What Is Crohn's Disease and How Does It Effect the Body Crohn's Advocate Magazine Your Body and Crohn's Disease As you know, you eat food to get nutrients like protein and carbohydrates, which keep your body running. When your gastrointestinal (GI) tract processes that food, it absorbs the necessary nutrients and gets rid of any waste. The GI tract starts from your mouth and ends with your anus and includes your esophagus, stomach, and intestines. (Read more about how Crohn's affects digestion and your GI tract in the Summer 2010 issue of Crohn'sAdvocate magazine .) When you have Crohn's disease, your body's immune system begins attacking healthy cells in your GI tract, causing inflammation. Because it is a disease of the immune system, Crohn's is classified medically as an autoimmune disorder. This means that your body is producing antibodies that work against itself. In addition to Crohn's, other autoimmune disorders include rheumatoid arthritis , ulcerative colitis , psoriasis , psoriatic arthritis , ankylosing spondylitis , lupus , and Graves' disease .

Inflammatory bowel disease, or IBD, is a category of bowel disorders that includes both ulcerative colitis and Crohn's disease. Crohn's disease is most often found in a section of the small intestine called the ileum , but Crohn's can happen anywhere in your GI tract from the mouth to the anus. Back to top What causes Crohn's disease? Unfortunately, no one knows exactly what causes Crohn's, just that something in your body causes your immune system to overreact. Various stimuli may trigger Crohn's disease, affecting individuals differently. For instance, it might be a kind of bacteria, something in your own intestines, or even your family history. In fact, scientists now believe it is a combination of all these factors. If you have Crohn’s disease, you may have inherited a unique gene in your immune system. Then, something happened that triggered that gene, causing the overreaction, which then caused inflammation in your intestines. Back to top Who gets Crohn's disease? Crohn’s disease can affect anyone at any age; however, it's usually first diagnosed in people in their teens and twenties.

(Read more about dealing with a Crohn’s diagnosis in the Fall 2010 issue of Crohn'sAdvocate magazine .) Crohn's tends to affect people of both sexes equally, though some groups, including blacks, whites, and Jews of European descent, are diagnosed more frequently than Asians and Hispanics. Also, people who have family members with Crohn’s disease appear to be more likely to have it themselves. Back to top Will Crohn's ever go away? Crohn's disease is a chronic condition, which means you have it for life. However, sometimes your disease may be in remission, with no symptoms at all. When Crohn's flare-ups occur, they may be caused by food, cigarettes, or stress, but they may also happen for no known reason at all. Currently, there is no cure for Crohn's disease, although advances are being made all the time. Often people need treatment to control symptoms and improve their quality of life. In essence, Crohn's disease can affect you and your life significantly—everything from your diet to your relationships to your choice of career . It's important to remember that with proper care the majority of people with Crohn's are able to live normal lives despite the disease.

Crohn's Disease: Symptoms, Diagnosis & Treatment Crohn's Disease: Symptoms, Diagnosis & Treatment By Tanya Lewis, Staff Writer | February 11, 2015 07:52pm ET MORE The digestive system includes the esophagus, stomach, liver, pancreas, gallbladder, small intestine and large intestine. Credit: The BioDigital HumanTM developed by NYU School of Medicine and BioDigital Systems LLC Crohn’s disease is a chronic inflammatory bowel disease (IBD) that involves inflammation in all or part of the digestive tract. Parts of the digestive system become swollen and develop deep sores or ulcers. Though Crohn’s can develop anywhere in the digestive tract from the mouth to the anus, it most often affects the last part of the small intestine and the first part of the large intestine, according to the Crohn's & Colitis Foundation of America. "We don’t what the cause is," said Dr. Razvan Arsenescu, a gastroenterologist at The Ohio State University's Wexner Medical Center in Columbus. Several genetic abnormalities are linked to the disease, but these only explain about 20 percent of cases, Arsenescu told Live Science.

Studies show that harmless bacteria in the intestine, which the immune system normally ignores, trigger an immune response in people with Crohn's, said Dr. Sophie Balzora, a gastroenterologist at NYU Langone Medical Center in New York City. "Why that response occurs, nobody truly knows," Balzora told Live Science. Those with Ashkenazi Jewish ancestry may have a higher chance of developing Crohn’s disease. It's less common among African Americans and Hispanics, although the number of cases in these populations is rising, Balzora said. Smoking is another risk factor for Crohn's. The disease affects men and women equally, runs in families, and most commonly starts in people between the ages of 15 and 35, according to the Crohn's & Colitis Foundation of America . Symptoms The symptoms of Crohn’s disease tend to focus on the digestive area. Abdominal pain and diarrhea, often with blood and sometimes up to 20 times a day, are common in Crohn’s patients. Because the body is struggling to properly digest food, and abdominal pain can lessen the appetite, weight loss is another common sign of Crohn’s disease.

