Crohn's Disease

Crohn's disease is one form of inflammatory bowel disease, a disorder that's characterized by inflammation in the gastrointestinal tract. Although Crohn's can affect any area in the GI tract, from the mouth to the anus, the inflammation usually occurs in the ileum, or the end of the small intestine.
By Stephanie Booth
Updated September 17, 2021

Crohn's disease is one form of inflammatory bowel disease, a disorder that's characterized by inflammation in the gastrointestinal tract. Although Crohn's can affect any area in the GI tract, from the mouth to the anus, the inflammation usually occurs in the ileum, or the end of the small intestine.

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What Is It?

Belly pain, diarrhea, fatigue, weight loss — these are all hallmark signs of Crohn's disease, a painful inflammation somewhere along your digestive tract.

More than half a million Americans live with Crohn's disease. You can have it at any age, but it's most commonly diagnosed in people in their 20s. Crohn's is a chronic condition that you'll live with for life, but many different treatments can successfully manage the symptoms. With the right treatment and a few careful lifestyle changes, it's also possible to go into remission and become symptom-free — sometimes for years at a time.

Even if you have mild symptoms of Crohn's, it's important to check in regularly with your doctor. If it's not managed well, Crohn's can cause other serious health issues, including anemia (low red blood cell count), arthritis, glaucoma, and liver or gallbladder disease. It can also occasionally cause life-threatening complications.

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Types

You can have five different types of Crohn's, depending on which part of your GI tract is affected:

Ileocolitis: The most common form of Crohn's, ileocolitis affects the end of your small intestine and your colon (large intestine.)

Ileitis: If only the end of your small intestine is affected, you have ileitis.

Gastroduodenal Crohn's: To be diagnosed with this type, your doctor will find inflammation in your stomach and the beginning of your small intestine (duodenum).

Jejunoileitis: Some people have inflammation spread here and there throughout the upper half of their small intestine.

Crohn's colitis: With this kind of Crohn's, inflammation is limited to your colon.

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Symptoms

The symptoms you have will depend on your diagnosis, and which part of your G/I tract is inflamed. Everyone experiences Crohn's differently, too. Some people will have severe symptoms that come out of nowhere. Others will feel a flare-up come on gradually.

Among the most common symptoms of Crohn's are:

You could also have periods of time where you have no symptoms at all.

Without treatment, Crohn's can potentially lead to complications like:

  • Malnutrition. Gut inflammation can make it hard for you to absorb enough nutrients from the food you eat.
  • Bowel obstruction. Scars can narrow your large intestine, causing a blockage.
  • Ulcers. Open sores can develop anywhere along your digestive tract, from your mouth to your anus.
  • Fistulas. If inflammation spreads through your intestine wall, it can create an abnormal tunnel between two organs, or between an organ and the outside of your body.
  • Abscess: Chronic inflammation can cause a painful, pus-filled pocket to form.
  • Anal fissures. These tiny tears in your anal tissue can be painful.
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Causes

Crohn's used to be blamed on a poor diet or too much stress, but it's now clear that although both can make the condition worse, neither is a root cause. It's still unclear what causes Crohn's disease, but two aspects could play a part:

  • Your genes. Inflammatory bowel disease is known to run in families. If you're directly related to someone with Crohn's, you have a higher risk of having it, too.
  • Your immune system. A misfiring immune system can cause infection-fighting cells to attack your digestive tract by mistake.

Other factors which are known to increase your risk of Crohn's include:

  • Ethnicity. White people, especially of Eastern European Jewish (Ashkenazi) descent, are more likely to have Crohn's.
  • Tobacco use. If you smoke, your chances of being diagnosed with Crohn's almost double. Smoking is also linked to more severe cases of Crohn's and a higher need for surgery.
  • Medication. Certain types, like birth control pills, NSAIDs (non-steroidal anti-inflammatory drugs), ibuprofen, and antibiotics, sometimes play a small role.
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Diagnosis

There's no single test that confirms you have Crohn's. Your doctor will likely run several tests to rule out other conditions and/or try to gauge the severity of your condition. For instance:

  • A blood test is where doctors often start to get more information about your health. For instance, 1 in 3 people with Crohn's have anemia, or too few red blood cells. Too many white blood cells can indicate an infection or inflammation.
  • A fecal sample can test for parasites that could be causing GI symptoms.
  • An upper GI exam uses x-rays to check how well your digestive tract is functioning.
  • Your doctor may want you to have a colonoscopy. During this out-patient procedure, an instrument is used to get an up-close view of the inside of your colon. Tissue samples may also be removed and tested.
  • A computed tomography (CT) scan is an imaging test that allows your doctor to see which parts of your digestive tract are inflamed and to what degree.
  • During an upper GI endoscopy, a very thin tube with a camera on the end is gently threaded into your throat to check for issues.
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Treatment

There's no cure for Crohn's disease — it's a lifelong condition. Although many treatments are available, you'll likely need to do several to reduce the inflammation that's causing your symptoms and to lower your risk of any future complications. To do that, your doctor could suggest any of the following:

  • Antibiotics
  • Anti-diarrhea medication
  • Bowel rest
  • Corticosteroids (which ease inflammation)
  • Medication (to suppress your immune system)
  • Nutrition therapy (a special diet can help reduce your bowel movements)
  • Surgery (to stop bleeding, remove intestinal blockages, fix tears and remove damaged areas)

Nearly half of all people living with Crohn's need surgery at some point, although the benefits of it are often short-lived. It's common for inflammation to usually return.

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Prevention

To manage Crohn's symptoms, you can:

  • Pay special attention to your diet. You may find that soft, bland foods are easier to digest than spicy foods or ones that are high in fiber, like raw veggies. Limiting dairy, greasy foods, or foods that cause gas (like beans or broccoli) could also help. A food journal will let you see connections between the foods you eat and your symptoms.
  • Avoid NSAIDs. These types of medicine are rough on your GI tract.  If you need an over-the-counter pain medicine, talk to your doctor. Acetaminophen (Tylenol) is probably your best choice.
  • Cut out tobacco. Once you stop smoking, you're likely to have fewer flares. You'll also reduce chances that you'll need surgery.
  • Limit caffeine and alcohol. Both can worsen Crohn's symptoms.
  • Manage your stress. Meditation, yoga, talk therapy, or deep breathing can all help you stave off — or get through — a flare.

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