Crohn’s Disease: Causes, Symptoms, Diagnosis, and Treatments

Overview

Crohn’s disease usually affects the ileum (the last portion of the small intestine) but in some cases it can occur anywhere along the GI tract from mouth to anus.

Inflammation in Crohn’s disease occurs in segments, with some colon areas being skipped (it is not continuous like colitis); the entire bowel wall from the inner to the outer lining gets inflamed.

As Crohn’s disease progresses it may cause thickening of the intestinal wall leading to narrowing of the intestinal passageway, which in time can result in intestinal obstruction preventing normal flow of stool.

Surgery must be done if the intestines become blocked.

Patients with Crohn’s disease usually suffer multiple bowel surgeries because when the diseased segment of the intestine is removed, in time (it takes anywhere from few months to 5 years) other previously healthy portions of the intestines become diseased and inflamed.

So one surgery triggers another until 50% or more of the intestine is removed causing Short Bowel Syndrome (when the patient runs to the bathroom 5-10 times daily and complains of chronic diarrhea, cramps, bloating, malnutrition and malabsorption.)

Crohn’s disease may also cause anal fissures (tear in the anal canal), abscesses (a pocket filled with urine,  feces or pus), fistulas (an abnormal passageway connecting two body cavities like the vagina and the rectum).

Besides intestinal symptoms, Crohn’s disease may affect  other organs and cause arthritis, osteoporosis, eye pain and inflammation, skin lesions, hemolytic anemia and depression.

Anemia can become chronic in Crohn’s disease due to blood loss, vitamin B12 deficiency (B12 is absorbed in the ileum), medication use (such as sulfasalazine and azathioprine).

And last but not least, Chrohn’s disease increases patient’s risk for small or large bowel cancer.

Cause

The following risk factors may trigger Crohn’s disease:

  • Viral / Bacterial infections
  • Antibiotics
  • Cigarette smoking
  • Birth control pills
  • Food allergies/sensitivities
  • High intake of meat and simple sugars

Symptoms

  • Abdominal pain (often in the right lower side)
  • Diarrhea with blood and mucus
  • Weight loss, poor appetite, fat malabsorption
  • Fever, fatigue, nausea/vomiting

Diagnosis

A gastroenterologist should complete a complete physical examination together with a detailed medical history along with the following tests:

Blood Work

  • CBC (complete blood count) for anemia and leucocytosis (C-reactive protein and ESR (erythrocyte sedimentation rate) indicate inflammation process)
  • Vitamin B12 and folate levels
  • Serological marker ASCA (anti-Saccharomyces cerevisiae antibodies) found in 60-70% of patients with Crohn’s.

Colonoscopy

A colonoscopy can be used to see the terminal ileum.  During colonoscopy, physician takes few biopsies (small tissue samples) for confirming Crohn’s disease diagnosis and pathology analysis.

Radiologic tests

Radiologic tests such as CT and MRI are used to locate small bowel obstruction, fistulae and abscesses.

Wireless Camera Capsule

A new technique using a wireless capsule has been used to identify Crohn’s disease in the small bowel.  Patient swallows a capsule with a built-in camera. While camera goes through the entire GI tract, it takes pictures. At the end, the patient discharges the capsule from the anus together with feces.

Medical Treatment

Drugs and surgery are two ways modern medicine treats Crohn’s Disease.

Antibiotics

Antibiotics are used to treat fistulas and perineal (pelvic area) Crohn’s disease.

Example: Flagyl (Metronidazole) and Cipro (Ciprofloxacin).

Side Effects: Nerve damage, vomiting, nausea, cramps and a metallic taste in the mouth.

Corticosteroids

Corticosteroids are used to reduce inflammation in moderate to severe Crohn’s  disease.

Example: Prednisone and Budesonide.

Side Effects: Osteoporosis, high blood pressure, increased risk of infection, depression and mood swings.

Immunosuppressive Drugs

Immunosuppressive drugs block inflammation by suppressing the body’s immune system. Immunosuppressants are used when Crohn’s disease stops responding to steroids.

Example: Methotreaxate, Imuran (Azathioprine), 6-MP (6-Mercaptopurine), Remicade (Infliximab), Humira (Adalimumab).

Side Effects: Pancreatitis, hepatitis, weakened immunity, bone marrow toxicity, upper respiratory infections, lymphoma, liver cirrhosis.

