How does Crohn’s disease affect bowel movements. What are the main causes of constipation in Crohn’s patients. Which dietary changes can help alleviate Crohn’s-related constipation. How do medications impact constipation in Crohn’s disease. What are the most effective treatments for Crohn’s-associated constipation.

Understanding Constipation in Crohn’s Disease

While Crohn’s disease is often associated with diarrhea, constipation can also be a significant issue for many patients. Constipation is defined as having fewer than three bowel movements per week, straining during defecation, or being unable to completely empty the bowels. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), approximately 52 million Americans, or 16% of the population, suffer from constipation.

For individuals with Crohn’s disease, constipation may indicate a more serious underlying problem. Dr. Justin L. Sewell, a professor of clinical medicine at the University of California, San Francisco, emphasizes the importance of determining whether there is evidence of active disease or inflammation when Crohn’s patients experience constipation.

Common Causes of Constipation in Crohn’s Disease

Several factors can contribute to constipation in people with Crohn’s disease:

1. Strictures

Strictures are narrowed areas in the gastrointestinal tract, typically occurring in the small intestine. They can cause abdominal pain, cramping, vomiting, and block the passage of food through the digestive system. Anal strictures are often responsible for constipation in Crohn’s patients.

Is surgery always necessary for treating strictures? Not always. While some cases may require surgical intervention, others can be managed with medications. However, 23-45% of ulcerative colitis patients and up to 75% of Crohn’s disease patients will eventually need surgery, according to the Crohn’s and Colitis Foundation.

2. Proctitis

Proctitis is inflammation in the lining of the rectum, common among people with inflammatory bowel disease (IBD). It causes tenesmus, a frequent urge to have a bowel movement even when the bowels are empty. This condition is more prevalent in ulcerative colitis but can also occur in Crohn’s disease patients.

3. Anal Fissures

An anal fissure is a cut or tear in the anus that can cause itching, pain, and bleeding during bowel movements. The pain associated with fissures often leads people to delay going to the bathroom, which can exacerbate constipation as stools become harder and more difficult to pass.

4. Medications

Certain medications commonly prescribed to Crohn’s patients or for other conditions can contribute to constipation. These include antidepressants, painkillers, iron supplements, and calcium channel blockers used for hypertension and heart disease.

Surgical Interventions for Crohn’s-Related Constipation

When conservative treatments fail to alleviate constipation caused by strictures, surgical options may be considered:

• Small bowel resection: This procedure involves removing diseased sections of the small intestine.
• Strictureplasty: A less invasive alternative where the surgeon makes a lengthwise incision along the narrowed area and sews it up crosswise, widening the passage without removing intestinal tissue.

Dr. Sewell notes that the choice between these procedures depends on various factors, including the length of the stricture and the patient’s surgical history. While strictureplasty preserves intestinal length, it carries risks such as bleeding and fluid leakage.

Medical Treatments for Crohn’s-Associated Constipation

Various medical interventions can help manage constipation in Crohn’s disease:

1. Mesalamine (5-ASA): An anti-inflammatory medication used to treat IBD symptoms.
2. Steroids: Used to reduce inflammation in the digestive tract.
3. Biologics: Advanced treatments that target specific proteins involved in inflammation.
4. Topical treatments: Such as aminosalicylates, applied directly to the affected area.
5. Hydrocortisone: A topical treatment used for anal fissures.

For anal fissures, daily warm sitz baths are often recommended to clean and soothe the affected area. In severe cases, surgery may be necessary.

Dietary Strategies to Prevent and Relieve Constipation

Nutrition plays a crucial role in managing Crohn’s disease symptoms, including constipation. However, dietary choices can be complex for Crohn’s patients, as certain foods may exacerbate symptoms.

Are there specific diets that can help manage Crohn’s-related constipation? While individual responses may vary, some dietary approaches that have shown promise include:

• Increasing fluid intake to soften stools and promote regular bowel movements.
• Gradually increasing dietary fiber intake, focusing on soluble fiber sources like oats, legumes, and some fruits.
• Experimenting with probiotic-rich foods or supplements to support gut health.
• Avoiding trigger foods that may worsen inflammation or digestive symptoms.

It’s important to work closely with a healthcare provider or registered dietitian to develop a personalized nutrition plan that addresses constipation while considering overall Crohn’s disease management.

