Crohn’s disease

Overview

Crohn’s disease is one of the chronic inflammatory bowel diseases. The condition is intermittent in nature, with episodes of abdominal pain and diarrhoea alternating with phases of relative well-being. The cause is unknown. However, smoking is a risk factor and should be given up. At the first signs of an attack, patients should go to the doctor without delay.

Symptoms

Main symptoms

• Intermittent in nature with phases of recovery
• Abdominal pain
  • Colicky in nature
  • Pain is usually most intense in the right central or lower abdomen
• Diarrhoea
  • Cramping when emptying the bowel
  • Undigested food in stool
  • Usually no blood or mucus in stool

Other symptoms

• Fever (in phases of severe inflammation)
• Malnutrition
  • Impaired absorption of nutrients
  • Consequences: tiredness, anaemia, drop in performance, gallstones and urinary tract stones, finally osteoporosis
  • Weight loss, failure to thrive (in children)
• Bloating, nausea, vomiting

Typical complications and long-term consequences

• Fistulas (i.e. inflamed tunnels)
  • Between different sections of the intestine
  • From the intestine to the vagina or bladder
  • Tunnels from the bowel to external organs or tissue (e.g. anal fistula)
• Anal abscess, anal fissure, abscesses in the abdominal cavity
• Intestinal stricture (i.e. narrowing) caused by adhesions
  • Constipation
  • Ileus (intestinal obstruction)
• Higher risk of bowel cancer (but smaller risk than for ulcerative colitis)

Causes and treatment

Causes

• Unknown
• Risk factors
  • Nicotine consumption
  • Genetic susceptibility is suspected (family history)

Further treatment by your doctor / in hospital

Possible tests

• Blood test and stool analysis
• Ultrasound (sonography)
• Endoscopic examination of bowel with removal of tissue sample (biopsy)
• MRI (magnetic resonance imaging)

Possible therapies

• Medication
  • Suppression of inflammation
  • Antibiotics for additional infection
• Operation
  • If all other measures fail
  • Required for intestinal obstruction, bowel perforation, peritonitis, uncontrolled bleeding
  • Crohn’s disease can't be cured

What can I do myself?

• Diet
  • Healthy bowel diets are controversial (judged to be either essential or useless)
  • Patients are advised to find out for themselves what diet suits them best
  • Ask for specialist advice
• Keep a close eye on the course of the disease
• Stop smoking
• Psychotherapeutic support, if necessary
• Join a self-help group

Get a personal Preventive Care Recommendation now.

When to see a doctor?

• Recurrent abdominal pain and diarrhoea without any discernible cause
• Sudden onset of severe lower abdominal pain
• Blood and mucus in stool
• Diagnosed disease
  • Without delay when an attack starts
  • Constant medical supervision and long-term therapy are required

Further information

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch

Schweizerische Morbus Crohn/Colitis ulcerosa-Vereinigung (SMCCV) (Swiss Crohn’s & Colitis Association)
www.smccv.ch

Synonyms

Crohn's disease, Crohn’s, CD, ileitis, Crohn syndrome, granulomatous enteritis, regional enteritis, Leśniowski-Crohn disease