can cause adhesions, intestinal blocks and even intestinal cancer , although the latter is rare.
Diet
Diet is one of the main methods of controlling Crohn’s disease and is a tool used to maintain remission.
Some foods can serve as triggers for new crises. This is the case of very fatty foods, alcohol (mainly beer) and fiber.
Normally, fibers are recommended for intestinal health, as they facilitate the passage of feces. However, they also increase the production of gas and colic, which for a Crohn’s disease patient may mean the start of a new crisis.
In remission, fibers do not need to be completely excluded from the diet, but they must be taken in moderation. During a crisis, they must be avoided completely.
In addition, hydration is extremely important, as well as avoiding any food to which the patient is sensitive. For example, if a person has lactose intolerance, drinking milk can trigger a crisis.
Therefore, the diet serves to reduce the stress placed on the intestine, which in turn reduces the chances of a crisis to start.
Parenteral feeding
In some cases, especially after surgery, the patient may not be able to eat. In these cases, nutrition is done through the veins.
Medicines
Several drugs can be used to control and maintain Crohn’s disease. Among them are:
Corticosteroids
Used to control crises, these drugs are usually indicated for patients with recent diagnosis and for a short time, since side effects can be dangerous. Are they:
- Prednisona ( Meticorten );
- Dexamethasone ( Decadron ).
Immunosuppressants
These drugs are used to control the immune system. They suppress its action, which causes inflammation to be reduced or eliminated.
There is a greater vulnerability to infections in patients using immunosuppressants, therefore, it is important to be careful and follow medical guidelines.
- Adalimubabe (Humira);
- Azathioprine ( Imuiran );
- Infliximabe (Remicade).
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living together
Crohn’s disease can significantly reduce the quality of life of patients and, as it is an incurable disease, it is important to learn to live with the condition.
Take your medications
Even when you are in remission, it is important not to stop taking the drugs prescribed by the doctor. They help to prevent further bouts of Crohn’s disease.
Take care of your diet
The diet is one of the main tools that the patient with Crohn’s disease has to deal with the condition.
Avoid eating fiber, alcohol, fats, caffeine, sugars and other foods that cause symptoms . Each patient may have different reactions to certain foods.
Those who are intolerant to some types of food (gluten, lactose) should stay away from these foods, as they greatly increase the chances of a Crohn’s disease attack.
Make a food diary
In a food diary you can write down which foods you ate and more easily identify which ones have positive or negative effects on your body. So, you can know what your triggers are and how to avoid them.
Do not smoke
Smoking irritates the intestines and considerably increases the chances of a Crohn’s disease attack, as well as making recurrences more severe and difficult to control. Quitting smoking is essential .
Consult a nutritionist
A consultation with a nutritionist can help you take care of your diet to control Crohn’s disease without losing nutrients.
Get medical follow-up
Follow medical guidelines to ensure that the disease will stay in remission as long as possible.
It is important to note that the condition can often cause the person to go to the hospital. Half of the patients may need surgery within 10 years.
This means that medical monitoring is essential to find problems before they pose a serious health risk. Tumors, for example, can appear as a result of constant healing in the digestive system.
Tests such as colonoscopy are recommended every 5 years to screen for possible intestinal cancers.
Avoid stressful situations
Stress is a trigger for intestinal problems. Avoiding them can facilitate living with the disease, ensuring that you will spend more time in remission, without Crohn’s disease crises.
Psychological treatment
Crohn’s disease patients are likely to have a reduced quality of life due to the condition. In addition, the symptoms can also cause social damage. Therefore, it is common for them to develop diseases such as anxiety and depression .
Psychological treatment is essential to avoid these conditions and ensure mental health during the treatment of the disease.
Food and diet for Crohn’s disease
Food is essential for proper control of Crohn’s disease, as what we eat greatly influences the way the intestine behaves.
When you have Crohn’s disease, certain foods should be avoided, always accompanied by specialized nutritional guidance.
What are the best foods?
- Rice;
- Purees;
- Lean meats;
- Boiled eggs;
- Cooked vegetables;
- Cooked fruits;
- Potato.
What not to eat?
Certain foods influence bowel movements, as well as intestinal flora, and should be avoided by people with Crohn’s disease to reduce the chances of a crisis. Are they:
- Coffee, caffeinated soft drinks;
- Raw vegetables;
- Fruit peel;
- Papaya;
- Plums;
- Honey and sugar;
- Alcohol;
- Fibers (such as oats);
- Fatty meats (such as pork);
- Chocolate;
- Fried food.
Will I need treatment for the rest of my life?
Probably yes. Despite drug treatment during a crisis and right after it aims to reach 6 months in remission, stopping treatment – especially in the food part – can make a crisis come back.
In addition, even after a long time without a crisis, the disease does not leave the body and can return at any time. Medication can prevent this.
Prognosis
The prognosis of Crohn’s disease, in mild and moderate cases, is relatively positive.
Although the disease is not curable, in these cases, it can be controlled with medication and attention to eating habits, guaranteeing patients quality of life in tandem with that of people without the condition.
However, it is important to remember that it is a serious disease and there are serious cases.
Approximately 20% of patients end up having to visit the hospital because of complications from the disease every year.
The life expectancy of patients is not necessarily less than that of healthy people.
Approximately 15% die within 30 years of diagnosis, but with dedication and attention to care, it is possible to have a long and healthy life.