Galina’s Opinion

Crohn’s is an autoimmune disease.  When our immune system becomes suppressed and out of balance, we get sick with autoimmune diseases.

I cannot find any logic in suppressing our already compromised immune system further with immunosuppressive drugs, when it should be strengthened and rebalanced via diet, physical exercise, natural herbs and supplements.

6 Responses to “Crohn’s Disease: Causes, Symptoms, Diagnosis, and Treatments”

  1. hi. would appreciate if you could send on any all round multi functional juicing recipies that you would reccomend. I train with weights also ,so take a large amount of protein via powder/bars which has led i think to black areas under the eyes, as i probably will continue to supplement with protein have you any specific juicing recipes for this.I juice first thing in the morning after the natural fast of nightime, so the first thing into a dehydrated system/dehydrated cells is juice. I am at the end of recent stomach upets after eating one of these protein bars…. i had 3 in pretty close sucession which led to stomach pains ,tenderness ,could not sleep for 3 nights, but has eased off considerably and appears to be at an end……i think.Could these bars be/have caused this. appreciate any informatiom.Thank

  2. Hey Tom, thanks for writing! You’ve got a few different questions here, so I’ll break them down:

    Q: What is causing your stomach pain?
    A: Your stomach pain could be caused by bacteria, food/drink/drug sensitivity, or a medical condition. It could even be an allergic reaction to ingredients in the protein bars. Sugar, dairy, peanut butter, and chocolate are common culprits. Without having a complete medical history, record of your diet, and bloodwork, it’s impossible for me to determine. I would recommend consulting with a gastroenterologist to diagnose whether your stomach pain is caused by bacteria like H. pylori (a common cause of stomach lining inflammation).

    Q: What causes under eye circles?
    A: Black circles under the eyes have many potential causes: anemia, kidney stress, heredity, lack of sleep, etc. Again, there’s that familiar refrain – it’s impossible for me to know without a complete medical history, record of diet, and bloodwork.

    Q: What is a good multifunctional juice recipe?
    A: In your case, I would recommend focusing on digestion first, since good digestion and absorption are necessary for gaining muscle mass (which I’m guessing is what you are after). Three times a day, 30 minutes before meals, drink 4 oz of green cabbage juice + 4 oz of carrot juice. Cabbage contains Vitamin U, which has a healing effect on the stomach lining. After meals, drink a cup of peppermint tea. The menthol promotes digestion and relaxes the muscles.

    Good luck! Let me know how it all works out.

    -Galina

  3. Is there a risk in stopping immunosuppressants all at once? Last week I decided to stop taking my medicine after being on Humira for 6months (Remicade before that for 2 years) and Imuran for 4 years. I am trying now to heal with raw foods and alternative medicine but my family does not support this and it’s scary when people tell you you’re doing the wrong thing…

  4. Sarah, I think you’re doing the right thing. Be strong and let them know that the only person who understands your experience is you. All medicines are poisons, and if you don’t feel its making you better, than it is making you ill in other ways. Go safely, and health to you;)

  5. Hi
    i have gravel in my gallbladder and also diagnosed ibs.twice in two weeks ive been at the hospital with severe pain under my right rib gage,come home feeling ok after a shot of morpine.I do have a burning sensation when i do no two and i go from constipation to the runs which was bright yellow with a bit of mucous in it.All the hospital wants to do is remove my gallbladder but in my hesrt i dont feel its that.
    Blessings

  6. Dear Denise:

    If your gallbladder is infected or blocked with stones, surgery may be the answer. I am not a physician. I am licensed clinical nutritionist/dietitian.
    And I can tell you, if this is not your case, there are certain diets and herbs, which can cleanse/support your liver and gallbladder.

    You must consider that your problem is clearly a complex one and in order to be resolved once and for all it requires holistic approach and comprehensive program. Comprehensive program simply means addressing both IBS and gallbladder issue.

    So, I can help your in the following manner: Immediately through individualized consultation.
    Here is the link to my consultation page: http://knowyourgut.com/consultation/index.html
    Should you decide to consult with me, purchase the consultation program online,
    and e-mail to me your phone number, so we can schedule initial consultation with you.

    Best Wishes of Health and Recovery,
    Galina Kotlyar MS, RD

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