Other symptoms include mouth sores, bowel blockages and anal tears/fissures. These symptoms can lead to complications like anemia, osteoporosis, arthritis, and skin problems. In Crohn’s disease, the intestinal wall is thickened and inflamed by swelling and scar tissue, narrowing the passageway for food that is being digested. When the intestine has narrowed, this is referred to as a stricture. One serious complication of Crohn’s disease is a fistula — ulcers that develop so deep that they create openings and tunnels to other organs. For example, an ulcer might develop and connect the intestines to the bladder, to the small bowel, or to the skin, all of which can cause serious infections. Symptoms may flare up thanks to infections, hormonal changes during a woman's menstrual cycle, smoking, failing to take medication, or anytime the body is under stress, Balzora said. Some patients go for a long time without symptoms (known as remission) then suffer the occasional flare up, while other patients have ongoing severe symptoms. Crohn’s disease can also worsen and progress, so it’s important to be aware of this.

Call your doctor immediately if you feel faint or your pulse is abnormal, you have severe abdominal pain, fever or shaking chills, or persistent vomiting. "Crohn's disease can differ for every single person," Balzora said. Diagnosis & treatment There are a number of ways to diagnose Crohn’s disease. Your doctor will first analyze your symptoms and do a physical exam before ordering tests. Tests that diagnose Crohn’s disease include: Blood work Barium X-rays/CT scans/MRI scans of the colon or small intestine Colonoscopy/sigmoidoscopy/video capsule endoscopy and biopsy Stool analysis Crohn’s disease isn’t curable, but the symptoms can be managed and treated to make sure that the patient has as normal a life as possible. Because patients have a wide range of symptoms, from mild to severe, there are varying ways of dealing with Crohn’s disease. Exercising, a healthy diet, and avoiding smoking can help alleviate many of the symptoms. However, "diet and exercise are not going to change the course of the disease," Balzora cautioned. The most common treatment for Crohn’s disease is prescription medication.

Patients can use over-the-counter medicines to treat diarrhea and other mild symptoms, but prescription medications will be needed to control inflammation in the intestines and prevent complications of the disease from occurring. Medications can help heal damaged tissue and postpone the need for surgery. Some of these drugs include: Biologics, such as infliximab (trade name Remicade), natalizumab (Tysabri), or Vedolizumab (Entyvio), which are delivered intravenously; or itolizumab (Alzumab), certolizumab pegol (Cimzia), or golimumab (Simponi), which can be taken at home. Vedolizumab (Entyvio) was approved by the U.S. Food and Drug Administration in June 2014.

Antibiotics to reduce bacterial growth caused by strictures or fistula Corticosteroids, such as azathioprine (trade name Azasan), 6-mercaptopurine (Purinethol), methotrexate (Trexall) Up to 80 percent of Crohn’s disease patients will need surgery at some point to correct problems like strictures, fistulas or intestinal bleeding. Though surgery can relieve some of the symptoms, it cannot cure Crohn’s disease, as the disease occurs in patches across the entire digestive system . While parts of the system can be removed, the Crohn’s disease could simply appear in a different part of the system. Types of surgery include: Strictureplasty — the strictured/narrowed area is widened without any intestinal removal Bowel resection — the damaged part of the small intestine is removed and the healthy ends surgically attached Large intestine removal — as the name implies, the large intestine is removed and an external pouch is attached for the collection of waste draining out of the body. The patient must empty the pouch several times a day for the rest of their lives Abscess drainage — Collections of pus or infection inside the abdominal cavity or around the anus are drained.

Coping with Crohn’s disease can be stressful, as it affects every part of a patient’s life. It’s important to have a good support system in family and friends. There are also support networks out there for people suffering from Crohn’s disease and other inflammatory bowel diseases , and their loved ones. Some Crohn’s disease sufferers seek counseling and therapy to help cope. Alternative treatments could also help your well-being. Though they aren’t proven to treat Crohn’s disease, they could alleviate symptoms and lower stress. These treatments include herbal supplements, acupuncture, and massage. Because Crohn’s disease makes it hard for your body to absorb nutrients from food, patients need to focus on a healthy meal plan that is high-calorie and high-protein to ensure that you’re getting the right nutrients. Try eating regular meals plus two or three snacks a day. Prevention There is no way to prevent Crohn's disease, but factors in early childhood could play a role. For example, the diet that mother has during pregnancy may be important (e.g., not eating red meat), and vaginal delivery of babies may be better than cesarean section because of the bacteria acquired during birth, said Dr. Arsenescu, of Ohio State University.

Breastfeeding, avoiding antibiotics and providing a smoke-free environment may also reduce the risk of a child developing Crohn's, he said. Additional reporting by Elaine J. Hom, Live Science Contributor Follow Tanya Lewis on Twitter . Follow us @livescience , Facebook & Google+ . Additional resources Crohn's Disease: What Is It? Symptoms, Causes, Prognosis, and More Rectal bleeding Other symptoms can develop, depending on complications related to the disease. For example, a person with a fistula (abnormal passageway between various organs or tissues) in the rectal area may have pain and leaking discharge around the rectum. Severe inflammation and obstruction of various parts of the gastrointestinal tract due to swelling and scar formation can cause other problems like bowel perforation, abdominal distension (swelling), severe pain, and fever. This can be life-threatening. Crohn’s is a disorder of uncertain etiology. It has often been thought of as an autoimmune disease but research suggests that the chronic inflammation may not be due to the immune system attacking the body itself, but rather a result of the immune system attacking harmless virus, bacteria or food in the gut causing inflammation that leads to bowel injury.

