CROHN'S DISEASE

General Information

DEFINITION--A chronic inflammatory disease of the gastrointestinal tract. It most commonly affects the ileum (the end of the small intestine where it joins the large intestine).

BODY PARTS INVOLVED--Ileum, colon and other parts of the gastrointestinal tract; regional lymph nodes; the mesentery (outside covering of the intestines).

SEX OR AGE MOST AFFECTED-- Adolescents, young adults and after age 60.

> Cramping abdominal pain--

especially after eating. The pain is sometimes in the right lower abdomen, mimicking appendicitis.

• Nausea and diarrhea; general ill feeling; fever.
• Appetite and weight loss.
• Abdominal tenderness; abdominal mass that can be felt.
• Bloody stools (sometimes).
• Growth retardation in children.

CAUSES--Unknown. Can be aggravated by bacterial infection or inflammation.

RISK INCREASES WITH

• Medical history of food allergies.
• Family history of Crohn's disease.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic procedures, such as sigmoidoscopy or colonoscopy (See Glossary for both); x-rays of the colon and small intestine.

> Surgery (see Ileostomy in Surgery section) to resect the inflamed area (sometimes)-- although non-surgical treatment is preferred.

POSSIBLE COMPLICATIONS

• Intestinal obstruction.
• Bleeding and anemia.
• Fistula between the bowel and bladder.
• Perirectal abscess.
• Perforation of the inflamed bowel.
• Increased susceptibility to cancer of the ileum.
• Joint pain and inflammation; eye inflammation.
• Kidney disorders.
• Malabsorption.
• Vitamin-B-12 deficiency.

PROBABLE OUTCOME--Attacks usually begin in patients in their early 20s and may continue for years. Intervals between attacks vary from every few months to every few years. Occasionally, symptoms appear only once or twice, and the disease disappears. If you and your doctor decide that your condition requires surgery, it can dramatically improve your condition and delay progress of the disease for many years. However, despite surgery, recurrences are quite possible.

How To Treat

GENERAL MEASURES--

• Use heat to relieve pain. Apply a heating pad or warm compresses to the abdomen. Warm water baths may help reduce discomfort. If abdominal cramps are continuous or severe, notify your doctor.
• Check your stool daily for signs of bleeding. Take any suspicious specimens to your doctor's office for analysis.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Pain relievers.
• Antidiarrhea medication.
• Vitamin supplements.
• Anti-inflammatory drugs and immunosuppressant medication.
• Antibiotics to fight infections.
• Steroids in acute cases.

ACTIVITY--

• During acute attacks, rest in bed or a chair. Get up only to go to the bathroom, to bathe or to eat.
• During periods between attacks, rest often during the day and sleep up to 10 hours a night.

DIET--

• Usually no restrictions.
• Reducing the amount of fat in the diet may help.
• If you have possible food allergies, omit milk, wheat, eggs, nuts and other suspected foods. Omit each one, especially milk, for a short period, then try it again in a few weeks.
• If diarrhea is a problem, increase amount of fiber in your diet.

Call Your Doctor If

• You have symptoms of Crohn's disease.
• You have black, tarry stools or blood in the stool.
• Your abdomen swells.
• Your temperature rises to 101F (38.3C) or higher.