Crohn's disease

Reviewed by Dr Paul Klenerman, consultant physician

What is Crohn's disease?

This is a chronic inflammatory disease which causes stomach pains, diarrhoea, and weight loss.

The disease is characterised by periods of activity and remissions.

It typically affects the lower part of the small intestine (ileum) or the large intestine (colon), but it can affect any part of the digestive system.

The affected areas become red and swollen and ulceration may occur. As the ulcers heal, the formation of scar tissue makes the intestine increasingly narrow, leading to obstruction.

There is no cure for Crohn's disease, but the symptoms can be treated and the periods of remission can be made to last several years.

What causes Crohn's disease ?

The cause of Crohn's disease is unknown, but it tends to be more common in relatives of patients with Crohn's disease.

The disease typically begins between the ages of 20 and 30.

What are the symptoms of Crohn's disease?

The symptoms vary and depend on the severity and location of the disease.

Many patients only have mild symptoms for a long time and have often had the disease for several years before it is diagnosed.

Periods of mild fever, sometimes with blood in the stools, and pain in the lower right part of the abdomen.

Loss of appetite.

Unintentional weight loss.

Boils (cavities containing pus) and fistulas (formation of small passages that connect the intestine with other organs or the skin).

General malaise.

How can Crohn's disease be prevented?

Crohn's disease cannot be prevented.

How is Crohn's disease diagnosed?

Crohn's disease is suspected in patients who have had diarrhoea, stomach pains and weight loss for more than three to four weeks. Blood samples, stool specimens, endoscopic examinations of the small and large intestines, and X-ray studies can often confirm or disprove the diagnosis of Crohn's disease. It is important that a biopsy be taken from the affected areas, as it can confirm or rule out the diagnosis in many cases.

What can be done at home?

Watch out for signs indicating that the disease is becoming worse:

blood in the stools

new or different pain

a fever which cannot be attributed to anything else.

If you have these symptoms, contact your doctor.

Activity

Acute attacks require rest.

In periods of remission, the patient should try to resume their normal activities.

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