Crohn's disease can cause other parts of the body to become inflamed (due to chronic inflammatory activity) including the joints, eyes , mouth , and skin . In addition, gallstones and kidney stones may also develop as a result of Crohn's disease. Moreover, children with the disease may experience decreased growth or delayed sexual development. What Causes Crohn's Disease? The cause of Crohn's disease is unknown. However, it is likely due to an abnormal response of the immune system. Food or bacteria in the intestines , or even the lining of the bowel may cause the uncontrolled inflammation associated with Crohn's disease. Who Gets Crohn's Disease? Crohn's disease is often inherited. About 20% of people with Crohn's disease may have a close relative with either Crohn's or ulcerative colitis . In addition, Jewish people of European descent (Ashkenazi) are at greater risk for the disease. While Crohn's disease can affect people of all ages, it is primarily an illness of the young. Most people are diagnosed before age 30, but the disease can occur in people in their 60's, 70's, or even later in life.

Continued How Is Crohn's Disease Diagnosed? A variety of diagnostic procedures and lab tests are used to distinguish Crohn's disease from other inflammatory gastrointestinal conditions like ulcerative colitis . First, your doctor will review your medical history. A specialist called a gastroenterologist may perform a colonoscopy or sigmoidoscopy to obtain bowel tissue for analysis. An upper endoscopy may also be done to look at the esopohagus, stomach and first part of the small intestine, the duodenum. A further look through the small intestine can be done with capsule endoscopy, which uses a small, pill-sized camera that is swallowed. Other tests your health care provider may order include: Blood tests, including blood counts (often high white blood cell counts -- a sign of inflammation -- and low red blood cells counts -- a sign of anemia from blood loss -- are present). Stool samples to rule out infections as the cause of diarrhea . Special X-rays (such as a CT scan or MRI ) of both the upper and lower gastrointestinal tract may be ordered as well to confirm the location of the inflammation. What Triggers a Worsening of Crohn's Disease?

Crohn's disease is characterized by periods of having symptoms, which can last for days, weeks or months, interspersed with periods of remission when no symptoms are present. Remissions can last days, weeks, or even years. Factors that worsen Crohn's disease include: Anti-inflammatory drugs, such as salicylates. Examples include mesalamine (Asacol, Lialda, Pentasa ), olsalazine ( Dipentum ), and sulfasalazine ( Azulfidine ). Side effects include gastrointestinal upset, headache , nausea , diarrhea , or rash . Corticosteroids, a more powerful type of anti-inflammatory drug. Examples include budesonide ( Entocort ), and prednisone or methylprednisolone (Solu- Medrol ). Side effects, if taken for long periods of time, can be severe and may include bone thinning, muscle loss, skin problems , and increased risk of infection. Entocort has fewer side effects. Immune system modifiers such as azathioprine ( Imuran ) or methotrexate ( Rheumatrex ). It can take up to six months for these drugs to work. These drugs are associated with increased risk of infections that can be life-threatening.

Antibiotics such as ciprofloxacin ( Cipro ), metronidazole ( Flagyl ), and others. Flagyl can cause a metallic taste in the mouth , nausea , and tingling or numbness of the hands and feet. Cipro can cause nausea and has been associated with rupture of the Achilles tendon . Antidiarrheal drugs. Biologic therapies, such as adalimumab (Humira), certolizumab pegol (Cimzia), infliximab ( Remicade ), and infliximab-dyyb (Inflectra), a bio-similar. Remicade neutralizes the activity of a substance called tumor necrosis factor alpha (TNF-alpha). This substance is overproduced by people with Crohn's and plays an important role in causing the inflammation associated with Crohn's disease. The drug is given intravenously (through the vein). Side effects include life-threatening infection, infusion reaction, headache , stomach upset, fatigue , fever, pain, dizziness , rash , and itching .

There are other biologic alternatives to the anti-TNF blockers natalizumab ( Tysabri ) and vedolizumab ( Entyvio ) block alpha-4 integrin. Ustekinumab ( Stelara ) blocks IL-12 and IL-23. Continued Response to therapy is evaluated within several weeks of starting treatment. Treatment is continued until remission is obtained (at which time, the health care provider may consider maintenance therapy). No improvement calls for more aggressive therapy. Nutritional supplements may also be recommended by your doctor. Surgery Surgery is eventually required in about two-thirds to three-quarters of people with Crohn's disease. Surgery is done to treat complications of the disease -- such as fistulas, abscesses, hemorrhage, and intestinal obstructions -- or to treat people who do not respond to medications. In most cases, the diseased part of the bowel is removed and the two healthy ends of bowel are joined together (anastomosis). This surgery can allow many people to remain symptom-free for years, but it is not a cure since Crohn's disease often recurs at the site of the anastomosis.

