Crohns disease

"Crohn's disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Inflammatory bowel disease (IBD) Crohns disease Crohns disease Crohns disease is a long-term condition that causes inflammation of the lining of the digestive system. Inflammation can affect any part of the digestive system, from the mouth to the back passage. But it mostly occurs in the last section of the small intestine (ileum) or the large intestine (colon). Crohns disease can affect people of all ages, but its usually diagnosed between the age of 15 and 40. Symptoms The symptoms of Crohns disease vary. They depend on which part of the digestive system is inflamed. Common symptoms include: recurring diarrhoea abdominal pain and cramping, which is usually worse after eating extreme tiredness (fatigue) unintended weight loss blood and mucus in your poo You may have long periods without symptoms, or very mild symptoms. This is known as remission. This may be followed by periods where the symptoms are particularly troublesome. These are known as flare-ups or relapses. Less common symptoms include: a high temperature (fever) of 38C (100F) or above feeling sick (nausea) being sick (vomiting) joint pain and swelling ( arthritis ) inflammation and irritation of the eyes (uveitis) areas of painful, red and swollen skin  most often the legs mouth ulcers anal pain and discharge due to perianal Crohns Children with Crohns disease may grow at a slower rate than expected. Speak to your GP practice if you have: diarrhoea for more than 7 days persistent abdominal pain unexplained weight loss blood in your poo concern about your childs development Causes The exact cause of Crohns disease is unknown. A combination of factors may be responsible, including: genetics  genes you inherit from your parents a problem with the immune system (the bodys defence against infection and illness)  where it attacks healthy bacteria in the gut and causes inflammation environmental factors  like air pollution, medication or previous infections smoking  smokers are twice as likely to develop Crohns disease, and usually have more severe symptoms than non-smokers Diagnosis Your GP will usually ask you about: your pattern of symptoms your diet any recent travel  for example, you may have developed travellers diarrhoea whether youre taking any medication, including any over-the-counter medicines whether anyone else in your family has any bowel conditions Your GP may also carry out a tests to check your general health. For example, they may: check your pulse check your blood pressure measure your height and weight measure your temperature examine your abdomen (tummy) Your GP may also: arrange blood tests to check for inflammation, infection and anaemia ask for a stool (poo) sample to use a qFIT test to check for blood and mucus, infection or inflammation via a faecal calprotectin test Referral to a specialist You may be referred to a gastroenterologist. A gastroenterologist is a specialist in conditions of the digestive system. They might recommend more tests, such as: gastroscopy  a thin flexible tube with a camera is put into your mouth to look at your food pipe and stomach colonoscopy  a thin, flexible tube with a camera is put into your bottom to look at the whole of your large bowel sigmoidoscopy  a thin, flexible tube with a camera is put into your bottom to look at the end of your large bowel a colon capsule endoscopy (pill camera) X-ray or barium enema MRI scan or CT scan You will be told what tests you need and what you need to do to prepare for them. Treatment Theres currently no cure for Crohns disease, but treatment can improve the symptoms and keep the inflammation under control. Your treatment will usually be provided by a range of healthcare professionals. Once your symptoms are under control, you are likely to be offered treatment to help keep them under control. If your Crohns stays under control for a long time, you may choose to stop treatment. You may need to start again if your symptoms come back. Steroid medication The first treatment offered is usually steroids, such as prednisolone or budesonide ( corticosteroids ) to reduce inflammation quickly. Steroids are often effective in reducing your symptoms. But they can have significant side effects . So theyre not suitable for long-term use and your dose will slowly be reduced when your symptoms start to improve. Medicines to suppress your immune system Medicines to suppress your immune system (immunosuppressants) may be given alongside steroids if your symptoms flare up twice or more during 12 months, or return when your steroid dose is reduced. Common types include azathioprine, mercaptopurine and methotrexate. Biological therapies If steroids and immunosuppressants dont help or arent right for you, biological therapies may be used. Biological therapies block particular chemicals involved in the immune response, which helps reduce inflammation. Theyre made using living cells in a lab. They can be given as a drip or an injection. Treatment usually lasts at least 12 months. Your inflammatory bowel disease (IBD) team will be able to discuss these with you. Common types are adalimumab, infliximab, ustekinumab or vedolizumab. Theres a risk that these medicines may cause side effects, which can cause symptoms such as: itchy skin a high temperature joint and muscle pain swelling of the hands or lips problems swallowing You should seek immediate medical help if you experience these symptoms. Reactions can occur immediately after treatment or months later, even after treatment stops. Surgery Surgery to treat Crohns disease may be an option if: you choose to have surgery instead of taking medications that may cause side effects medications dont control your symptoms your quality of life is severely affected by your condition you have serious complications of Crohns disease Surgery might involve widening narrow parts of your bowel, or removing parts of it (resection). Resection involves removing the inflamed area of the intestine. If you have a resection, you might have the healthy sections of bowel joined back together. Or you might have the end of your small bowel joined to the skin of your tummy (an ileostomy or stoma). In this case, poo comes out of the opening on your tummy and is collected in special bags that you wear. An ileostomy might be temporary, to give your bowel time to heal, or it might be permanent. Your IBD team will tell you what surgery they recommend and let you know what to expect. Diet and smoking There is no evidence that a particular diet causes or triggers flare-ups of Crohns disease. But alongside medications, some changes to your diet may help control symptoms for some people. Do eat 5 to 6 small meals rather than 3 main meals try to eat a healthy, varied diet that includes a wide variety of fruit, vegetables, nuts, seeds, proteins and wholegrains drink plenty of water Do not make major changes to your diet without talking to your IBD team and make sure you are still getting all the nutrients you need. You can speak to your IBD team about: keeping a food diary to find out if any particular foods affect your symptoms removing trigger foods from your diet taking a food supplement if you are struggling to get enough nutrients from your diet being referred to a dietitian If you smoke, it is advised that you make every effort to stop smoking , especially if you need to have surgery. If you smoke, smoking can make Crohns worse and is it important that you make every effort to stop smoking . Fertility and pregnancy A womans chance of becoming pregnant isnt usually affected by Crohns disease. However, surgery for Crohns disease might affect your fertility. Most women with Crohns disease will have a normal pregnancy and a healthy baby. But if youre pregnant or planning a pregnancy you should discuss it with your IBD team. This is because they may need to change your medication. If youre having a flare-up of Crohns disease you may also be advised to avoid getting pregnant until its under control. Complications Over time, inflammation can damage sections of the digestive system. This can result in complications such as: narrowing of the bowel (stricture) a channel developing between your bowel and your skin, another section of bowel or a body organ (fistula) These problems usually need surgical treatment. Information about you If you have Crohns disease, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Source: Scottish Government - Opens in new browser window Last updated: 25 January 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to\n            Info For Me Also on NHS inform Ulcerative colitis Inflammatory bowel disease (IBD) Other health sites Crohn's & Colitis UK: Crohn's Disease Crohn's & Colitis UK: Symptoms Crohn's & Colitis UK: Tests and investigations Crohn's & Colitis UK: Fistulas Crohn's & Colitis UK: Stoma Crohn's & Colitis UK: Smoking Crohn's & Colitis UK: Treatments Crohn's & Colitis UK: Reproductive health Chron's & Colitis UK: Getting a diagnosis Chron's & Colitis UK: Joints Chron's & Colitis UK: Pregnancy and breastfeeding NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats  2023 NHS 24  v1.1.1.17852"