Lifestyle Modifications to Improve Bowel Function

In addition to dietary changes, several lifestyle modifications can help alleviate constipation in Crohn’s disease:

1. Regular exercise: Physical activity can stimulate bowel movements and improve overall digestive health.
2. Stress management: Chronic stress can exacerbate Crohn’s symptoms, including constipation. Techniques such as meditation, yoga, or cognitive-behavioral therapy may be beneficial.
3. Establishing a regular bathroom routine: Setting aside time each day for bowel movements can help promote regularity.
4. Proper toilet posture: Using a footstool to elevate the feet while on the toilet can improve the angle of the rectum, making bowel movements easier.

Can these lifestyle changes completely eliminate constipation in Crohn’s disease? While they may not provide a complete solution for everyone, many patients find significant relief by incorporating these strategies into their daily routines.

The Role of Hydration in Managing Crohn’s-Related Constipation

Proper hydration is crucial for preventing and relieving constipation in Crohn’s disease. Adequate fluid intake helps soften stools and promotes regular bowel movements. However, the amount of fluid needed can vary depending on factors such as activity level, climate, and overall health status.

What are the best hydration strategies for Crohn’s patients dealing with constipation? Consider the following tips:

• Aim for at least 8-10 glasses of water per day, or more if you’re experiencing diarrhea or excessive sweating.
• Include hydrating foods in your diet, such as watermelon, cucumbers, and zucchini.
• Avoid or limit beverages that can contribute to dehydration, such as alcohol and caffeinated drinks.
• Use oral rehydration solutions when necessary, especially during flare-ups or periods of increased fluid loss.

Remember that individual hydration needs may vary, and it’s essential to consult with your healthcare provider to determine the optimal fluid intake for your specific situation.

Monitoring and Managing Medication-Induced Constipation

As mentioned earlier, certain medications used to treat Crohn’s disease or other conditions can contribute to constipation. It’s crucial for patients to be aware of this potential side effect and work closely with their healthcare providers to manage it effectively.

How can Crohn’s patients address medication-induced constipation? Consider these approaches:

1. Open communication: Discuss any changes in bowel habits with your doctor, especially after starting new medications.
2. Medication adjustments: Your healthcare provider may be able to adjust dosages or switch to alternative medications that are less likely to cause constipation.
3. Supplementary treatments: In some cases, your doctor may recommend stool softeners or gentle laxatives to counteract the constipating effects of necessary medications.
4. Timing of medication: Taking certain medications at specific times in relation to meals may help minimize their impact on bowel function.

It’s important to never adjust or discontinue medications without consulting your healthcare provider, as this could lead to worsening of Crohn’s symptoms or other health issues.

The Importance of Regular Screening and Monitoring

For Crohn’s disease patients experiencing chronic or recurrent constipation, regular screening and monitoring are essential to detect and address potential complications early. This may include:

• Regular colonoscopies to assess the state of the colon and detect any strictures or areas of inflammation.
• Imaging studies such as MRI or CT scans to evaluate the small intestine for strictures or other abnormalities.
• Blood tests to monitor inflammation levels and overall nutritional status.
• Stool tests to check for infections or other gastrointestinal issues that may be contributing to constipation.

How often should Crohn’s patients undergo these screenings? The frequency of monitoring will depend on individual factors such as disease severity, previous complications, and response to treatment. Your gastroenterologist can provide personalized recommendations based on your specific situation.

Emerging Therapies and Research in Crohn’s-Related Constipation

As our understanding of Crohn’s disease and its associated complications continues to evolve, researchers are exploring new approaches to managing constipation and other gastrointestinal symptoms. Some promising areas of investigation include:

1. Microbiome-based therapies: Targeting the gut microbiome through probiotics, prebiotics, or fecal microbiota transplantation to improve digestive function and reduce inflammation.
2. Novel anti-inflammatory agents: Developing new medications that can more precisely target the inflammatory processes involved in Crohn’s disease while minimizing side effects.
3. Intestinal stem cell therapies: Exploring the potential of stem cells to regenerate damaged intestinal tissue and improve overall gut function.
4. Neurogastroenterology advances: Investigating the complex interactions between the nervous system and the digestive tract to develop new treatments for motility disorders and constipation.