Unfortunately, too many resection surgeries can lead to a condition called short gut syndrome where there isn't enough bowel left to adequately absorb nutrients . An ileostomy may also be required if the rectum is diseased and cannot be utilized for an anastomosis. This is a connection of the intestine to the skin overlying the abdominal wall. The result is an opening in the skin from which waste products can be excreted into a specially designed pouch. What Role Does Diet Play in Crohn's Disease? While foods appear to play no role in causing Crohn's disease, soft, bland foods may cause less discomfort than spicy or high-fiber foods when the disease is active. Except for restricting milk in lactose intolerant people, most gastroenterologists try to be flexible in planning the diets of their Crohn's disease patients. Ask your doctor to create a dietary plan for you. CCFA: What is Crohn's Disease | Causes of Crohn's What is Crohn's Disease Crohn’s Disease is a Chronic Condition By understanding your body and managing your symptoms, you can live a full and rewarding life What is Crohn’s Disease? + Share Named after Dr. Burrill B.

Crohn, who first described the disease in 1932 along with colleagues Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer, Crohn’s disease belongs to a group of conditions known as Inflammatory Bowel Diseases (IBD). Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract. When reading about inflammatory bowel diseases, it is important to know that Crohn’s disease is not the same thing as ulcerative colitis , another type of IBD. The symptoms of these two illnesses are quite similar, but the areas affected in the gastrointestinal tract (GI tract) are different. Crohn’s most commonly affects the end of the small bowel (the ileum) and the beginning of the colon, but it may affect any part of the gastrointestinal (GI) tract, from the mouth to the anus. Ulcerative colitis is limited to the colon, also called the large intestine. Download an illustration of the GI Tract (.pdf) Crohn’s disease can also affect the entire thickness of the bowel wall, while ulcerative colitis only involves the innermost lining of the colon.

Finally, in Crohn’s disease, the inflammation of the intestine can “skip”-- leaving normal areas in between patches of diseased intestine. In ulcerative colitis this does not occur. Watch this webcast to learn more about Crohn's disease. Recognizing the Signs and Symptoms Crohn’s disease can affect any part of the GI tract. While symptoms vary from patient to patient and some may be more common than others, the tell-tale symptoms of Crohn’s disease include: Symptoms related to inflammation of the GI tract: Persistent Diarrhea Night sweats Loss of normal menstrual cycle Even if you think you are showing signs of Crohn’s Disease symptoms, only proper testing performed by your doctor can render a diagnosis. People suffering from Crohn’s often experience loss of appetite and may lose weight as a result. A feeling of low energy and fatigue is also common. Among younger children, Crohn's may delay growth and development. Crohn's is a chronic disease, so this means patients will likely experience periods when the disease flares up and causes symptoms, followed by periods of remission when patients may not notices symptoms at all.

In more severe cases, Crohn’s can lead to tears (fissures) in the lining of the anus, which may cause pain and bleeding, especially during bowel movements. Inflammation may also cause a fistula to develop. A fistula is a tunnel that leads from one loop of intestine to another, or that connects the intestine to the bladder, vagina, or skin. This is a serious condition that requires immediate medical attention. The symptoms you or your loved one experience may depend on which part of the GI tract is affected. Read more about the Types of Crohn's Disease and Associated Symptoms . What are the Causes of Crohn’s Disease? Who is Affected? Crohn’s disease may affect as many as 780,000 Americans. Men and Women are equally likely to be affected, and while the disease can occur at any age, Crohn's is more prevalent among adolescents and young adults between the ages of 15 and 35. The causes of Crohn’s Disease are not well understood. Diet and stress may aggravate Crohn’s Disease, but they do not cause the disease on their own.

Recent research suggests hereditary, genetics, and/or environmental factors contribute to the development of Crohn’s Disease. The GI tract normally contains harmless bacteria, many of which aid in digestion. The immune system usually attacks and kills foreign invaders, such as bacteria, viruses, fungi, and other microorganisms. Under normal circumstances, the harmless bacteria in the intestines are protected from such an attack. In people with IBD, these bacteria are mistaken for harmful invaders and the immune system mounts a response. Cells travel out of the blood to the intestines and produce inflammation (a normal immune system response). However, the inflammation does not subside, leading to chronic inflammation, ulceration, thickening of the intestinal wall, and eventually causing patient symptoms. Crohn’s tends to run in families, so if you or a close relative have the disease, your family members have a significantly increased chance of developing Crohn’s. Studies have shown that 5% to 20% of affected individuals have a first – degree relative (parents, child, or sibling) with one of the diseases. The risk is greater with Crohn’s disease than ulcerative colitis. The risk is also substantially higher when both parents have IBD.

