Understanding Crohn’s Disease: Treatment Options and Care
Although there is no cure for Crohn’s disease, this immune-mediated inflammatory disease causes inflammation in the digestive tract can be managed. Its treatment usually focuses on calming inflammation, reducing flare-ups, easing symptoms, and preventing complications. In some cases, surgery may also be needed when medicines are no longer enough.
Keep reading to find out the best treatment for Crohn's disease, along with key causes, risk factors, common symptoms, prevention tips, and more.
What is Crohn’s Disease?
Crohn’s disease is chronic inflammatory bowel disease (IBD) that causes swelling and irritation in the tissues of your digestive tract. It’s an autoimmune condition that affects the small and large intestines. However, it may also affect any part of your digestive tract from the mouth to the anus.
The inflammation can spread to deeper layers of the bowel and lead to serious or life-threatening complications at times.
What Causes Crohn’s Disease?
There’s no definite known cause of Crohn’s disease, but it’s mainly related to an irregular immune response. Some possible causes and risk factors of Crohn’s disease include:
1. Dysfunctional Immune Response
The immune system tries to fight off an invading bacterium. Sometimes, it becomes overactive and launches an inappropriate attack on bacteria normally found in your gut, causing Crohn’s-related inflammation in your intestines. This autoimmune response can lead to Crohn’s disease.
2. Genetics
Around 20% of people with Crohn’s disease have a family member with the condition. If you have a first-degree relative, such as a parent or sibling, with Crohn’s disease, then you’re at increased risk of developing the condition.
3. Age
Crohn’s disease can affect anyone at any age, but people are usually diagnosed in their late teens through early 30s.
4. Appendectomy
People who have undergone appendix surgery may have a slightly higher risk of Crohn’s disease. The reasons behind it are unclear, but you shouldn’t avoid this surgery if it’s necessary.
5. Environmental Factors
Crohn’s disease is more common in cities and developed countries than in rural areas. Diet, pollution, lifestyle changes, and frequent antibiotic use may be some of the reasons behind this.
6. Smoking
Studies have shown that smoking cigarettes may double your risk of getting Crohn’s disease. It may worsen inflammation in the digestive tract and increase the chances of complications or surgery later on.
7. Stress
Stress and anxiety do not directly cause Crohn’s disease, but they can worsen symptoms during flare-ups and trigger stomach pain, cramps, or diarrhoea in some people.
8. Certain Medications
Pain relievers such as ibuprofen, naproxen sodium, diclofenac sodium, and others can cause inflammation in the bowel that worsens the symptoms of Crohn’s disease.
Common Symptoms of Crohn’s Disease
The symptoms of Crohn’s disease develop gradually or appear suddenly. When the symptoms suddenly become active, it’s called a flare-up. Some common symptoms of Crohn’s disease are:
- Stomach ache or cramps
- Watery stool or chronic diarrhoea
- Rectal bleeding (passage of bloody stool or bloody diarrhoea)
- Reduced appetite and weight loss
- Chronic pain in the mouth or gums, or ulcers in the mouth
- Chronic fatigue and fever
- Painful, pus-filled abscesses near the anal canal
- In children, Crohn’s disease can cause a delay in growth.
It can also cause symptoms in other parts of the body, outside of your digestive tract, such as:
- Pain in the joints or arthritis
- Eye inflammation, like uveitis (swelling inside the eye) and episcleritis (redness and inflammation on the white part of the eye)
- Skin rashes
- Loss of bone mass or osteoporosis
- Kidney stones
- Inflammation in the bile ducts
- Skin tags (small, harmless folds of skin) around the anus
What Are the Treatment Options for Crohn’s Disease?
Since there is no known cure, the Crohn’s disease treatment depends on the severity of the condition. Mild to moderate symptoms can be managed easily with medicines. But people with severe symptoms may require surgical intervention if medicines don’t work.
Different types of medicines used for the treatment of Crohn’s disease are:
1. Anti-inflammatory Medications
These are often the first step in treatment because they help reduce inflammation in the intestines. However, if the inflammation lies in the small intestine, then it won’t work well.
2. Corticosteroids
Medicines like prednisone and budesonide can help reduce inflammation in the body, but they don't work effectively for everyone. Some people may need steroids given through a vein (intravenous steroids) in a hospital for a short time. These medicines are usually used for 3 to 4 months to control flare-ups and help other medicines start working effectively.
3. Immunosuppressants
Medicines like Azathioprine and mercaptopurine are used to reduce inflammation. They work by targeting the substances that the immune system produces to trigger the symptoms.
4. Biologics
These medicines calm the parts of your immune system by targeting the proteins made by the immune system. It’s used to treat moderate to severe flare-ups of symptoms. Medications include TNF inhibitors, integrin inhibitors, IL-12/23 inhibitors and IL-23 inhibitors that you are given either through an IV or a shot.
5. Small Molecule Therapies
These are oral medications that help reduce inflammation by targeting parts of the immune system that cause inflammation in the intestines. These are also known as Janus kinase (JAK) inhibitors, which are recommended if your symptoms haven’t responded to other therapies. Upadacitinib is the only JAK inhibitor approved by the U.S. Food and Drug Administration to treat Crohn’s disease.
