Crohn’s Disease Explained - Signs, Triggers and Therapies

Crohn’s Disease: Symptoms, Causes & Treatment Approaches

Crohn’s Disease (CD) is a long-term inflammatory bowel disease (IBD) that can impact any part of the digestive tract. It most often affects the small intestine and the start of the large intestine, causing symptoms such as abdominal pain, diarrhoea, fatigue, and weight loss. The condition can vary in severity and may lead to complications over time.

What are the key symptoms of Crohn’s disease?

Crohn’s disease can manifest with a wide range of symptoms. Here are some of the key symptoms which are common in individuals suffering from Crohn’s disease:

• Diarrhoea: Patients suffering from CD experience frequent and persistent watery bowel movements.
• Abdominal Pain and Cramps: Pain can range from mild to severe, and sometimes it can occur anywhere within the abdominal region.
• Weight Loss: Individuals sometimes experience unexplained weight loss due to malnutrition and the body’s inability to absorb nutrients.
• Fatigue: Extreme tiredness and constant fatigue are common symptoms of Crohn’s disease.
• Blood in Stool: In some cases, patients experience blood in their stools, and the stool appears black and tarry.
• Mouth Sores: Frequent ulcers or sores in the mouth without any injuries may be a sign of Crohn’s disease.
• Perianal Disease: Sometimes patients may experience pain, inflammation, or drainage near the anus due to fistulas or other related complications.
   

What Causes Crohn’s Disease?

The exact cause of Crohn’s disease is unknown, but scientists believe that it may occur due to a combination of environmental, genetic, and immune system factors. In the following section, we will discuss these factors in detail:

• Abnormal Immune Reaction: Crohn’s disease exhibits chronic inflammation in the digestive tract, which often occurs due to triggered abnormal immune responses. Autoimmune responses can attack and damage the healthy cells within the linings of your digestive tract, causing inflammation.
• Genetical Factors: Crohn’s disease can run in families, which may suggest a genetic predisposition. Scientists have identified over 200 genes associated with this condition, but their specific roles are still under research.
• Environmental Factors: Certain environmental factors are associated with an increased risk of developing Crohn's disease or triggering flares. These include smoking and the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and oral contraceptives.
• Gut Microbiome: The gut microbiome, or the community of microbes in the digestive tract, may also be involved in the development of Crohn’s disease. Studies have found differences in the microbiomes of people with or without Crohn’s disease.

What are the treatments for Crohn’s disease?

Healthcare providers generally manage Crohn’s disease through a combination of treatments, including nutritional therapy, medications, and, in some cases, surgery. The primary goal is to reduce inflammation, alleviate symptoms, and achieve remission.

Let us explore some medications that doctors recommend to treat Crohn’s disease:

• Anti-inflammatory Medications: Doctors commonly recommend certain anti-inflammatory medicines, such as corticosteroids and prednisone, to reduce inflammation. However, these are not recommended for long-term treatment due to their potential side effects.
• Oral 5-aminosalicylates: Certain medications, like mesalamine and sulfasalazine, can treat the inflammation in the inner linings of the colon. These drugs mainly reduce inflammation in the linings of the gastrointestinal tracts. 
• Immunosuppressant: Medications like azathioprine and 6-mercaptopurine can suppress the immune system. Eventually, there will be a decrease in unexpected immune responses, leading to a reduction in inflammation.
• Biologics: Biologics are a cornerstone of modern treatment for moderate to severe Crohn's disease. These antibodies target specific proteins in the immune system to reduce inflammation. They include TNF-alpha inhibitors, integrin receptor antagonists and interleukin-12 and IL-23 antagonists

The therapy is personalized based on disease severity, location, and complications. The goal is to induce and maintain remission, achieve mucosal healing, and prevent long-term complications. Medications are chosen strategically to meet these goals.

In addition, healthcare providers may prescribe antibiotics to help manage complications of Crohn’s disease, particularly for infections such as perianal abscesses or fistulas. These medications help reduce inflammation and prevent bacterial overgrowth, improving symptoms and promoting healing in affected areas of the digestive tract.