While many of these approaches are still in the experimental stages, they offer hope for improved management of Crohn’s-related constipation in the future. Patients interested in participating in clinical trials or learning more about emerging therapies should discuss options with their healthcare providers.

Holistic Approaches to Managing Crohn’s Disease and Constipation

Many Crohn’s disease patients find that incorporating holistic or complementary approaches alongside conventional medical treatments can help manage symptoms, including constipation. Some potentially beneficial practices include:

• Acupuncture: Some studies suggest that acupuncture may help reduce inflammation and improve gastrointestinal motility.
• Herbal remedies: Certain herbs, such as slippery elm or marshmallow root, may have soothing effects on the digestive tract. However, it’s crucial to consult with a healthcare provider before using any herbal supplements, as they can interact with medications or cause side effects.
• Mind-body techniques: Practices like mindfulness meditation, guided imagery, or hypnotherapy may help reduce stress and improve overall digestive function.
• Massage therapy: Abdominal massage techniques may help stimulate bowel movements and relieve constipation in some individuals.

Can these holistic approaches replace conventional medical treatments for Crohn’s disease? While they may provide complementary benefits, it’s important to view them as part of a comprehensive treatment plan rather than standalone solutions. Always discuss any alternative or complementary therapies with your healthcare provider to ensure they are safe and appropriate for your individual situation.

The Psychological Impact of Crohn’s-Related Constipation

Dealing with chronic constipation can have significant psychological effects on individuals with Crohn’s disease. The discomfort, unpredictability, and potential embarrassment associated with bowel issues can lead to anxiety, depression, and social isolation. Addressing these psychological aspects is crucial for overall well-being and quality of life.

How can Crohn’s patients cope with the emotional challenges of constipation? Consider the following strategies:

1. Seek professional support: A mental health professional, particularly one experienced in working with chronic illness patients, can provide valuable coping strategies and emotional support.
2. Join support groups: Connecting with others who have similar experiences can provide a sense of community and valuable insights for managing the condition.
3. Practice self-compassion: Be kind to yourself and recognize that managing a chronic condition is challenging. Celebrate small victories and focus on progress rather than perfection.
4. Educate friends and family: Helping loved ones understand your condition can foster a more supportive environment and reduce feelings of isolation.

Remember that addressing the psychological aspects of Crohn’s disease and its symptoms is an essential part of comprehensive care. Don’t hesitate to discuss these concerns with your healthcare provider, who can offer resources and referrals as needed.

Navigating Social and Professional Situations with Crohn’s-Related Constipation

Managing Crohn’s disease and its associated symptoms, including constipation, can be particularly challenging in social and professional settings. However, with proper planning and communication, it’s possible to navigate these situations more comfortably:

• Develop a routine: Establish a regular schedule for meals and bathroom breaks to help manage symptoms throughout the day.
• Plan ahead: When traveling or attending events, research bathroom locations in advance and bring any necessary medications or supplies.
• Communicate with employers: If constipation or other Crohn’s symptoms are affecting your work, consider discussing accommodations with your employer, such as flexible work hours or a private restroom.
• Be prepared for emergencies: Carry an emergency kit with items like wet wipes, a change of clothes, and any necessary medications.
• Practice self-advocacy: Don’t be afraid to speak up about your needs or excuse yourself when necessary. Your health and comfort should be a priority.

How can Crohn’s patients balance openness about their condition with maintaining privacy? This balance is personal and may vary depending on the situation. Some individuals find that being open about their condition helps reduce stress and fosters understanding, while others prefer to keep their health issues private. There’s no one-size-fits-all approach, and it’s okay to adjust your level of disclosure based on your comfort and the specific circumstances.

By implementing these strategies and working closely with healthcare providers, individuals with Crohn’s disease can effectively manage constipation and other symptoms, improving their quality of life and overall well-being. Remember that managing Crohn’s disease is an ongoing process, and it’s important to stay informed about new developments in treatment options and self-care strategies.

How to Manage Constipation Associated With Crohn’s Disease

People with Crohn’s disease often deal with diarrhea. Though not as common, constipation does occur and may signal an underlying problem.

