Could Crohn’s disease be causing your gastrointestinal symptoms?

Across the globe, approximately 7 million people are living with an inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. But getting an accurate diagnosis of Crohn’s disease can be challenging because the symptoms can also be caused by a wide range of other conditions—including infections, pelvic inflammatory disease and endometriosis, and damage to the digestive tract caused by medications—and can affect different parts of the digestive tract.

If you’re living with symptoms that may be caused by Crohn’s disease, your health advisor can connect you with an experienced gastroenterologist who can help you get an accurate diagnosis, develop a treatment plan, and advise you on strategies to help manage your symptoms.

What causes Crohn’s disease and what are the symptoms?

The definitive cause of Crohn’s disease has not yet been identified. It is a chronic disease that causes swelling, irritation, and, over time, thickening and scarring in the tissues of the gastrointestinal (GI) tract. It can affect any part of the GI tract, from the mouth to the anus, and can affect multiple, separate parts of the GI tract at the same time or the entirety of the GI tract. The most commonly affected areas are the small intestine and beginning of the large intestine.

The type of Crohn’s disease you are diagnosed with is based on what part of the GI tract is affected. Ileocolitis, the most common type, affects the end of the small intestine and the colon. Ileitis affects only the end of the small intestine. Gastroduodenal Crohn’s disease affects the stomach and duodenum (start of the small intestine). Jejunoileitis causes areas of inflammation in the upper small intestine. Crohn’s granulomatous colitis affects only the large intestine or colon.

Some researchers believe that an atypical autoimmune reaction to bacteria, viruses, and environmental factors may be one of the underlying causes of the disease. In addition, there is some research that suggests that genetics may also play a role in your risk of developing Crohn’s disease.

Previously, stress and food choices were thought to be Crohn’s disease causes, but after more research, it became clear that these factors aggravate but do not cause the condition. Researchers have also found an association between smoking and a significantly higher risk of developing the disease.

The most common symptoms of Crohn’s disease include:

• Diarrhea
• Abdominal pain and cramps
• Blood in the stool
• Fever
• Fatigue
• Decreased appetite and weight loss
• Mouth sores

It can also cause symptoms outside the GI tract, including:

• Kidney stones
• Liver and bile duct inflammation
• Anemia
• Skin, eye, and joint inflammation
• Growth delays in children
• Arthritis

Over time, Crohn’s disease has the potential to cause complications, including low bone mass and osteoporosis, malnutrition, strictures (narrowing) and obstructions in the intestine, fistulas (abnormal connections between organs or between organs and the skin), abscesses, anal fissures, an increased risk of colon cancer if the disease affects your colon, and ulcers in the mouth, intestines, anus, and perineum. Working closely with your gastroenterologist and adhering to your treatment plan to decrease inflammation and its impact on your body can significantly reduce your risk of complications.

How is Crohn’s disease diagnosed?

There is no single test for Crohn’s disease and the process of diagnosis can involve several steps. Your gastroenterologist will ask what symptoms you experience, how long you’ve been experiencing them, and about your personal and family health history, especially about other family members who have been diagnosed with inflammatory bowel disease. You’ll also undergo a physical exam of your abdomen to check for swelling and tenderness.

Your physician may also order blood tests, which can help rule out other causes for your symptoms and check for inflammation and anemia. Other potential lab tests include stool studies to find bacteria, blood, and inflammation markers like calprotectin.

There are a number of imaging tests and procedures that may also be recommended, including:

• Colonoscopy
• Upper endoscopy
• Sigmoidoscopy
• CT scan
• MRI
• Upper GI X-rays
• Capsule endoscopy (swallowing a pill that contains a small camera that collects images as it passes through the GI tract)

What are my treatment options?

To date, there is no cure for Crohn’s disease, but there are a growing number of different types of medications that can help manage symptoms and reduce inflammation and damage to the tissue of the GI tract. For some people, treatment helps them achieve remission of the disease, periods when the symptoms are reduced or resolved.

The medications fall into five main categories:

• Anti-inflammatory medications, including corticosteroids (used on a short-term basis) and oral 5-aminosalicylates (older medications that contain an anti-inflammatory compound called 5-ASA and are used for mild to moderate Crohn’s disease)
• Immunosuppressants to reduce inflammation, including azathioprine and mercaptopurine, as well as methotrexate for people whose disease does not respond well to other medications
• Biologics, which inhibit TNF (an immune system protein); interfere with the action of interleukin (a protein involved in inflammation); stop integrins (immune cell molecules) from binding to other cells in the intestinal lining; and act against interleukin-23 (a pro-inflammatory protein)
• Janus kinase (JAK) inhibitors, which reduce inflammation by targeting the parts of the immune system involved in GI inflammation
• Antibiotics, to treat fistulas and abscesses and reduce bacteria associated with inflammation

Your physician may also prescribe medications to help you manage symptoms, such as anti-diarrhea and pain medications.

Some people need surgery to remove parts of the intestines that become too damaged or to close fistulas and drain abscesses.

Proactive steps to help you manage symptoms

In addition to the treatment plan developed by your physician, there are also several lifestyle changes that may help you better manage your symptoms and lower the risk of a disease flare-up. Try these proactive strategies:

• Quit smoking.
• Choose a healthy diet, which looks different for people living with Crohn’s disease and includes avoiding high fiber fruit, vegetables, nuts, and whole grains; cooking fruits and vegetables to reduce fiber content rather than eating them uncooked; limiting or avoiding dairy foods; avoiding foods high in fat; avoiding spicy and salty foods; and not drinking caffeinated beverages or eating foods with caffeine.
• Get regular physical activity, which can boost your immune system and lower stress levels.
• Manage stress.
• Don’t use nonsteroidal anti-inflammatory medications (NSAIDs), which can impair the GI tract’s ability to heal itself.
• Limit or avoid alcohol.

PinnacleCare support

Managing a chronic condition can be a lot of work. PinnacleCare is here to help you, whether it is finding new specialists, seeking out second opinions, or confirming treatment plans. Connect with our team today to learn more.

PinnacleCare is a member of the Sun Life Financial Inc. (“Sun Life”) family of companies. PinnacleCare and its employees do not diagnose medical conditions, recommend treatment options or provide medical care, and any information or services provided should not be considered medical advice. Any medical decisions should be made only after consultation with and at the direction of your medical provider. Any person or entity who provides health care services following a referral or other service provided does so independently and not as an agent or representative of PinnacleCare.

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