This chronic condition affects over three million Americans. Learn more about its symptoms, how to manage flares, available treatments options, and more.
Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal (GI) tract. An estimated three million Americans have this condition, and men and women are equally likely to be diagnosed. Though it can affect anyone, the average age of diagnosis is between 15 and 35.
Crohn’s disease can affect any part of the GI tract, from the mouth to the anus. It most commonly affects the end of the small intestine (the ileum) where it joins the beginning of the colon. Crohn’s disease may appear in “patches,” affecting some areas of the GI tract while leaving other sections completely untouched. In Crohn’s disease, the inflammation may extend through the entire thickness of the bowel wall.
The exact cause of Inflammatory Bowel Disease (IBD)—another term used for Crohn’s disease and ulcerative colitis—is not entirely understood, it is known to involve an interaction between genes, the immune system, and environmental factors. The immune system usually attacks and kills foreign invaders, such as bacteria, viruses, fungi, and other microorganisms. However, in people with IBD, the immune system mounts an inappropriate response to the intestinal tract, resulting in inflammation.
As the lining of the intestine becomes inflamed and ulcerated, it loses its ability to adequately process food and waste or absorb water, resulting in loose stools (diarrhea), and in severe cases, weight loss. Most people with Crohn’s disease experience an urgency to have a bowel movement and have cramping abdominal pain. Inflammation can cause small sores (ulcers) to form in the colon and rectum. These can join together and become large ulcers that bleed, resulting in bloody stools. Blood loss can eventually lead to anemia if unchecked.
The symptoms of Crohn’s disease vary from person to person, may change over time, and can range from mild to severe. People with Crohn’s disease often go through periods when the disease is quiet with few or no symptoms (remission), alternating with times when the disease is active and causing symptoms (flares).
While there is no cure for Crohn’s disease, it is possible to manage symptoms and minimize the triggering of flares. We’ve listed the different types of Crohn’s disease and the symptoms, as well as tips on how you can manage symptoms and flares. Remember that it is always best to consult a doctor about your symptoms and to develop a treatment plan with their assistance.
Symptoms and the different types of Crohn’s disease
People with Crohn’s disease may experience severe symptoms, followed by periods of little to no symptoms lasting from a few weeks to a few years. Symptoms of Crohn’s disease include:
- Diarrhea, sometimes with blood, pus, and/or mucus
- Weight loss
- Abdominal pain
- Bleeding from the anus
- Urgent need to move the bowels
- Feeling of incomplete evacuation
- Night sweats
- Loss of normal menstrual cycle
If you are diagnosed with Crohn’s disease, it is important to know which type you have to figure out the best treatment plan for you. Keep a record of the symptoms you experience and inform your doctor of them. Your doctor can diagnose which type of Crohn’s disease you have:
- Ileocolitis: The most common form of Crohn’s disease. It affects the large intestine and the end of the small intestine. Symptoms may include diarrhea, cramping, pain in the middle or lower part of the abdomen, and weight loss.
- Ileitis: Only affects the small intestine. The symptoms are the same as Ileocolitis.
- Crohn’s Colitis: Only affects the large intestine. Symptoms may include rectal bleeding, diarrhea, abdominal pain, and diseases around the anus.
- Gastroduodenal Crohn’s Disease: This affects the stomach and the beginning of the small intestine. People with this may have symptoms like nausea, vomiting, loss of appetite, and weight loss.
- Jejunoileitis: Characterized by patches of inflammation throughout the small intestine. Symptoms may include mild to intense abdominal pain and cramps after meals and diarrhea.
Complications of Crohn’s disease include:
- Fistula: Ulcers on the wall of the intestine that extend and cause a tunnel (fistula) to another part of the intestine, the skin or another organ
- Stricture: A narrowing of a section of intestine caused by scarring, which can lead to an intestinal blockage
- Abscess: A collection of pus, which can develop in the abdomen, pelvis, or around the anal area
- Perforated bowel: Chronic inflammation of the intestine may weaken the wall to such an extent that a hole develops
- Malabsorption and malnutrition, including deficiency of vitamins and minerals
- Eyes (redness, pain, and itchiness)
- Mouth (sores)
- Joints (swelling and pain)
- Skin (tender bumps, painful ulcerations, and other sores/rashes)
- Bones (osteoporosis)
How to manage Crohn’s symptoms and flares
A variety of factors can trigger flares. Some triggers can be easily identified, while others can be seemingly random. Keep a record of symptoms to recognize incoming flares and share it with your doctor to work out a treatment plan that works best for you.
1.) Avoid NSAIDs
Nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen (e.g. Advil, Motrin) can cause disruptions in the GI tract, which could cause a flare. If you have pain or a fever, it is recommended to take acetaminophen instead of NSAIDs.
2.) Keep your diet simple and cut out certain foods
While there is no specific diet that prevents or cures Crohn’s disease, there may be certain foods that can worsen symptoms and/or trigger a flare. Keep a food journal to pinpoint which foods trigger your symptoms and flares. Some foods to avoid include dairy, oily foods, foods that cause gas (such as beans and cruciferous vegetables), and high fiber foods (such as raw vegetables and whole grains). Patients should also avoid caffeine and alcohol.
3.) Quit smoking
Smoking increases your chances of developing Crohn’s disease and can trigger a flare. Quitting smoking can also reduce flares, medication treatments, and the risk of requiring surgery.
4.) Reduce stress
Though stress does not cause Crohn’s disease, excess stress can trigger a flare. Try different techniques to help keep your stress levels low, such as meditation, deep breathing exercises, and yoga. Another way to reduce stress levels is to ensure you get enough sleep. Practice good sleep hygiene by going to bed and waking up at the same time every day.
There may be times when you enter a state of remission, which is when your flares are not active. Remember that remission does not mean your Crohn’s disease is cured. It is only an extended period when your flares and inflammation are not active.
Understanding your symptoms and what can trigger flares will make it easier to manage Crohn’s disease and minimize its interference in your daily life. Be sure to contact your doctor at the first sign of a flare.
Crohn’s disease and the workplace
Crohn’s disease has its challenges and can interfere with people’s professional lives and careers. But it is possible to manage them even in the workplace and prepare for flares. While it could be difficult to do so, tell your employer and teammates about your condition. Being open and communicative about your circumstances can make it easier to plan for when flares happen. You can also prepare an emergency kit with a spare change of clothes, wipes, and medication.
If you are an employer and have an employee with Crohn’s disease, the best way to support them is to listen when they tell you about their condition and be understanding. Make them feel comfortable in the workplace by making accommodations for them. Give them work-from-home options and a flexible schedule. For example, if an employee with Crohn’s disease tends to experience flares in the morning, you can arrange for your employee to have a later start to the work day. If flares happen in the afternoons, you can grant them an extended lunch and allow them to continue with tasks past normal working hours. You can also arrange for them to take regular breaks and give them easy access to the bathroom.
You can also include gut health resources to benefit packages. Digital apps like GIThrive provide resources, 24/7 access and care, and consultation with medical professionals to help employees track Crohn’s disease and other GI illnesses.
Crohn’s disease is a chronic condition that can interfere with daily life, but it is not impossible to manage. With the right help and support, you can take control of your gut health and live a fulfilling life.