A person is considered to be constipated if they:

• Have fewer than three bowel movements a week
• Have to strain to pass stool
• Are unable to completely empty their bowels

Not being able to “go” is common. About 52 million people, or nearly 16 percent of the American population, suffer from constipation, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

“Anyone can develop constipation. Most often it’s because they aren’t drinking enough fluids or eating enough dietary fiber, or they’re taking certain medications,” says Justin L. Sewell, MD, a professor of clinical medicine in the division of gastroenterology at the University of California in San Francisco.

“For people with Crohn’s, constipation could mean actual blockage in the intestine,” Dr. Sewell says, “so it’s important to determine if there’s evidence of active disease or inflammation.”

Here are some possible reasons people with Crohn’s may have constipation.

Strictures

For people with Crohn’s, strictures — narrowed areas in the gastrointestinal tract, usually in the small intestine — can cause abdominal pain, cramping, and vomiting. Strictures can also block food from passing through the digestive tract. Anal strictures are typically the cause of constipation.

“If there’s a stricture in the bowels, it’s generally managed with medications or requires surgery to remove a part of the bowel that’s blocking the passage of food,” says Sewell.

In general, 23 to 45 percent of people with ulcerative colitis and up to 75 percent of people with Crohn’s disease will eventually require surgery, according to the Crohn’s and Colitis Foundation. While surgery may be optional for some, others will require it because of complications of the disease.

Small bowel resection — surgery that removes diseased sections of the small intestine — is commonly used to treat strictures. A less-invasive alternative is strictureplasty, in which the surgeon makes a lengthwise incision along the narrowed area and then sews it up crosswise, widening the area without removing any portion of the small intestine, thus preserving intestine length.

The procedure is generally safe and effective, but it can cause bleeding in the bowels and fluid leakage from the stitches, and other strictures may form over time.

Even though it seems preferable to cut out a section of the bowel if the stricture is short, Sewell notes, if it’s a long stricture or the patient has already had previous resections, it puts them at risk of short bowel syndrome. “Then, perhaps, strictureplasty would be more favorable,” he says.

Proctitis

Common among people with inflammatory bowel disease (IBD), proctitis is inflammation in the lining of the rectum that causes tenesmus, a frequent urge to go to the bathroom even when the bowels are empty. There’s generally a feeling of fullness in the rectum and pain during bowel movements.

“This is usually common among patients with ulcerative colitis, but it could occur in people with Crohn’s,” says Sewell.

The cause is rectal inflammation, so keeping an eye on the disease and staying on top of prescribed medications could help prevent inflammation from worsening and causing tenesmus.

But if the symptom does develop, doctors may prescribe mesalamine (a 5-ASA), steroids, biologics, or anti-inflammatory topical treatments, such as aminosalicylates.

Fissures

An anal fissure is a cut or tear in the anus that typically causes itching, pain, and bleeding with bowel movements.

“Since it’s painful, people will often delay going to the bathroom,” says Sewell. “The longer they wait, the harder the stool becomes, which makes it harder for the stool to pass.”

Anal fissures — not to be confused with fistulas, which are abnormal openings that form in the wall of the intestine and connect to other tissues or organs — are usually managed with daily warm sitz baths to clean the affected area and a topical treatment such as hydrocortisone. Severe cases often require surgery.

Certain medications

Medications such as antidepressants, painkillers, iron supplements, and calcium channel blockers for hypertension and heart disease can cause constipation, too.

If reducing or stopping the medication isn’t an option, Sewell recommends increasing water and dietary fiber intake or using stool softeners or stimulant laxatives.

Can Diet Help Prevent or Relieve Constipation?

According to the Crohn’s and Colitis Foundation, nutrition is vital to controlling IBD symptoms. Food choices can become more complicated for people with Crohn’s, because certain foods may worsen symptoms.

A variety of diets have been used to help manage Crohn’s symptoms or maintain remission, but there is no one tried-and-true diet that works for constipation.

“Getting enough fluids, including fiber in the diet, such as soluble fiber like fruits, vegetables, and whole grains, or taking fiber supplements could help,” says Adam Cheifetz, MD, director of the center for inflammatory bowel disease at Beth Israel Deaconess Medical Center in Boston. “An unprocessed healthy diet without a lot of additives is key,” he says.

Increasing fiber should be gradual, cautions Kelly Kennedy, RDN, Everyday Health staff nutritionist, to prevent gas and discomfort.