The disease is most common among people of eastern European backgrounds, including Jews of European descent. In recent years, an increasing number of cases have been reported among African American populations. The environment in which you live also appears to play a role. Crohn’s is more common in developed countries rather than undeveloped countries, in urban rather than rural areas, and in northern rather than southern climates. NEW!! Test your knowledge of Crohn’s disease by taking this self-assessment for an opportunity to win a gift card! You can find the assessment here . Click video below to learn more about Crohn's Disease Get Involved Crohn's disease Complications - Mayo Clinic References Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed June 2, 2014. Management of Crohn's disease in adults. Bethesda, Md.: American College of Gastroenterology. Accessed June 2, 2014. Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. Accessed June 2, 2014. Crohn's disease.

The Merck Manual for Healthcare Professionals. Accessed June 2, 2014. Peppercorn MA, et al. Clinical manifestations, diagnosis and prognosis of Crohn's disease in adults. Accessed June 2, 2014. Smoking and your digestive system. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed June 2, 2014. What is Crohn's disease? Crohn's and Colitis Foundation of America. Accessed June 2, 2014. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. Accessed June 6, 2014. Peppercorn MA, et al. Colorectal cancer surveillance in inflammatory bowel disease. Accessed June 9, 2014. Inflammatory bowel disease. Centers for Disease Control and Prevention. Accessed June 9, 2014. Farrell RJ, et al. Overview of the medical management of mild to moderate Crohn disease in adults. Accessed June 2, 2014.

Korzenik JR. Investigational therapies in the medical management of Crohn disease. Accessed June 5, 2014. Crohn's and Colitis Foundation of America. Accessed June 10, 2014. Farrell RJ, et al. Overview of the medical management of severe or refractory Crohn disease in adults. Accessed June 2, 2014. Sakuraba A, et al. Natalizumab in Crohn’s disease: Results from a US tertiary inflammatory bowel disease center. Inflammatory Bowel Diseases. 2013;19:621. Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. June 26, 2014. What should I know about screening for colorectal cancers? Centers for Disease Control and Prevention. Accessed June 9, 2014. Seminerio JL, et al. Infliximab for Crohn's disease: The first 500 patients followed up through 2009. Digestive Diseases and Sciences. 2013;58:797. Living with Crohn's and Colitis.

Crohn's and Colitis Foundation of America. Accessed June 2, 2014. Dignass A, et al. The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Current management. Journal of Crohn's and Colitis. 2010;4:28. Heppell J. Operative management of Crohn disease of the small bowel and colon. Accessed June 2, 2014. Albenberg LG, et al. Food and the gut microbiota in inflammatory bowel diseases: A critical connection. Current Opinion in Gastroenterology. 2012;28:314. D'Haens GR, et al. Future directions in inflammatory bowel disease management. Journal of Crohns and Colitis. In press. Accessed June 2, 2014. Leiman DA, et al. Therapy of inflammatory bowel disease: What to expect in the next decade. Current Opinion in Gastroenterology. 2014;30:385. What is complementary and alternative medicine (CAM)? International Foundation for Functional Gastrointestinal Disorders.

Accessed June 25, 2014. Kane SV, et al. Natalizumab for moderate to severe Crohn's disease in clinical practice: The Mayo Clinic Rochester experience. Inflammatory Bowel Diseases. 2012;18:2203. Sartor RB. Probiotics for gastrointestinal diseases. Accessed June 10, 2014. Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. Accessed June 4, 2014. Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. June 2, 2014. U.S. News best hospitals 2013-2014. U.S. News & World Report. Accessed April 24, 2014. Products and Services Crohn's Disease Symptoms, Treatment, Causes - What causes Crohn's disease? - MedicineNet What causes Crohn's disease? Quick GuideCrohn's Disease Causes, Symptoms, Diet What causes Crohn's disease? The cause of Crohn's disease is unknown.

Some scientists suspect that infection by certain bacteria, such as strains of mycobacterium, may be the cause of Crohn's disease. To date, however, there has been no convincing evidence that the disease is caused by infection per se. Crohn's disease is not contagious . Although diet may affect the symptoms in patients with Crohn's disease, it is unlikely that diet is responsible for causing the disease. Activation of the immune system in the intestines appears to be important in IBD. The immune system is composed of immune cells and the proteins that these immune cells produce. Normally, these cells and proteins defend the body against harmful bacteria, viruses , fungi, and other foreign invaders. Activation of the immune system causes inflammation within the tissues where the activation occurs. (Inflammation is an important mechanism of defense used by the immune system.) Normally, the immune system is activated only when the body is exposed to harmful invaders. In individuals with IBD, however, the immune system is abnormally and chronically activated in the absence of any known invader. The continued abnormal activation of the immune system results in chronic inflammation and ulceration. The susceptibility to abnormal activation of the immune system is genetically inherited.

