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Crohn disease

Crohn's disease; Inflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis; IBD - Crohn disease

Crohn disease is a disease where parts of the digestive tract become inflamed.

Crohn disease is a form of inflammatory bowel disease (IBD).

Ulcerative colitis is another form of IBD.

Images

Digestive system
Crohn disease - X-ray
Inflammatory bowel disease
Anorectal fistulas
Crohn disease - affected areas
Ulcerative colitis

Presentation

Inflammatory bowel disease - series

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Causes

The exact cause of Crohn disease is unknown. It occurs when your body's immune system mistakenly attacks and destroys healthy body tissue (autoimmune disorder), mainly in the digestive tract.

When parts of the digestive tract remain swollen or inflamed, the walls of the intestines become thickened.

Factors that may play a role in Crohn disease include:

Crohn disease may occur at any age. It mostly begins in people between ages 15 and 35. But recently Crohn disease has been increasing in the older population, too.

Symptoms

Symptoms depend on the part of the digestive tract involved. Symptoms range from mild to severe, and can come and go, with periods of flare-ups.

The main symptoms of Crohn disease are:

Other symptoms may include:

Exams and Tests

A physical exam may show a mass or tenderness in the abdomen, skin rash, swollen joints, or mouth ulcers.

Tests to diagnose Crohn disease include:

A stool culture or other tests may be done to check for other possible causes of the symptoms, such as infection, and to look for inflammation.

This disease may also alter the results of the following tests:

Treatment

Tips for managing Crohn disease at home:

DIET AND NUTRITION

You should eat a well-balanced, healthy diet. Include enough calories, protein, and nutrients from a variety of food groups.

An elemental diet has been shown to improve Crohn disease and its symptoms. However, this diet is not used often because of the taste.

Depending on the location(s) of your Crohn disease, the type of your Crohn disease, and the other problems it may cause, certain foods may be more difficult to eat. Types of food problems may vary from person to person.

Some foods can make diarrhea and gas worse. To help ease symptoms, try:

Ask your health care provider about extra vitamins and minerals you may need, such as:

If you have an ileostomy, you will need to learn:

STRESS

You may feel worried, embarrassed, or even sad and depressed about having a bowel disease. Other stressful events in your life, such as moving, a job loss, or the loss of a loved one can worsen digestive problems.

Ask your provider for tips on how to manage your stress.

MEDICINES

Ask your provider about taking anti-diarrheal medicines. In general, these should be avoided in people with IBD, if possible. Treating the IBD is the key to making diarrhea and other symptoms better.

Other medicines to help with symptoms include:

Your provider may also prescribe medicines to help control Crohn disease:

SURGERY

Some people with Crohn disease may need surgery to remove a damaged or diseased part of the intestine. In some cases, the entire large intestine is removed, with or without the rectum.

People who have Crohn disease that does not respond to medicines may need surgery to treat problems such as:

Surgeries that may be done include:

Support Groups

Social support can often help with the stress of dealing with illness, and support group members may also have useful tips for finding the best treatment and coping with the condition.

More information and support for people with Crohn disease and their families can be found at:

www.crohnscolitisfoundation.org

Outlook (Prognosis)

There is no cure for Crohn disease. However, the goals of treatment are to quiet the disease and keep it quiet. Surgery is used in particular situations but does not cure Crohn disease. If you smoke, stopping will help improve the disease.

Possible Complications

You have more risk for small bowel and colon cancer if you have Crohn disease. Your provider may suggest tests to screen for colon cancer. A colonoscopy is often recommended if you have had Crohn disease involving the colon for 8 or more years.

Those with more severe Crohn disease may have these problems:

When to Contact a Medical Professional

Contact your provider if you:

Related Information

Chronic
Ulcers
Intestinal obstruction and Ileus
Vitamin B12
Erythema nodosum
Ileostomy
Total abdominal colectomy
Total proctocolectomy and ileal-anal pouch
Total proctocolectomy with ileostomy
Crohn disease - discharge
Low-fiber diet
Constipation - what to ask your doctor
Diarrhea - what to ask your health care provider - adult
Ileostomy - what to ask your doctor
Bland diet
Ileostomy and your child
Ileostomy and your diet
Ileostomy - caring for your stoma
Ileostomy - changing your pouch
Types of ileostomy
Ileostomy - discharge
Living with your ileostomy
Large bowel resection - discharge
Small bowel resection - discharge

References

Ananthakrishnan AN, Reguerio MD. Management of inflammatory bowel diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 116.

Feuerstein JD, Ho EY; American Gastroenterological Association Institute Clinical Guidelines Committee, et al. AGA clinical practice guidelines on the medical management of moderate to severe luminal and perianal fistulizing Crohn's disease. Gastroenterology. 2021;160(7):2496-2508. PMID: 34051983 pubmed.ncbi.nlm.nih.gov/34051983/.

Galandiuk S, Netz U, Morpurgo E, Tosato SM, Abu-Freha N, Ellis CT. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 52.

Kaplan GG, Ng SC. Epidemiology, pathogenesis, and diagnosis of inflammatory bowel diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 115.

Lichtenstein GR. Inflammatory bowel disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 127.

Ricci JP, Talamini MA. Management of Crohn's disease of the small bowel. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:134-137.

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Review Date: 1/24/2025  

Reviewed By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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