Crohn’s Disease

4 January 2025

Crohn’s disease is a chronic condition involving inflammation of the digestive tract. Understand the possible risk factors, treatment and how best to manage this disease.

What is Crohn’s Disease

Crohn’s disease is a chronic inflammatory bowel condition that affects the digestive tract. It can impact any area from the mouth to the anus but most frequently involves the small intestine and the start of the colon.

As a lifelong disease, it can cause various symptoms and complications, significantly influencing one’s quality of life.

Potential Causes

The exact cause of Crohn’s disease remains unclear, but it appears to arise from a combination of genetic, immune, and environmental factors. Possible contributing elements include:

Genetic Factors: The condition tends to run in families, suggesting a hereditary component. Certain genetic mutations may increase the likelihood of developing Crohn’s disease, though the inheritance pattern is not straightforward.
Immune System Issues: An abnormal immune response to environmental triggers leads to persistent inflammation and tissue damage in the digestive tract. The immune system mistakenly targets healthy cells in the gastrointestinal tract, causing inflammation and tissue thickening.
Environmental Triggers: Factors like diet, smoking, infections, and certain medications or pollutants may trigger or worsen inflammation in those who are genetically predisposed to Crohn’s disease. Diets high in processed foods, refined sugars, and saturated fats may contribute to gut inflammation.
Microbiome Imbalance: Changes in gut bacteria composition and diversity have been linked to Crohn’s disease. This imbalance, known as dysbiosis, can disrupt immune regulation, intestinal barrier function, and inflammatory pathways.

Symptoms

Crohn’s disease symptoms can vary widely, affecting the digestive tract and potentially other body systems. Common signs include:

Abdominal Pain: Persistent or occasional cramping or discomfort, often located in the lower abdomen. Pain can be crampy, sharp, or dull and may worsen with eating or during flare-ups.
Diarrhoea: Frequent, loose, or watery stools often accompanied by urgency, incomplete evacuation, or incontinence. diarrhoea may be ongoing or intermittent.
Rectal Bleeding: Blood in the stool or on toilet paper due to inflammation or ulcers in the intestinal lining.
Weight Loss: Unintended weight loss, malnutrition, or nutrient deficiencies from reduced appetite or poor absorption.
Fatigue: Chronic tiredness or lethargy, possibly linked to anaemia, nutrient deficiencies, or the body’s response to inflammation.
Fever and Chills: Low-grade fevers, night sweats, or chills during active inflammation.
Extraintestinal Symptoms: Joint pain, skin rashes, eye inflammation, mouth ulcers, liver problems, or bone loss.

Diagnosis

To diagnose Crohn’s disease, a healthcare provider will conduct a thorough evaluation that may include:

Medical History and Physical Exam: Your doctor will review your symptoms, medical background, family history, and lifestyle, followed by a physical examination.
Diagnostic Tests: Blood tests, stool tests, imaging (CT, MRI, ultrasound), and endoscopic procedures (colonoscopy, upper endoscopy) may be used to confirm the diagnosis and assess disease severity.

Treatment Options

Treatment focuses on reducing inflammation, alleviating symptoms, inducing remission, and preventing complications. Options may include:

Medications: Depending on disease severity and location, treatments may include anti-inflammatory drugs, corticosteroids, immunosuppressants, biologic therapies, or antibiotics.
Dietary Adjustments: Specific diets like low-residue or exclusive enteral nutrition may help control symptoms. Avoiding trigger foods such as high-fat, spicy, or dairy-based products can also help.
Nutritional Support: In cases of malnutrition, supplements or specialized diets may be necessary. Parenteral (IV) nutrition may be used during severe flare-ups.
Surgery: Surgery may be needed to remove damaged intestinal sections or treat complications like abscesses. While it can relieve symptoms, it does not cure the disease.
Lifestyle Changes: Quitting smoking, managing stress, regular exercise, and avoiding NSAIDs can reduce inflammation and improve well-being.

Monitoring and Follow-Up

Long-term management is essential, involving regular check-ups to assess symptoms, treatment efficacy, and potential complications. Monitoring may include:

Clinical Assessments: Regular visits to evaluate symptoms and medication effectiveness.
Lab Tests: Blood tests to measure inflammation and nutritional status.
Imaging: Periodic scans to detect complications and assess treatment response.
Endoscopy: Ongoing endoscopic exams to monitor intestinal healing and detect any new issues.

Complications and Outlook

Complications may include intestinal strictures, fistulas, abscesses, blockages, malnutrition, bone loss, or an increased risk of colorectal cancer. The outlook varies based on disease severity, response to treatment, and other factors. While Crohn’s disease is not curable, effective management can help maintain remission, improve quality of life, and prevent serious complications.

Conclusion

Crohn’s disease is a chronic condition involving inflammation of the digestive tract, with symptoms and severity differing among individuals.

While the exact cause is uncertain, it likely involves genetic, immune, and environmental factors. Treatment aims to reduce inflammation, alleviate symptoms, and prevent complications.

With proper management, individuals can achieve remission, improve their quality of life, and limit complications.

Arranging To Visit A Private GP

To discuss any worrying symptoms that could be an indication of Crohn’s disease make an appointment with one of our private GPs. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our Buckinghamshire hospital, or live locally.

If you have insurance which covers a GP visit, we can in most cases invoice the insurer directly. Where you are paying directly, the cost for a 30 minute consultation is £125.

Any additional costs will always be discussed. They could apply if you are referred for an MRI scan, or to a consultant, or for other agreed decisions to support your health.

Our Resident Private GP

Dr Chamali is welcoming and highly experienced. He offers his patients sound diagnosis and treatment, along with individual care focused on their future health.