Thus, first degree relatives (brothers, sisters, children, and parents) of people with IBD are more likely to develop these diseases. Recently a gene called NOD2 has been identified as being associated with Crohn's disease. This gene is important in determining how the body responds to some bacterial products. Individuals with mutations in this gene are more susceptible to developing Crohn's disease. Other genes are still being discovered and studied which are important in understanding the pathogenesis of Crohn's disease including autophagy related 16-like 1 gene (ATG 16L1) and IRGM, which both contribute to macrophage defects and have been identified with the Genome-Wide Association study2. In this regard, there have also been studies which show that in the intestines of individuals with Crohn's disease, there are higher levels of a certain type of bacterium, E. coli , which might play a role in the pathogenesis1. One postulated mechanism by which this could occur is though a genetically determined1 defect in elimination of the E. coli, by intestinal mucosal macrophages. The exact roles that these various factors play in the development of this disease remain unclear.

Medically Reviewed by a Doctor on 11/4/2015 Crohn's Disease - National Library of Medicine - PubMed Health Cyclosporine for treatment of active Crohn's disease The results of this review demonstrate that low dose oral cyclosporine is not effective for treatment of active Crohn's disease. Studies indicate that Crohn's patients treated with low dose (5 mg/kg/day) oral cyclosporine could experience side effects including kidney problems. Therefore the use of this medication for the treatment of chronic active Crohn's disease is not advisable. Higher oral doses and injections of cyclosporine have not been sufficiently evaluated. Larger doses of cyclosporine are not likely to be useful for the long‐term management of Crohn's disease due to the risk of kidney damage and the availability of other proven medications. Natalizumab for treatment of active Crohn's disease Crohn's disease is a chronic inflammatory disease of the intestines. Crohn's disease frequently occurs in the lower part of the small intestine, called the ileum, but it can affect any part of the digestive tract, from the mouth to the anus.

The most common symptoms of Crohn's disease are abdominal pain, often in the lower right area, and diarrhea. Natalizumab blocks the adhesion and migration of white blood cells into the gut reducing chronic inflammation associated with Crohn's disease. Four high quality studies were reviewed. The studies tested 1692 people over the age of eighteen who had moderate to severe Crohn's disease. The subjects received 1 to 3 infusions of natalizumab (at a dosage of 300 mg or weight based dosages of 3, 4 or 6 mg/kg) or placebo (fake infusions). The studies lasted for 12 weeks. The results of the studies indicate that natalizumab is effective therapy for some people with active Crohn's disease. People with active disease responded positively to even one treatment of the drug and the studies examined showed increased benefits with additional injections of natalizumab. More people improved through treatment using natalizumab than those using the fake treatments. The drug was generally well tolerated and side effects occurred infrequently. Serious side effects occurred rarely (range 7 to 11% for natalizumab and placebo patients).

Few patients withdrew from the studies due to side effects (2 to 8% for natalizumab compared to 3 to 7% for placebo). Side effects that occurred during the trials included: headache, worsening of Crohn's disease, abdominal pain, arthralgia, colitis, influenza syndrome, infection, nausea, vomiting, fatigue, hypersensitivity‐like reactions, and the development of antibodies against natalizumab. Recently, it was found that two patients who received natalizumab in combination with interferon beta‐1 for multiple sclerosis and one patient who received natalizumab in combination with azathioprine for Crohn's disease developed a severe disease called progressive multifocal leukoencephalopathy (PML) resulting in two deaths. PML is a serious infection of the nervous system. However an investigation of more than 3500 patients who took natalizumab found no new cases of PML. It was discovered that PML is not always fatal and regular testing of patients could provide adequate safety and ensure the well‐being of those taking natalizumab.

However, the benefits of natalizumab for people with Crohn's disease should be carefully weighed against the potential risk of serious adverse events such as the possibility of infection of the nervous system. Probiotics for treatment of active Crohn's disease Crohn's disease is a chronic inflammatory disease of the intestines which has periods of inactivity and periods when it flares up. Crohn's disease can affect any part of the digestive tract, from the mouth to the anus. The most common symptoms of Crohn's disease are abdominal pain, and diarrhoea. Probiotics are living microorganisms that are thought to benefit health by altering the growth of bacteria in the intestines thereby reducing inflammation. Only one study was identified and this did not show that probiotics had any effect in treating active Crohn's disease. However this study was only small (11 patients) and no definite conclusion can be made regarding the effectiveness of probiotics. Probiotics were generally well tolerated and no side effects were reported. There is insufficient evidence to make any conclusions about the effectiveness of probiotics for treatment of active Crohn's disease.

Cyclosporine for treatment of active Crohn's disease The results of this review demonstrate that low dose oral cyclosporine is not effective for treatment of active Crohn's disease. Studies indicate that Crohn's patients treated with low dose (5 mg/kg/day) oral cyclosporine could experience side effects including kidney problems. Therefore the use of this medication for the treatment of chronic active Crohn's disease is not advisable. Higher oral doses and injections of cyclosporine have not been sufficiently evaluated. Larger doses of cyclosporine are not likely to be useful for the long‐term management of Crohn's disease due to the risk of kidney damage and the availability of other proven medications. Natalizumab for treatment of active Crohn's disease Crohn's disease is a chronic inflammatory disease of the intestines. Crohn's disease frequently occurs in the lower part of the small intestine, called the ileum, but it can affect any part of the digestive tract, from the mouth to the anus. The most common symptoms of Crohn's disease are abdominal pain, often in the lower right area, and diarrhea.