“Fiber is something that many people with Crohn’s disease limit, so I wouldn’t advise going from 0 to 60, but rather increasing little by little until the desired effects are achieved,” she says. And during a Crohn’s flare, patients should limit fiber intake and replace it with foods like white pasta and white rice, even though they are considered to be processed foods. When the flare is over, they can return to gradually increasing fiber intake, Kennedy says.

For people with significant strictures, a low-residue diet may be recommended. If effective it would be used for the short term, until the patient has had surgery, for example, says Dr. Cheifetz.

“The diet helps by preventing high-residue foods that are not digestible, like corn, nuts, skins of fruits, and mushrooms, from getting stuck behind a stricture leading to a small bowel obstruction,” he says. (Patients should always get an okay from their doctor first.)

The use of probiotics, also called good bacteria, is thought to be good for the gut and has been linked to positive health outcomes, according to a review published in March 2017 in the journal Nutrients. However, more research is needed. A recent study found the effects of probiotics inconclusive. While they can’t hurt, the American College of Gastroenterology does not recommend them outside of a trial. You can find probiotics in yogurt that contains live and active cultures or in supplement form.

“The main limitation at this time is that they haven’t quite figured out which strain(s) and in which amounts might be helpful for a condition such as Crohn’s disease,” Kennedy says.

“I’ve used probiotics in patients who have underlying [irritable bowel syndrome] symptoms,” Cheifetz says. “It’s been helpful, especially for those who deal with bloating.”

Avoiding foods that worsen or trigger symptoms and making sure to follow a well-balanced, nutrient-rich diet are key.

“The only diet I would recommend is a general healthy diet with lots of whole foods and being sure to limit or avoid processed foods, which are low in nutritional value and fiber,” says Kennedy.

Crohn’s disease and constipation: Causes and treatments

Crohn’s disease tends to cause frequent diarrhea, but it can also cause constipation. This constipation may result from medications, other health conditions, or lifestyle factors.

Doctors consider a person to have constipation if they have fewer than three bowel movements a week. Other symptoms of constipation can include hard or dry stools, pain or difficulty passing stools, and a feeling of incomplete evacuation.

In this article, we discuss potential causes of constipation in people with Crohn’s disease, treatment options, and when to see a doctor.

There are several possible causes of constipation in people with Crohn’s disease. These can include:

Medications

A variety of medications can cause constipation, including antidiarrheal drugs, iron supplements, calcium channel blockers, and certain pain relievers.

Low-fiber diet

Doctors sometimes recommend a low-fiber diet for people experiencing a Crohn’s flare-up.

However, reducing the intake of fiber while also taking antidiarrheal medications can lead to constipation in some individuals.

Strictures

Share on PinterestEating fresh fruit can provide essential dietary fiber, which may help prevent constipation.

Crohn’s disease can cause a section of the intestines to narrow, due to severe inflammation.

This section is called a stricture, and it can block or slow the passage of stool or digested food through the bowels, leading to constipation.

Strictures can also cause abdominal pain, bloating, and nausea and vomiting. It is important for people with symptoms of a stricture or another blockage to see a doctor.

Without treatment, a stricture can lead to potentially life-threatening complications. Doctors can often treat strictures with medications, but some people may require surgery, such as a strictureplasty or bowel resection.

Other causes

Other causes of constipation in people with Crohn’s disease may include:

• not drinking enough fluids
• eating too little food
• an inactive lifestyle
• irritable bowel syndrome
• proctitis, which is an inflammation of the rectum

Treatments include dietary and lifestyle changes, medications, and bowel training. We discuss some of these options below:

Dietary fiber

Consuming more dietary fiber leads to more water absorption in the bowels. This makes stools softer and easier to pass.

Foods rich in fiber include:

• fresh or dried fruits, such as unpeeled apples and pears, prunes, berries, and oranges
• fresh or cooked vegetables, such as spinach, carrots, broccoli, sweet potatoes, and unpeeled potatoes
• legumes, such as lentils, beans, and peas
• nuts and seeds
• high-fiber breakfast cereals, which often include bran or whole grains
• whole-grain breads, pastas, and rice

Speak to a doctor or dietician before making significant dietary changes. People with strictures should not adopt high-fiber diets.