Complications
There are several dangerous complications from Crohn’s disease. In some cases, they need to be resolved with surgery and, in others, with drug treatment or other actions.
Among the main complications are:
Tumors
Tumors due to Crohn’s disease are rare (usually more common in other inflammatory bowel diseases), but they can arise.
The constant healing of a region that is often inflamed can cause certain cells to reproduce inappropriately.
These tumors can be benign or malignant (cancer), which is why it is important that tests are performed frequently in search of these masses, thus ensuring that they are found in the early stages of development.
Usually, when one of them is identified, a biopsy may be necessary to confirm the type of disease represented by the tumor.
Intestinal block
Constant healing, in addition to the inflammation, swelling and adhesions caused by Crohn’s disease, presents a serious risk of intestinal blockage. Tumors can also cause blockage when growing inside the intestine.
When the intestine is blocked due to Crohn’s disease, feces and bacteria can accumulate in an intestinal region.
This accumulation can be problematic because it causes pain, and it can also help in the multiplication of microbes.
In some cases, if the accumulation of fecal matter and gases is very large, there may be a rupture of the intestine, which causes infection of the abdominal cavity.
The condition affects all internal organs and can cause fecal matter to return to the upper gastric system, causing fecal vomiting , which can be fatal.
Intestinal adhesions
Adhesions happen when one part of the intestine creates tissue and sticks to another part, usually due to the scar tissue that arises because of inflammation.
Thus, adhesions can cause deformities of the intestine and are one of the main causes of intestinal blockages.
Infections
It is impossible to control bowel movements and, even if the organ is inflamed, it will maintain contractions. That’s where the great pains of Crohn’s disease come from.
But these movements of the inflamed tissue can also cause sores in the intestine. These wounds can be a way for feces and bacteria to infect the bloodstream.
It is also possible that a rupture of the intestine will take bacteria and feces into the abdominal cavity, causing infection of several organs of the body simultaneously.
Hemorrhoids and anal fistulas
Crohn’s disease can cause hemorrhoids, which are small anal veins that can become swollen and cause pain, and anal fistulas, which are small open channels in the muscle that can become infected, causing severe discomfort and pain.
Malnutrition
Due to inflamed and scar tissue, the intestine may have difficulties in absorbing nutrients into the body. This can cause malnutrition, since most of the food is not used.
Crohn’s disease also reduces a patient’s appetite, which can be another factor that causes nutritional problems.
Depression
Crohn’s disease can cause severe declines in the patient’s quality of life, both in the physical health factor and in social life.
Because of this, many patients develop depression. Psychological monitoring of patients is important to avoid problems of this nature.
How to prevent Crohn’s disease?
Crohn’s disease is believed to have a genetic origin, but its manifestation is influenced by the external environment.
Therefore, some habits can help to prevent the condition from arising. These same habits can also prevent seizures if you are in remission:
Do not smoke
Smoking increases your chances of developing Crohn’s disease if you have the tendency. Avoid tobacco as much as possible, which is also recommended if you do not have the disease, as smoking is bad for anyone’s health.
Take care of your food
Healthy eating is a way to prevent Crohn’s disease. Avoiding eating sugars and fats frequently is one way to ensure that your gut will have less stress.
Fiber, on the other hand, shouldn’t be avoided if you don’t have Crohn’s disease. In general, they are good for intestinal transit. It is only important to avoid them if you develop the disease.
Common questions
Is the life span shorter for patients with Crohn’s disease?
Not necessarily. With proper treatment, it is possible that the patient’s life will be long and with quality, and the life expectancy of these people is not reduced.
Which blood test detects Crohn’s disease?
There are no specific blood tests to identify Crohn’s disease or any of the inflammatory bowel diseases. However, those who are made look for signs of inflammatory disorders that the body makes available, like neutrophils, a type of leukocyte, which are cells of the immune system.
Other tests are necessary for the diagnosis. For example, endoscopy and colonoscopy are used to identify inflammation by image, as well as radiographs that look for obstructions and volumes that would not normally be found in the region.
Can Crohn’s disease cause cancer?
Although other inflammatory bowel diseases (IBD) are more likely to cause cancerous tumors, Crohn’s disease also has this possibility. Therefore, it is important to perform colonoscopic exams every 5 years when you have the condition.
Can I eat anything when I am not in crisis?
You must avoid. Foods such as fiber, alcohol and fats worsen crises and cause them to start if you are in remission. So, avoid these foods.
Is the person born with Crohn’s disease?
No, but the person is born with a genetic predisposition . This means that the possibility that she may develop the condition is in her genes and behaviors that put her at risk can trigger Crohn’s disease.
It is believed that this predisposition is transmitted to the children, but not all cases manifest the disease. In addition, the genetic mutation can happen spontaneously, in the formation of the fetus.
Are colitis and Crohn’s disease the same thing?
No , but they are similar. The biggest difference is that colitis affects only the large intestine and only the inner lining of the organ, whereas Crohn’s disease can affect the entire digestive system, from the mouth to the anus, and can cause inflammation throughout the tissue.
Both, however, are Inflammatory Bowel Diseases (IBD) and can bring similar complications and symptoms in certain cases.
Crohn’s disease is a chronic inflammatory digestive condition, which can cause serious impairments to the quality of life of patients, in addition to serious health complications.
However, with proper treatment and controlled diet, it is possible to control the disease.
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