Natalizumab blocks the adhesion and migration of white blood cells into the gut reducing chronic inflammation associated with Crohn's disease. Four high quality studies were reviewed. The studies tested 1692 people over the age of eighteen who had moderate to severe Crohn's disease. The subjects received 1 to 3 infusions of natalizumab (at a dosage of 300 mg or weight based dosages of 3, 4 or 6 mg/kg) or placebo (fake infusions). The studies lasted for 12 weeks. The results of the studies indicate that natalizumab is effective therapy for some people with active Crohn's disease. People with active disease responded positively to even one treatment of the drug and the studies examined showed increased benefits with additional injections of natalizumab. More people improved through treatment using natalizumab than those using the fake treatments. The drug was generally well tolerated and side effects occurred infrequently. Serious side effects occurred rarely (range 7 to 11% for natalizumab and placebo patients).

Few patients withdrew from the studies due to side effects (2 to 8% for natalizumab compared to 3 to 7% for placebo). Side effects that occurred during the trials included: headache, worsening of Crohn's disease, abdominal pain, arthralgia, colitis, influenza syndrome, infection, nausea, vomiting, fatigue, hypersensitivity‐like reactions, and the development of antibodies against natalizumab. Recently, it was found that two patients who received natalizumab in combination with interferon beta‐1 for multiple sclerosis and one patient who received natalizumab in combination with azathioprine for Crohn's disease developed a severe disease called progressive multifocal leukoencephalopathy (PML) resulting in two deaths. PML is a serious infection of the nervous system. However an investigation of more than 3500 patients who took natalizumab found no new cases of PML. It was discovered that PML is not always fatal and regular testing of patients could provide adequate safety and ensure the well‐being of those taking natalizumab.

However, the benefits of natalizumab for people with Crohn's disease should be carefully weighed against the potential risk of serious adverse events such as the possibility of infection of the nervous system. Crohn's Disease: Digestive Symptoms and Complications Crohn's disease is a chronic inflammation of the digestive tract. What are the parts and functions of the digestive system? The digestive system is made up of the digestive tract, which is a long series of organs, including the esophagus , the stomach, the small intestine, and the large intestine , that runs from the mouth to the anus. The digestive tract in an adult is about 30 feet long. Digestion begins in the mouth where saliva begins to break down food. Food is swallowed from the mouth into the esophagus, which then moves the chewed food to the stomach. The stomach has strong muscular walls that mix and churn the food with acid and enzymes (known as gastric juice), breaking the food into smaller pieces. The processed semiliquid food, called chyme, is slowly released from the stomach into the small intestine. Most digestion and absorption occurs in the small intestine.

The small intestine has 3 parts: 1) the duodenum, 2) the jejunum, and 3) the ileum. Enzymes and other substances made by intestinal cells, the pancreas, and the liver are secreted into the small intestine and breakdown starches, sugars, fats , and proteins. Absorption of nutrients occurs through the millions of tiny fingerlike projections called villi and the even tinier projections on the villi called microvilli. Any undigested material moves to the large intestine. The large intestine or colon has four sections called the 1) cecum/ascending colon, 2) transverse colon, 3) descending colon/sigmoid, and 4) rectum. The main job of the large intestine is to remove water and salts ( electrolytes ) from the undigested material and to form solid waste (feces) that can be excreted. The remaining contents of the large intestine move to the rectum, where feces are stored until they leave the body through the anus as a bowel movement. Picture of Crohn's Disease What part of the digestive system does Crohn's disease affect?

Any part of the digestive tract from the mouth to the anus can be involved, although it most commonly affects the end of the small intestine called the terminal ileum and the beginning of the large intestine called the cecum. The inflammation may extend deep into the tissues of the organ that is affected. Medically Reviewed by a Doctor on 6/23/2016 Medical Author: Crohn's Disease | MedlinePlus Crohn's Disease URL of this page: Crohn's Disease Also called: Regional enteritis, Regional ileitis On this page Patient Handouts Summary Crohn's disease causes inflammation of the digestive system. It is one of a group of diseases called inflammatory bowel disease. Crohn's can affect any area from the mouth to the anus. It often affects the lower part of the small intestine called the ileum. The cause of Crohn's disease is unknown. It may be due to an abnormal reaction by the body's immune system. It also seems to run in some families. It most commonly starts between the ages of 13 and 30. The most common symptoms are pain in the abdomen and diarrhea.

