Crohn's is a severe, chronic inflammatory bowel disease. It causes inflammation, ulcers, and bleeding in the digestive tract. It usually affects the end portion of the small intestine called the ileum. However, any part of the digestive tract can be affected, from the mouth to the anus.

Small Intestine

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The cause of Crohn's disease is not known. Inflammatory bowel diseases ( ulcerative colitis and Crohn's disease) seem to run in some families. Some researchers think that it is due to a reaction to a virus or bacteria. The immune system overreacts and causes damage to the intestines.

Risk Factors

Factors increase your chance of getting Crohn's include:

• Family members with inflammatory bowel disease
• Jewish heritage

Symptoms

Symptoms include:

• Diarrhea
• Abdominal cramps and pain
• Rectal bleeding
• Anemia
• Weight loss
• Fatigue, weakness
• Nausea
• Fever
• Mouth sores
• Sores, abscesses in the anal area

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Blood tests
• Stool examination
• Barium swallow —a series of x-rays of structures inside the throat that are taken after drinking a barium-containing liquid
• Barium enema x-ray —insertion of fluid into the rectum that makes your colon show up on an x-ray
• Flexible sigmoidoscopy —a thin, lighted tube inserted into the rectum to examine the rectum and the lower colon
• Colonoscopy —a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
• Biopsy —removal of a sample of colon tissue for testing (may be performed as part of a flexible sigmoidoscopy or colonoscopy)

If you are diagnosed with Crohn's disease, follow your doctor's instructions .

Treatment

Treatment may include:

Dietary Changes

Your doctor may recommend that you avoid foods that provoke symptoms. These foods are different for each person. They may include:

• Dairy foods (due to lactose intolerance)
• Highly seasoned foods
• High-fiber foods

Medications

There are many types of medicines that are used to treat Crohn's disease. Examples of these medicines include:

• Aminosalicylate medicines—such as sulfasalazine, mesalamine, olsalazine
• Anti-inflammatory medicines—such as prednisone, methylprednisolone, budesonide
• Immune modifiers—such as azathioprine, 6-mercaptopurine, methotrexate
• TNF-inhibitors—such as infliximab, adalimumab, etanercept, certolizumab, golimumab
• Antibiotic medicines—such as metronidazole, ampicillin, ciprofloxacin

Surgery

Very severe Crohn's may not improve with medicines. You may be advised to have the severely diseased section of your intestine removed. The two remaining healthier ends of the intestine are then joined together. You are still at high risk for recurrence of the disease elsewhere.

Surgery may also be done if you have an obstruction or fistulas.

Untreated Crohn's disease may lead to:

• Fistulas—abnormal connections between the intestine and other organs or tissues, such as the bladder, vagina, or skin
• Intestinal obstruction
• Arthritis
• Eye inflammation
• Liver disease
• Kidney stones
• Gallstones
• Skin rashes
• Osteoporosis

Prevention

There are no guidelines for preventing Crohn's disease because the cause is unknown.