Inflammatory Bowel Disease (IBD) is a broad term that describes conditions with chronic or recurring immune response and inflammation of the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. In Crohn’s disease, inflammation can affect the entire digestive tract but is usually centered in the ileum (the final segment of the small intestine) and the beginning part of the colon (large intestine). Ulcerative colitis presents exclusively in the colon. Both illnesses are characterized by an abnormal response to the body’s immune system. They can occur at any age, but often initially develop in teenagers and young adults.
NOTE: It is easy to confuse IBD and irritable bowel syndrome (IBS), but they are very different diseases. IBS is a chronic disorder that affects the colon’s muscle contractions. Symptoms include cramping, abdominal pain, bloating, gas, diarrhea and constipation. While these symptoms are similar to IBD, they are generally less severe and many times can be controlled by diet.
The key difference between IBD and IBS is that IBS does not cause changes in bowel tissue or increase your risk of colorectal cancer. Intestinal inflammation is not a symptom of IBS, which is a much less serious disease than ulcerative colitis or Crohn’s disease. This site is devoted to providing information about IBD, specifically Crohn’s disease, and the information here will not assist people suffering from IBS.
What are the Symptoms of Crohn’s disease?
Crohn’s disease is a condition of chronic inflammation, and the symptoms of Crohn’s disease are different for each individual. It can potentially involve any location of the gastrointestinal tract, but it often affects the ileum and the beginning part of the colon. An estimated 4 million people worldwide suffer from this debilitating disease.
Historically, Crohn’s disease has predominately affected the adult population, but the number of children being diagnosed with this disease is increasing at an alarming rate. Although the disease affects patients from any ethnic background, research shows that it is prevalent among the Eastern European Jewish population.
In Crohn’s disease, all layers of the intestine may be involved and there can be normal healthy bowel between patches of diseased bowel. Symptoms include:
- Persistent diarrhea (loose, watery, or frequent bowel movements).
- Abdominal pain.
- Rectal bleeding (at times).
Loss of appetite and weight loss also may occur. Fatigue is another common complaint. While Crohn’s disease is usually contained to the digestive tract, it can also affect the joints, eyes, skin, and liver. There are different types of Crohn’s disease including:
- Crohn’s colitis: Only the colon is affected.
- Gastroduodenal Crohn’s disease: The stomach and the first part of the small intestine (duodenum) are chronically inflamed.
- Ileitis: The end of the small intestine (ileum) is affected.
- Ileocolitis: This is the most common form of Crohn’s disease and it affects the end of the small intestine (ileum) and the colon.
- Jejunoileitis: The upper half of the small intestine (jejunum) is affected by the disease.
- Perianal Disease: This affects about a third of Crohn’s patients and is characterized by perianal fistulas, fissures and skin tags.
- Oral Crohn’s: The mouth is affected, causing swollen lips and mouth fissures. Mouth ulcers (canker sores) are frequently found in Crohn’s patients, but this does not necessarily indicate oral Crohn’s disease.
- Metastatic Crohn’s: In rare cases, granulomatous lesions normally found in the gastrointestinal tract of Crohn’s patients are found in sites other than the gastrointestinal tract. When these occur on the skin, it is called Cutaneous Crohn’s disease.
The most common complication of Crohn’s disease is blockage of the intestine due to swelling and scar tissue. This occurs when the chronic inflammation common in Crohn’s disease produces scar tissue that builds up inside the intestine to create a stricture. A stricture is a narrowed passageway that can slow the movement of food through the intestine, causing pain and cramping. Strictures can partially or completely block the intestinal tract. Symptoms of blockage include cramping pain, vomiting, and bloating. Another complication is sores or ulcers within the intestinal tract. Sometimes these deep ulcers turn into tracts—called fistulas.
The majority of patients with Crohn’s disease will require surgery at some point during their lives. Surgery becomes necessary in Crohn’s disease when medications can no longer control the symptoms. Nearly 80% of Crohn’s patients will eventually require surgery to treat their disease, and of those, about 60% will have a recurrence of their disease within 10 years of surgery. Crohn’s patients may also have an increased risk of colon cancer as well.
The lives of Crohn’s patients are blighted by multiple hospitalizations, surgeries, and immunosuppressive therapies, which often come with nasty side effects. As a result, many have difficulty holding down a job or attending school. There is currently no cure for Crohn’s disease and the annual financial burden of IBD in the United States may be more than $31 billion. In the United Kingdom, the NHS spends more than £720 million each year. A cure would not only give Crohn’s disease sufferers their lives back, but could offer huge cost savings to the patients, insurance companies, government and NHS.
Currently, there is no acknowledged cause of Crohn’s disease. However, there is mounting evidence that a bacteria, specifically a human strain of Mycobacterium avium subspecies paratuberculosis (MAP), may play a key role.