Patient education: Crohn disease in adults (The Basics)

What is Crohn disease? — Crohn disease is a condition that can cause diarrhea, belly pain, and other symptoms. It mainly affects the digestive system. The digestive system includes all of the parts of the body that take in food and break it down into nutrients and waste. It includes the mouth, stomach, and intestines (figure 1).

Crohn disease is a type of "inflammatory bowel disease" ("IBD"). While the cause of IBD is not clear, people with IBD typically have problems with their immune system (the body's infection-fighting system). This leads to inflammation, which can cause symptoms.

So far, doctors do not have a cure for Crohn disease. But medicines and other treatments can help improve symptoms and heal inflammation.

What are the symptoms of Crohn disease? — The most common symptoms are:

●Diarrhea

●Belly pain

●Feeling tired

●Weight loss

●Fever

Some people with Crohn disease also get mouth sores, skin rashes, joint pain, and eye redness.

Symptoms can get better or worse at different times.

Is there a test for Crohn disease? — Yes. There are a few tests that can help diagnose Crohn disease. These include:

●Lab tests – These could include blood tests or stool tests.

●Imaging tests – Imaging tests show pictures of the inside of the body. Examples include X-rays, CT scans, and MRI scans.

●"Colonoscopy" – This test looks at the lining of the large intestine (figure 1). During this test, a doctor puts a thin tube into the rectum and moves it up into the colon. The tube has a camera on the end so the doctor can look inside the colon (figure 2).

Depending on your symptoms, you might get other tests, too. This can help your doctor figure out if something other than Crohn disease is causing your symptoms.

Is there anything I can do on my own to feel better? — Yes. Your symptoms might improve if you:

●Avoid or limit foods that make your symptoms worse. Some people have problems with foods that have a lot of fiber, such as fruits and vegetables. Alcohol and caffeine might also make your symptoms worse.

●Quit smoking, if you smoke. Smoking makes symptoms worse and increases the chances that you will need surgery. It can be hard to quit smoking, but your doctor or nurse can help.

●Avoid medicines such as ibuprofen (sample brand names: Motrin, Advil) and naproxen (sample brand name: Aleve).

How is Crohn disease treated? — There are many different medicines that help reduce the symptoms of Crohn disease. Almost all of these medicines work by reducing inflammation and the body's immune response. Some medicines treat symptoms when they are at their worst. Other medicines help keep symptoms from starting or coming back.

You might have to try a few different medicines before you find the one that works best for you.

Is surgery an option? — Surgery is helpful if medicines do not do enough to control your symptoms, or if the medicines cause really bad side effects. Surgery does not cure the disease, but it can help you feel better and return to normal activities.

Surgery might be needed to:

●Re-open parts of the intestine that have become blocked

●Remove parts of the intestine that are leaking (called a "perforation")

●Remove the diseased part of the colon

Does Crohn disease lead to colon cancer? — It can. Your risk depends on how long you've had Crohn disease and whether your colon is affected.

Experts suggest that people with long-standing Crohn disease that affects the colon get screened for colon cancer. Your doctor will talk to you about how often this is needed. Doctors can look for signs of colon cancer and treat it if they find it.

What will my life be like? — People with Crohn disease often need treatment for life. But with treatment, many people can live fairly normal lives.

Talk to your doctor or nurse if your Crohn disease is making you feel stressed or depressed. They can help you find ways to manage these feelings. For example, it might help to find a support group for people with Crohn disease.

What if I want to get pregnant? — In most cases, Crohn disease does not affect a person's ability to get pregnant. If you want to get pregnant, talk to your doctor or nurse before you start trying. They can make sure that you get all of the tests you need before and during your pregnancy. Plus, your doctor or nurse might want to switch your medicines. That's because some of the medicines used to treat Crohn disease might not be safe for a baby.

When should I call the doctor? — Call for advice if you:

●Have signs of infection – These include a fever of 100.4°F (38°C) or higher and chills.

●Have very bad belly pain

●Have vomiting, or cannot keep down food or liquids

●Have bloody or black bowel movements

●Are having trouble coping with your Crohn disease

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