To prevent gas and bloating, it is best to gradually introduce high-fiber foods into the diet.

Fluids

Drinking more fluids can help soften stools and make them easier to pass. Fluids can include:

• water
• clear soups
• fruit and vegetable juices with no added sugar
• low-sugar sports drinks
• non-caffeinated beverages

Exercise

Share on PinterestRegular exercise can help support healthy bowel movements.

Getting more exercise can help stools move through the colon more quickly and increase the frequency of bowel movements.

Experts recommend doing at least 30 minutes of aerobic exercise on most days, or about 150 minutes per week. This can involve activities such as cycling, swimming, and brisk walking.

It may not always be easy or possible to exercise when symptoms flare up. Other ways to increase physical activity can include:

• Taking short walks
• using the car and elevator less
• taking regular breaks from desks and computers to walk around and stretch

Laxatives

Laxatives are a short-term option for the treatment of constipation. Longer-term use of these medications can make it difficult for a person to have a bowel movement without taking a laxative.

People with Crohn’s disease should speak to a doctor before trying a laxative.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the following types of laxatives are available over the counter:

• osmotic agents, such as milk of magnesia or Miralax
• bulk-forming agents, such as Citrucel or FiberCon
• stool softeners, such as Colace or Docusate
• lubricants, such as mineral oil
• stimulants, such as Correctol or Dulcolax

Doctors generally only recommend stimulant laxatives for people with severe constipation, or if other treatments have not worked.

Prescription medications

For people with severe or difficult-to-treat constipation, a doctor may prescribe lubiprostone, linaclotide, or plecanatide.

Lubiprostone works by increasing fluid in the large intestine, which helps soften stool and lead to more frequent bowel movements.

Linaclotide and plecanatide can help restore regular bowel movements, but they may take up to 1 week to have an effect. These two medications may cause severe dehydration in some people, and children should not take them.

Doctors need to rule out any intestinal obstructions, such as from strictures, before a person starts taking these medications.

Stopping medications

If a medication is causing a person’s constipation, the doctor may recommend changing, reducing, or stopping the drug or supplement.

Bowel training

Doctors may recommend bowel training for some people with constipation.

This involves trying to have a bowel movement at the same time each day. Bowel training may also include changing the way a person sits on the toilet.

Over time, this can help a person have more regular bowel movements.

Biofeedback therapy

Biofeedback therapy can help treat constipation in people who have problems with their pelvic floor muscles.

It involves using electronic devices to provide feedback on the activity of specific muscles, which allows the person to retrain them and gain better control.

Share on PinterestA person with Crohn’s disease should see a doctor if they experience a high fever.

People with Crohn’s disease should have regular check-ins with their doctor or other members of their healthcare team. Doing so allows healthcare professionals to monitor symptoms and recommend adjustments to the treatment plan.

Severe or sudden constipation, especially if it is associated with abdominal pain, may indicate a stricture or blockage in the bowels. Without treatment, blockages can lead to life-threatening complications, such as tearing in the intestine.

Symptoms of a stricture or blockage can include:

• severe abdominal pain, cramping, or bloating
• nausea and vomiting
• a high fever
• severe constipation
• an inability to pass gas

Anyone with these symptoms should speak to a doctor immediately.

Although Crohn’s disease typically causes diarrhea during flare-ups, some people may also experience constipation. Causes of this constipation can include medications, strictures, lifestyle factors, and other health conditions.

Constipation treatments for people with Crohn’s disease include making dietary and lifestyle changes, taking stool softeners or laxatives, and bowel training.

Consider speaking to a healthcare professional if symptoms do not improve.

Read this article in Spanish.

Crohn’s disease: diagnosis and treatment in Moscow

Causes of Crohn’s disease

Scientists are still wondering what exactly causes the disease. There are several theories according to which it may be an unexplored virus or microorganism. There are opinions that people get sick because of problems with immunity or malnutrition. It is known that genetics plays an important role in the occurrence of the disease. Almost all patients have close relatives suffering from Crohn’s disease.

