Crohn’s disease is often referred to as “the other bowel disorder” because its symptoms closely mimic ulcerative colitis. Indeed, both conditions cause incurable, chronic inflammation of the lining of the digestive tract, triggering severe episodes of diarrhea and abdominal cramping after meals.
Doctors refer to both diseases together as inflammatory bowel disease, and more than one million Americans suffer from it.
There are notable differences, however, between the two conditions. Crohn’s can occur in patches throughout the digestive tract, including the throat and stomach, often boring deep into tender tissue. Ulcerative colitis usually appears in a continuous pattern only on the innermost layer of tissue of the large intestine and rectum.
In addition to diarrhea, Crohn’s may cause:
- loss of appetite
- unexplained weight loss
- blood in stool
- joint pain
The causes of Crohn’s are unknown, although researchers believe they’ve found a genetic trigger that may lead to breakthroughs in its prevention. And doctors already know that the disorder runs in families—one in every five patients has a close relative with the disease.
Other theories include an as-yet unidentified virus or bacterium, an immune system disorder, a fat-laden diet or certain environmental factors. The disease can strike at any age, although it usually develops equally in males and females between ages 15 and 35.
Doctors diagnose Crohn’s disease by looking for signs of blood loss. Tests may reveal anemia, for example, which suggests intestinal bleeding. Or a stool sample may reveal occult (hidden) blood. Other signs, such as an elevated white blood cell count, indicate that the patient is fighting inflammation inside the body.
Doctors may also use these diagnostic tools:
- Upper GI series. The patient drinks barium, a chalky fluid that adheres to the small intestine and looks white on X-rays. This helps doctors spot abnormalities and inflammation in the intestine.
- Barium enema. Barium is given by enema, creating an outline of the rectum, large intestine and part of the small intestine which doctors can then examine with X-rays.
- Sigmoidoscopy. Using an endoscope—a thin, flexible lighted tube tipped with a miniature TV camera—doctors can view the sigmoid, or last 24 inches of the colon and rectum.
- Colonoscopy. With an endoscope, doctors can see the insides of the rectum as well as the large intestine and take note of inflammation or bleeding. Colonoscopy is considered the most sensitive diagnostic tool for Crohn’s.
- Biopsy. During colonoscopy, tissue samples from the intestine are removed and placed under a microscope to detect granulomas—clusters of inflamed cells that occur only with Crohn’s disease.
Although Crohn’s disease is still a mystery illness, several effective therapies are available that sometimes result in years of remission between flare-ups.
Medication to reduce inflammation is normally the first line of treatment for Crohn’s. Aminosalicylates, including mesalamine, are widely prescribed, while corticosteroids are given for more severe cases. Drugs called immune system suppressants block the immune reaction that causes inflammation.
Once symptoms subside, doctors can treat related conditions with nutritional therapy, iron and vitamin B12 supplements to fight anemia, antibiotics to help heal abscesses, antidiarrheals to give bulk to stool and acetaminophen for mild pain relief.