Crohn's disease or Crohn's disease, a type of chronic inflammatory bowel disease (IBD), is a medical condition in which the digestive tract wall becomes inflamed, causing severe diarrhea and severe abdominal pain. Often the inflammation spreads deep into the layers of the affected tissues. Crohn's disease can be both painful and debilitating, and in some cases it can lead to life-threatening complications.
At the moment there is no definitive cure for this chronic disease, but therapies are available that can greatly alleviate the symptoms and even eliminate them for a long time. With these therapies, many people with Crohn's disease are able to lead normal lives.
Steps
Method 1 of 2: Part One: Recognize the Symptoms and Confirm the Diagnosis
Step 1. Recognize the signs and symptoms of Crohn's disease
Symptoms of this disease are similar to those of other intestinal conditions, such as ulcerative colitis and irritable bowel syndrome. A wide range of symptoms that vary in intensity and severity can occur at regular intervals. They differ from person to person, based on which part of the gastrointestinal tract was affected. Some of the classic symptoms include:
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Diarrhea:
the inflammation that occurs in Crohn's disease causes the affected cells in your gut to secrete a large amount of water and salt. Since the colon cannot fully absorb excess fluid, you will develop diarrhea.
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Cramps and abdominal pain:
inflammation and ulceration could cause the walls of the intestine to swell which eventually thickens with scar tissue. This affects the normal movement of the contents of the intestinal tract that comes during the digestive phase causing cramps and pain.
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Blood in the stool:
food channeling into the digestive tract can cause already inflamed tissues to bleed. Your intestines may also bleed regardless of passing food.
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Ulcers:
Crohn's disease begins with small clusters of sores spread over the intestinal surface. Eventually these sores become ulcers that penetrate deeply or through the intestinal walls.
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Reduced appetite and weight loss:
cramps, abdominal pain and inflammatory reaction in the intestinal wall can affect appetite and the ability to absorb and digest food.
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Fistulas or abscesses:
Crohn's disease-induced inflammation may transfer from the intestinal wall to adjacent organs, such as the bladder and vagina, generating a pathological tubular communication called a fistula. This process can also lead to an abscess, a swollen, pus-filled sore.
Step 2. Learn to recognize less common symptoms of Crohn's disease
In addition to the symptoms mentioned so far, patients suffering from this condition may experience other side effects: pain in the joints, constipation and gingivitis.
- Patients with advanced Crohn's disease may have fever and fatigue and additional symptoms affecting other organs or systems, such as arthritis, eye inflammation, skin problems, liver and biliary tract inflammation.
- Patients affected at a young age may have delayed sexual growth and development.
Step 3. Consider when to seek medical advice
Contact your doctor if you experience any of the following symptoms:
- You feel faint or have an irregular heartbeat.
- You have severe pain in your stomach.
- You have a fever of unknown origin or chills that last more than a couple of days.
- You have persistent vomiting.
- You have blood in your stool.
- You have bouts of diarrhea that don't respond to classic over-the-counter products.
Step 4. Get tested to confirm the diagnosis
If your doctor suspects that you may have Crohn's disease, he or she may refer you to a gastroenterologist who will undergo various diagnostic tests. These include:
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Blood analysis:
your doctor may order blood tests to check for anemia, which is a typical consequence of Crohn's disease (caused by blood loss).
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Colonoscopy:
this exam allows the doctor to view the colon using a thin, flexible tube connected to a camera. Thanks to the images of the video camera, the specialist will be able to identify any inflammation, bleeding, ulcers present on the colon wall.
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Flexible sigmoidoscopy:
In this procedure, the doctor uses a flexible tube to examine the sigmoid and rectum, which are the last tract of the colon.
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The barium enema:
this diagnostic test allows the doctor to examine the intestine on X-rays. Before the test, barium, a contrast agent, enters the intestine via an enema.
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X-ray of the small intestine:
this exam uses x-rays to examine the part of the small intestine that cannot be seen through a colonoscopy.
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Computed Tomography (CT):
in some cases a CT is performed, a particular radiographic technique that provides more detailed (three-dimensional) data than a classic X-ray. This exam looks at the entire intestine - including the external tissues that cannot be analyzed with other methods.
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Capsular endoscopy:
If you have typical symptoms of Crohn's disease, but the classic diagnostic tests fail, your doctor may recommend that you undergo a capsular endoscopy.
Method 2 of 2: Part Two: Evaluate Treatment Options
Step 1. Ask your doctor about the available drug therapies
Several medications can be taken to relieve the symptoms of Crohn's disease. The best solution for your case will depend on the nature of the condition and the severity of the symptoms. Some commonly used medications include:
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Anti-inflammatory drugs:
these drugs are often the first treatment option used for the treatment of Crohn's disease. They include sulfasalazine, used primarily in diverticulitis, mesalamine (Asacol) which may be prescribed to prevent Crohn's disease from relapse after surgery, and corticosteroids.
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Immunosuppressive drugs:
these drugs reduce inflammation by acting on your immune system, which is responsible for the inflammatory process in the intestinal tract. They include azathioprine and mercaptopurine, infliximab, adalimumab, certolizumab pegol, methotrexate, cyclosporine and natalizumab.
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Antibiotics:
these drugs can treat fistulas and abscesses. They include metronidazole (Flagyl) and ciprofloxacin (Ciproxin).
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Antidiarrheal drugs:
Crohn's disease patients suffer from chronic diarrhea which usually responds well to antidiarrheal drugs such as loperamide. Loperamide is an over-the-counter drug (Imodium, Dissenten).
