What Is Crohn's Disease?
Crohn's disease makes parts of the intestine (bowel) red and swollen. It's a chronic condition, which means it lasts a long time or constantly comes and goes.
Crohn's disease is an inflammatory bowel disease (IBD). It can happen in any part of the gastrointestinal tract from mouth to anus (where poop comes out). It most often affects the end of the small intestine and the beginning of the large intestine. The inflammation of Crohn's disease damages the entire bowel wall.
What Are the Signs & Symptoms of Crohn's Disease?
The most common symptoms of Crohn's disease are belly pain and diarrhea. Other symptoms include:
- blood in the toilet, on toilet paper, or in the stool (poop)
- nausea or vomiting
- low energy
- skin tags, sores, or drainage around the anus
- mouth sores
- weight loss
Because Crohn's disease damages the whole bowel wall, there can be scarring, narrowing of the bowel, and fistulas. A fistula (FISS-chuh-luh) is an abnormal connection that links the bowel to the skin, bladder, vagina, or other loops of bowel. A fistula may leak stool (poop), pus, or blood.
Crohn's disease can cause other problems, such as rashes, eye problems, joint pain and arthritis, kidney stones, and gallstones. Children with Crohn's disease may not grow as well as other kids their age and may go through puberty later.
What Causes Crohn's Disease?
The exact cause of Crohn's disease is not clear. It is probably a combination of genetics, the immune system, and something in the environment that triggers inflammation in the gastrointestinal tract. Diet and stress may make symptoms worse, but probably don't cause the condition.
Crohn's disease tends to run in families. But not everyone with the condition has a family history of Crohn’s or IBD. Crohn's disease can happen at any age, but is usually diagnosed in teens and young adults. People who smoke are more likely to get it..
How Is Crohn's Disease Diagnosed?
Doctors diagnose Crohn's disease with a combination of blood tests, stool (poop) tests, and X-rays. They will check stool samples for blood. They also might do imaging tests, such as CT scans and MRI, might be done too.
Doctors can look at the colon using an endoscope, a long, thin tube with a camera attached to a TV monitor:
- In a colonoscopy, the tube goes in through the anus.
- In an upper endoscopy, the tube passes down the throat.
The doctor can see inflammation, bleeding, or ulcers in the esophagus, stomach, small intestine and on the wall of the colon. During the procedure, the doctor might do a biopsy, taking small tissue samples for testing in a lab.
How Is Crohn's Disease Treated?
Crohn's disease is treated with medicines, changes in diet, and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems and flare-ups, and possibly heal the inflamed intestines.
The doctor may recommend:
- anti-inflammatory drugs to decrease the inflammation
- immunosuppressive agents to prevent the immune system from causing more inflammation
- biologic agents to block proteins that cause inflammation
- nutrition therapy to give the bowel a chance to heal
Because some medicines make it harder to fight infections, it's important that your child be tested for tuberculosis and have all the recommended vaccines before starting treatment.
Doctors may prescribe antibiotics to prevent or treat infections. People with Crohn’s disease should always check with their doctor before using antidiarrheal medicine.
Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for someone with the condition to get the calories and nutrients they need. Kids should eat a variety of foods, get plenty of fluids, and learn to avoid foods that make symptoms worse. Some may need supplements, like calcium or vitamin D. Kids who are not growing well may need special formulas to boost calories and nutrition.
Surgery may be necessary if:
- the bowel gets a hole
- the bowel becomes blocked or narrowed
- a fistula forms
- bleeding can't be stopped
- symptoms don't respond to treatment
What Else Should I Know About Crohn's Disease?
People with Crohn’s disease are at risk for colon cancer, which is related to chronic inflammation. So they should get a colonoscopy every 1–2 years, starting about 10 years after diagnosis.
Kids and teens with Crohn's disease may feel different and not be able to do the things their friends can do, especially during flare-ups. Some struggle with a poor self-image, depression, or anxiety. They may not take their medicine or follow their diet. It's important to talk to your health care professional if you're concerned about your child's mood, behavior, or school performance.
Parents can help teens with Crohn's disease can take on more responsibility for their health as they get older. Encourage teens to take their medicine, take care of themselves, and manage stress in positive ways. Yoga, meditation, breathing and relaxation techniques, music, art, dance, writing, or talking to a friend can help.
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