About Crohn's disease: Know the facts

What is Crohn's disease?

Currently affecting an estimated 500,000 people in the United States, Crohn's disease is a chronic inflammatory bowel disease (IBD) that causes inflammation or swelling of the digestive tract, also known as the gastrointestinal (GI) tract¹.

Crohn's disease can affect any part of the GI tract, though it usually occurs at the end of the small intestine, also known as the ileum, and the beginning of the large intestine, also known as the colon². Crohn's disease often is mistaken for other GI disorders that cause similar symptoms, such as ulcerative colitis, diverticulitis and irritable bowel syndrome (IBS)¹.

Symptoms and potential complications of Crohn's disease

Crohn's disease symptoms may range from mild to severe and can vary widely from person to person². Most people experience periods when they have flare ups, followed by episodes of remission when the symptoms decrease or even disappear². Commonly reported symptoms include the following:

• Persistent diarrhea
• Abdominal cramps and pain
• Fever
• Fatigue

Rectal bleeding and loss of appetite may also occur. In addition to the effects on the gastrointestinal tract, Crohn's disease can also affect other areas of the body such as the joints, eyes, skin, and liver².

Along with painful symptoms, Crohn's disease can lead to complications, including an obstruction of the intestine due to swelling and the formation of scar tissue¹.

Other potential complications of Crohn's disease include the development of fissures (small cuts or tears in the anal canal), abscesses (localized infection or collection of pus), and fistulas (an abnormal tunnel that forms between two structures of the body)^1,2.

Causes and risk factors of Crohn's disease

Not much is known about what causes Crohn's disease. What is known is that it is a chronic inflammatory disease of the digestive or gastrointestinal tract that appears to be a result of a complex interaction of factors including³:

• Inherited genes
• The immune system
• Environmental factors

Researchers believe that once a person's immune system is "turned on" it doesn't know how to "turn off" at the right time causing inflammation that damages the intestines. This results in the pain and other symptoms of Crohn's disease².

Though it can occur at any age, most people are diagnosed with Crohn's disease between the ages of 15 and 35¹. Roughly 20% of people with Crohn's disease have a sibling, parent or child with some form of IBD³. Men and women are at equal risk, while people of European heritage are more likely to develop the disease¹.

Treatment options for Crohn's disease

Several types of drugs are used to treat Crohn's disease, including^1,2:

• Aminosalicylates: a class of anti-inflammatory drugs typically used to treat mild to moderate disease.
• Corticosteroids: steroids are used typically for moderate to severe disease.
• Immune modifiers: used especially for patients with moderate to severe disease and those who are steroid dependant.
• Antibiotics: may be used to treat fistulas and other infectious complications of Crohn's disease.
• Biologic therapy: used to treat moderate to severe disease when conventional therapy has proven ineffective.

Biologic drugs, also known as TNF (tumor necrosis factor) blockers, are a recent class of drug for the treatment of Crohn's disease. They work by neutralizing TNF, a protein in your body that in excess can cause inflammation in your gastrointestinal tract.

Biologic therapies work selectively, unlike corticosteroids which target the entire immune system.

As the location, symptoms and severity of Crohn's disease can vary greatly from person to person, finding the right treatment for you is crucial. That's why it's important to get as much information about treatment options as you can and to share it with your healthcare provider. Remember, only your doctor can determine which medications may be right for you.

References:

1. Mayo Foundation for Medical Education and Research. Crohn's disease. Available at: http://www.mayoclinic.com/health/crohns-disease/DS00104. Accessed December 6, 2006.
2. Crohn's and Colitis Foundation of America (CCFA). About Crohn's disease. Available at: http://www.ccfa.org/info/about/crohns. Accessed December 6, 2006.
3. National Institutes of Health (NIH). Crohn's Disease. NIH Publication No. 06-3410. February 2006