6. Antibiotics
These are prescribed to reduce drainage from fistulas (abnormal tunnel-like openings between organs or tissues) and abscesses (pus-filled infections), which helps them heal properly. It can also reduce harmful bacteria that may be causing inflammation in the intestine. Ciprofloxacin and metronidazole are the commonly prescribed antibiotics for Crohn’s disease.
7. Other Medicines
To manage specific symptoms of Crohn’s disease, these additional medicines may be prescribed:
- Pain Relievers: Paracetamols may be prescribed to treat mild to moderate pain. However, strong painkillers are not recommended since they can worsen the flare-ups.
- Anti-diarrheal Medicines: Fibre supplements such as psyllium husk or methylcellulose may be prescribed to treat mild to moderate diarrhoea by adding bulk to the stool. Medicines like loperamide can prove effective for severe diarrhoea.
- Vitamins or Supplements: If your body isn’t absorbing enough nutrients, then your doctor may prescribe vitamins and other nutritional supplements.
8. Nutritional Therapy
When the body doesn’t receive the right nutrition, then the healthcare professional may recommend a special diet given by a feeding tube, called enteral nutrition. It can also be delivered into a vein, which is called parenteral nutrition. It will improve your overall health and allow the bowls to rest, which will reduce inflammation in the short term.
9. Surgery
If medicines and dietary adjustments are not working in case of severe symptoms, you may need surgery. While it doesn’t cure the disease completely, the surgery can remove intestinal perforations (holes), fistulas, strictures (narrowed sections of the intestine) and blockages to curb the complications of Crohn’s disease.
Tips to Prevent Crohn’s Disease
While you can’t prevent Crohn’s disease completely, you can follow these tips to ease symptoms and reduce flare-ups:
1. Avoid Smoking
Try to quit smoking, as it may significantly reduce the risk of flare-ups and complications.
2. Manage Stress
Stress can worsen the symptoms of Crohn’s disease during flare-ups. Try to get at least seven hours of sleep a night, exercise regularly, and find healthy ways to relieve stress, such as meditation, journaling, and yoga.
3. Avoid Foods That Trigger Flare-ups
If you have stricture, then the medical professional may ask you to avoid fibre-rich foods. Carbonated drinks, caffeine, and alcohol can worsen your symptoms, so try to avoid them completely. If you’re lactose intolerant, then avoid dairy products to reduce flare-ups.
4. Spread Out Your Meals
Try to eat in smaller amounts five or six times a day rather than eating three square meals. This may help ease digestion during flare-ups.
5. Avoid Medicines That Increase Risk of Flare-ups
If you’re experiencing pain, then consult your healthcare professional to prescribe a mild pain reliever. Avoid nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, as they can worsen symptoms.
Crohn’s disease symptoms can be managed with patience, discipline, and long-term treatment. Most people with Crohn’s disease enjoy a full, active life by adhering to a healthy lifestyle, practicing proper pain management, and engaging in timely health monitoring.
Reader Information: The information provided in this article is intended for educational and informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Crohn’s disease is a complex condition that requires individualized care based on a patient’s medical history, severity of symptoms, and overall health.
Always consult a qualified healthcare professional, such as a gastroenterologist, before starting, changing, or stopping any medication, treatment plan, or dietary regimen.
FAQs
1. Does Crohn’s disease increase the risk of cancer?
Yes, Crohn’s disease does increase the risk of developing colon cancer, typically after 8 to 10 years of the onset of the disease. This is specifically seen in patients who have long-term, untreated inflammation of the colon.
Therefore, patients with Crohn’s disease require regular screenings and follow-ups to detect any cancers or precancerous changes. An early diagnosis of either colon cancer or precancerous stage can be effectively treated with surgical intervention.
2. Is Crohn’s Disease Fatal?
Crohn’s disease isn’t usually a life-threatening condition. It can be effectively managed with medications and lifestyle adjustments. However, if the inflammation is left untreated, it can lead to serious health complications over time, such as intestinal blockages, ulcers, internal bleeding, and even colon cancer.
3. How does Crohn’s disease affect pregnancy?
Most people with Crohn’s disease have healthy pregnancies if they conceive while the disease is in remission (a period when symptoms are inactive). However, flare-ups during pregnancy may increase the risk of miscarriage, premature labour, and low birth weight of the newborn baby.
4. Do patients with Crohn’s disease need surgery?
Yes, around 50 – 70% of patients with Crohn's disease will need surgery at some point in their lives.
5. Can surgery cure Crohn’s disease?
A surgery can’t cure Crohn's disease, as it can come back in any part of the intestine. However, the surgery may help if a segment of the intestine is severely damaged or not responding to treatment.
6. Can Ayurveda cure Crohn’s disease?
While there is no permanent cure, the Crohn's disease ayurvedic treatment aims for long-term remission. It mainly focuses on managing the root cause to reduce flare-up frequency and improve quality of life.