For unknown reasons, ulcers and areas of overgrown connective tissue (granulomas) appear on the surface of organs. Because of this, the sizes and shapes of organs change, their work is disrupted. The most frequently recorded form of the disease with ulcerative lesions of the intestine. It is very dangerous, because the changed mucosa thickens, making it difficult for food to pass. Constant inflammation of the mucosa leads to persistent diarrhea that is difficult to treat.

Symptoms of Crohn’s disease

Patients experience instability of the stool (alternating constipation and diarrhea), bloating and increased flatulence. An inflamed intestine causes pain that occurs in one place (localized) or spreads throughout the abdomen. Pain is not associated with eating. During exacerbations, the temperature may rise significantly, chills, fever, nausea and vomiting may occur. Sometimes there is blood in the stool.

Crohn’s disease, like all chronic pathologies, occurs with periods of exacerbations and remissions (subsidence of symptoms). At this time, patients feel normal.

In addition to intestinal damage, the disease causes ulcers and nodules on the skin, inflammation of the joints and even the eyes. Due to improper digestion, the absorption of vitamins from food is disrupted, which leads to beriberi and anemia (anemia). The liver and gallbladder are often affected. Patients lose weight, complain of weakness, apathy, nausea and dry mouth. Irritation of the skin around the anus, caused by diarrhea, provokes the appearance of anal fissures and other lesions of the rectum. Patients suffering from constipation often develop hemorrhoids.

If Crohn’s disease is not treated, complications can occur:

● Life-threatening intestinal perforation;

● Fistulas through which intestinal contents and flora penetrate into other organs;

● Destruction of blood vessels leading to massive bleeding;

● Adhesive patency disorder. In this case, an operation is performed during which artificial pathways are created for the removal of food. The intestine is brought out with the formation of a stoma. The stool is removed into the colostomy bag.

People with Crohn’s disease are five times more likely to develop bowel cancer than healthy people. Those most at risk are those who have had cases of oncological pathologies of the colon or small intestine in the family.

Treatment of Crohn’s disease

Crohn’s disease is very difficult to detect, so patients are misdiagnosed and treated ineffectively for a long time. For diagnosis, a complex of laboratory, radiographic and endoscopic studies is carried out, only after that it is possible to identify the disease.

Radical methods of combating the disease do not exist. Only symptomatic and treatment and medical procedures are used that improve the condition of the intestines, prevent scarring and relieve inflammation.

Since the disease can affect different parts of the gastrointestinal tract, its manifestations can also vary. Treatment is selected individually, taking into account the symptoms that a particular person has.

Constipation in Crohn’s disease: treatment and recommendations

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Constipation in Crohn’s disease: treatment and advice

Crohn’s disease tends to cause frequent diarrhea, but it can also lead to constipation, which can result from medication, other illnesses, or certain lifestyle factors.

Doctors diagnose constipation when a person has fewer than three stools per week. Other symptoms may include hard or dry stools, pain or difficulty passing a bowel movement, and a feeling of incomplete evacuation.

Constipation can be caused by the following:

1. Use of medications. Various drugs can have this side effect, including antidiarrheals, iron supplements, calcium channel blockers, sorbents (eg, activated charcoal, smecta, almagel, etc.), and certain pain relievers.
2. Low fiber diet. Doctors sometimes recommend a low-fiber diet for individuals who are at the peak of Crohn’s disease. However, reducing the intake of plant fibers, as well as taking antidiarrheal drugs, can lead to constipation in some people.
3. Strictures. Crohn’s disease can cause narrowing of the intestinal tract due to a strong inflammatory process. These wall changes, called strictures, can block or slow the passage of feces or digested food through the intestines, resulting in constipation. Strictures can also cause abdominal pain, bloating, nausea, and vomiting, so it’s important for people with symptoms of eating disorders to see a doctor. Without proper treatment, a stricture can lead to potentially life-threatening complications. Doctors can often prescribe certain medications, but some patients require surgery.
4. Other causes may include: insufficient fluid intake, too little daily diet, inactive lifestyle, irritable bowel syndrome, proctitis (inflammation of the rectal wall. – approx. Trans.).

Treatment for this problem is complex and may include the following:
1. Eating more dietary fiber, which results in more water absorption in the intestines, making stools easier to pass. Fiber-rich foods include: fresh or dried fruits; fresh or boiled vegetables; legumes; nuts and seeds; high-fiber breakfast cereals; whole grain bread, pasta and rice.