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Bile acid sequestrants:
Patients with disease involving the terminal ileum or who have undergone resection of the ileum (the terminal part of the small intestine) may not normally absorb bile acids, resulting in secretory diarrhea within the colon. These patients may experience beneficial effects if they take biliary sequestrants such as cholestyramine or colestipol.
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Other drugs:
Several other medications that can relieve symptoms of Crohn's disease include steroids, immunosuppressants, high-fiber supplements, laxatives, pain relievers, iron, vitamin B12, calcium, and vitamin D supplements.
Step 2. Follow the medical instructions regarding the diet to be followed
There is no scientific evidence that shows a relationship between some foods and this pathology. But some foods and drinks can aggravate the disease (especially during an acute episode), while other foods can help relieve symptoms and prevent future outbreaks.
- Fiber-rich supplements appear to have beneficial effects. The reason seems to be due to the fact that the fiber is converted into short-chain fatty acids, which help the colon to heal.
- Try to avoid dairy products, as most patients with Crohn's disease (especially when the small intestine is affected) are lactose intolerant. You could use calcium-rich supplements to counteract any deficiencies and reduce the risk of osteoporosis.
- Avoid gas-producing foods, such as beans and some vegetables. You should also limit the consumption of fatty or fried foods that can affect proper digestion. Also, you should eat small portions of food with each meal to avoid overloading the digestive system.
- In some cases, your doctor will recommend a special enteral or parenteral (intravenous) diet to treat Crohn's disease. This is only a temporary solution, often practiced during the convalescence phase following surgery.
- Know that every Crohn's disease patient is different from the others. One way to understand food intolerances is to keep a journal, which can help you identify foods that make symptoms worse. Once you have identified your food intolerances, you can make an effort to avoid these foods.
Step 3. Change your lifestyle
Although Crohn's disease cannot be cured, you can reduce symptoms and lead a normal life by following your doctor's directions and changing your lifestyle. These changes include:
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Reduce Stress:
although stress is not the cause of the disease, it can contribute to worsening symptoms and trigger relapses. While it's not always possible to avoid stress, you can learn to manage it.
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Stop smoking:
if you smoke, you are much more likely to develop Crohn's disease. Additionally, smoking worsens symptoms and increases the likelihood of complications that can make surgery unavoidable.
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Exercise more:
regular exercise will help keep you fit and reduce stress - two factors that will make a difference in getting your disease under control. Look for a sport that you get excited about - be it ballet, mountaineering or rowing.
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Avoid drinking alcohol:
the symptoms of Crohn's disease can get worse if you drink alcohol. So, drink in moderation or stop drinking altogether.
Step 4. Try surgical treatments
If diet and lifestyle changes, drug therapy, or other measures do not relieve your symptoms, your doctor may recommend that you undergo surgery to remove the most damaged portion of the intestine, close fistulas, or remove scar tissue. The three main surgical methods to which patients with Crohn's disease are subjected are the following:
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Proctocolectomy:
this procedure involves the surgical removal of the rectum and colon or the most damaged tract. It is performed under general anesthesia by a surgeon who specializes in this procedure. The hospital stay lasts from 4 to 6 weeks.
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Ileostomy:
ileostomy is a second procedure performed in addition to proctocolectomy. It involves connecting the ileum (the last part of the small intestine) to an opening in the abdomen called the stoma. A small pouch is attached to the stoma to collect stool. After the surgery, the patient will be instructed on emptying and cleaning the pouch, and will be able to lead a normal life.
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Bowel resection surgery:
this type of surgery involves the removal of the diseased part of the intestine. After removal, the two healthy tracts are connected, allowing the intestine to resume normal functions. The hospital stay ranges from 3 to 4 weeks.
- It is estimated that two-thirds of Crohn's disease patients will need surgery sooner or later. Unfortunately, the disease often recurs after surgery, so further procedures will be needed.
Step 5. Try herbs that may help with Crohn's disease
Herbs like Glycyrrhiza glabra, Asparagus racemosus, and others can be beneficial.
- Studies conducted on Glycyrrhiza glabra (licorice) suggest that this plant can normalize the intestinal environment by reducing inflammation and improving ulcer healing.
- Studies conducted on Asparagus racemosus suggest that it can soothe the lining of the gastric mucosa and promote the repair of damaged and stressed tissues.
- Studies conducted on Valeriana officinalis suggest that this advanced homeopathic resonance remedy can relieve symptoms such as abdominal pain, constipation, diarrhea, involuntary bowel movements and nausea.
- Studies conducted on Veratrum album suggest that this advanced homeopathic resonance remedy can improve loose or liquid stools.
Advice
- Follow medical advice carefully and do regular blood tests to rule out side effects of any medications you are taking.
- Exercise regularly and eat a healthy diet - this will help reduce stress.
- Alcohol makes symptoms worse. It is recommended to drink moderately or to stop drinking to reduce the symptoms of the disease.
- Make a daily diary to identify foods that can make symptoms worse and try to eliminate them from your diet.
- Contact associations that can give you access to support groups.
- Crohn's disease can affect any individual, but it usually develops at a young age.
- Only take medicines prescribed by your doctor or gastroenterologist.
- White people are at higher risk, but Crohn's disease can affect other ethnic groups as well.
- If you live in an urban area or industrialized country, you are more likely to develop Crohn's disease.
- You are at higher risk if you have a family member with this condition.
Warnings
- Do not take non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Moment, Nurofen), or naproxen sodium (Aleve). These medications could make your symptoms worse.
- Take antidiarrheal medications with great caution and only after consulting your doctor, as they increase the risk of toxic megacolon, a potentially deadly inflammation of the colon.
- Check with your doctor before taking laxatives, as even over-the-counter products, in the condition you are in, may not be the best choice.