Other symptoms include Bleeding from the rectum Weight loss Fever Your doctor will diagnose Crohn's disease with a physical exam, lab tests, imaging tests, and a colonoscopy. Crohn's can cause complications, such as intestinal blockages , ulcers in the intestine, and problems getting enough nutrients. People with Crohn's can also have joint pain and skin problems. Children with the disease may have growth problems. There is no cure for Crohn's. Treatment can help control symptoms, and may include medicines, nutrition supplements, and/or surgery. Some people have long periods of remission, when they are free of symptoms. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Start Here Crohn’s Disease Symptoms and How They May Affect You Fatigue and a feeling of low energy Reduced appetite Crohn’s can affect the entire GI tract — from the mouth to the anus — and can be progressive Increasing in extent or severity. , so over time, your symptoms could get worse. That's why it's important that you have an open and honest conversation about your symptoms , since your doctor will use that information to help determine what treatment plan is best for you.

It might be helpful to refer to the chart below to help you understand the differences between mild, moderate and severe symptoms, since your doctor may use similar measures. Crohn’s Disease Symptom Severity Mild to Moderate Persistent symptoms despite appropriate treatment for moderate to severe Crohn’s, and you may also experience: High fever Persistent vomiting Evidence of intestinal obstruction (blockage) or abscess (localized infection or collection of pus). A few of these symptoms may include abdominal pain that doesn’t go away or gets worse, swelling of the abdomen, nausea or vomiting, diarrhea, and constipation. More severe weight loss Once you and your doctor have discussed your symptoms and created a treatment plan, it’s important to follow directions and take your treatment as prescribed. If you ever have any questions or concerns about your treatment , you should contact your doctor before making any changes or adjustments. Crohn’s disease is unpredictable. Over time, your symptoms may change in severity, or change altogether. You may go through periods of remission—when you have few or no symptoms. Or your symptoms may come on suddenly, without warning. Tips for patients with IBD Gastroenterologist Dr. Millie Long discusses 3 key tips for patients with Crohn’s and ulcerative colitis.

Millie Long, M.D., M.P.H., is an Associate Professor at the University of North Carolina Chapel Hill School of Medicine. The location of your disease may determine what kind of symptoms you have The five types of Crohn’s disease and their symptoms: Ileocolitis Affects the end of the small intestine (the ileum) and the large intestine (the colon). Symptoms include weight loss, diarrhea and cramping or pain in the middle or right lower abdomen. Ileitis Affects the ileum. Symptoms include weight loss, diarrhea and cramping or pain in the middle or right lower abdomen. Jejunoileitis Characterized by patchy areas of inflammation in the upper half of the small intestine (the jejunum). Symptoms include mild to strong abdominal pain and cramps following meals, as well as diarrhea. Gastroduodenal Crohn’s disease Affects the stomach and the beginning of the small intestine (the duodenum). Symptoms include loss of appetite, weight loss, nausea, and vomiting. Crohn’s colitis Affects the colon. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers).

To help you be prepared for unexpected symptoms, carry a Restroom Request Card * when you’re out and about. It can help you discreetly ask for access to restricted restrooms. Complications of Crohn’s disease Along with painful symptoms, Crohn’s disease can lead to complications in your intestines such as: Obstruction (blockage) of the intestines Formation of scar tissue Fissures (small cuts or tears in the anal canal, which may bleed) Abscesses (localized infection or collection of pus) Fistulas (abnormal tunnels that form between two structures of the body) Your doctor may recommend surgery to remove a damaged portion of your digestive tract to close fistulas, remove scar tissue, or to repair damage caused by Crohn’s disease. In addition to the symptoms listed above, Crohn’s disease complications may include: Increased risk of colon cancer, due to chronic inflammation of the colon Vitamin and mineral deficiencies: Chronic inflammation of the small intestine, or patients who have had damaged portion of their intestines removed, may have issues with malabsorption of the vitamin B-12. Over time, blood loss from inflammation and ulceration of the intestines can lead to iron-deficiency anemia.

People with Crohn’s disease can have decreased vitamin D, which can lead to bone loss (osteopenia Reduction in bone volume to below normal levels. and/or osteoporosis A condition that is characterized by the decrease in bone mass with decreased bone density causing brittle bones, usually occurs in older women. ). Corticosteroid use can make bone loss worse. Kidney stones can be a complication if you have Crohn’s in the small intestine. Crohn’s can affect more than the GI tract Sometimes, Crohn’s disease causes inflammation outside of the GI tract, in areas such as: Eyes Skin Joints These symptoms are called extra-intestinal Situated or occurring outside the intestines. symptoms and can also be linked to inflammation. You should talk to your doctor if you experience any symptoms—even if they seem to have nothing to do with your gastrointestinal tract. Inflammation can lead to Crohn’s disease symptoms Painful flare-ups The sudden intensification of disease symptoms or the return of symptoms suddenly. occur when the lining of your intestines swells and thickens, obstructing normal movement of food through your digestive tract. Learn more about your Crohn’s symptoms and how they could be linked to damaging inflammation with Expert Advice .

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Question: Crohn’s Disease affects which part of the body?
Answer: Intestines