What Is a Crohn’s Disease Flare-up?

How Long Does a Crohn’s Flare Last?

The length and frequency of a Crohn’s flare are highly individual, says David S. Lee, MD, a gastroenterologist at NewYork–Presbyterian in New York City. According to Harvard Health Publishing, a flare can last anywhere from a few weeks to several months. Flare-ups can happen after months or years of being in remission.

For this reason, it’s important to work with your doctor on the best treatment option and follow the treatment schedule. “Sometimes patients get better and then they think they’re cured and they stop the treatment without communicating with their doctor,” says Madalina Butnariu, MD, a gastroenterologist at the Ohio State University Wexner Medical Center in Columbus. Stopping treatment on your own can lead to another flare up or may interfere with the efficacy of a medication.

How to Keep Your Disease in Remission

You can’t completely prevent disease flare-ups from happening. But there are things you can do to manage your disease. Effective medication helps with the management of Crohn’s disease. “These medications treat inflammation and prevent complications,” Dr. Lee says. Other steps to managing your disease include:

• Preventing and Reducing Stress During times of emotional stress, people tend to report more flare-ups. According to a study published in May 2020 in PLOS ONE, roughly 75 percent of people with IBD believed that stress and other mental health conditions could trigger flare-ups. And the more people worried about a flare-up, the worse it got: Feeling stressed about IBD was associated with more active disease. According to the Crohn’s & Colitis Foundation, changes in the GI tract and decreased resistance to inflammation may be felt after a stressful event. Taking care of your mental health improves your quality of life and also helps to manage Crohn’s disease symptoms. Some small studies have shown that relaxation exercises and rest can sometimes help alleviate Crohn’s symptoms, Lee says. A review published in 2019 in Frontiers in Pediatrics reported stress to be a major trigger for flare-ups in both adolescents and adults with IBD. But stress reduction techniques such as mindfulness, cognitive behavioral therapy, and yoga were effective in alleviating gastrointestinal pain. For people with Crohn’s who have anxiety and depression, relaxation techniques might also work, in addition to antidepressant medication if your doctor deems it necessary. A study published in 2018 in the Journal of Psychosomatic Research found meditation beneficial in reducing depression and anxiety in people with Crohn’s disease. This also improved their overall quality of life.
• Exercising Exercising benefits everyone — and people with Crohn’s disease are no exception. According to the Crohn’s & Colitis Foundation, exercise helps to manage anxiety and depressive symptoms that can emerge after a diagnosis. Walking for as little as 10 to 20 minutes per day can make a huge difference in lowering stress levels and reducing Crohn’s disease symptoms. For people in remission, a 2020 review published in Intestinal Research reported on the benefits of resistance training, including increased muscle strength and improvements in their quality of life. Make sure to let your body rest when it’s too tired to work out or during a flare-up. Consider speaking with a doctor about what exercise works best for you during remission and in times of a flare-up.
• Eating Healthy You are what you eat. Your diet can help manage Crohn’s disease symptoms and keep you healthy overall. On the other hand, there are some foods you may want to skip to avoid complications such as weight loss and malnutrition. The American College of Gastroenterology recommends a nutrition plan that avoids high-fiber foods such as vegetable skin and fried foods. It’s also important to stay hydrated with beverages including water, broth, or tomato juice. If you’re excluding foods, there might be a risk of vitamin deficiency. Talk to your doctor about taking vitamin D or B12 as needed.
• Monitoring Your Symptoms Keeping a close eye on your everyday symptoms will make it easier to predict when a flare-up is about to happen. Mobile apps such as GI Monitor and myIBD easily track your symptoms and gives you a snapshot of how you’re doing.
• Being Prepared Although flares tend to come on gradually, there is a chance that you will develop a flare quickly. And since you don’t know when the urge to go or abdominal pain will strike — at home, in the car, at the office — you should always make sure that you are ready to act. “If you have Crohn’s disease, you should be prepared at all times by noting where the restrooms are and keeping a spare set of clothes in the car or nearby, just in case,” Rood says.

Tips for Managing Discomfort During a Flare

• Reach for an OTC. Over-the-counter medication is also a good option to relieve pain associated with a Crohn’s flare. “If you have pain related to Crohn’s disease, take Tylenol only,” Lee says, “since ibuprofen and NSAIDs (nonsteroidal anti-inflammatory drugs) can worsen inflammation. ”
• Use ointment. You might experience anal irritation during a flare-up. Instead of toilet paper, use a moist towelette or soft baby wipe. At night, consider applying an all-purpose skin protectant such as Desitin around the surrounding anus area.
• Maintain a healthy diet. Sticking to a nutritious IBD diet helps in alleviating flare-up symptoms. If you’re lacking in a specific nutrient, consider taking a multivitamin as a supplement.
• Switch to medicinal mouthwashes. Severe flare-ups occasionally create canker sores around the mouth. Canker sores tend to go away once the flare-up is under control, but medicinal mouthwashes can help in the meantime to alleviate discomfort.
• Take a bath. To relieve painful bowel movements, take care of your bottom by bathing in warm water.
• Stretch your joints. About one in three people with Crohn’s disease will experience painful and swollen joints, according to Crohn’s & Colitis UK. While flare-ups can bring back joint pain, it can be managed through a combination of medication, exercise, and physical therapy. Your doctor may recommend a physiotherapist or physical therapist to work on stretching to reduce stiffness. They might also recommend walking, swimming, or cycling to keep you moving your back and neck muscles. Pilates can also help with stretching and strengthening your posture.

The Bottom Line

The better you’re prepared for a flare and how it will affect your routine, the better you’ll be at dealing with it when it occurs.

Above all, befriend your gastroenterologist. You should tell your doctor about any changes in your disease and stay on track with all medical appointments for tests and procedures. “Management of Crohn’s disease with medications and close follow-up with a gastroenterologist can help prevent Crohn’s flares in the first place,” Lee says.

Additional reporting by Jocelyn Solis-Moreira.

Why It Can Get Worse and What to Do if It Does

When you have ulcerative colitis, it can be hard to predict exactly how you’ll feel over the long haul. Usually, you go back and forth between flare-ups and remission. But like any long-term disease, you’re bound to see changes.

Flare-ups might take days or weeks. Remission might last for months or even years. You may go from a mild flare-up to a severe one and back again. Or, it may get more advanced and spread to other parts of your colon.  

Two main things affect how you feel: where you get inflammation and how severe it is.

There are lots of ways it might seem to be getting worse. And it’s different in everyone who has it. So you should work closely with your doctor to understand what any changes mean for you.

What to Look For

The key is to pay attention to your specific symptoms. The more you’re aware of them, the better able you are to spot changes.

And there are lots of ways your symptoms can change. You might get new ones. Or the ones you have may get worse, last longer, or come on more often.

Usually, a flare-up brings at least:

• An urgent need to poop
• Blood or mucus in your stool
• Cramps in your lower belly

If it spreads to more areas of the colon, everything gets more intense. You have more diarrhea. Cramps get more severe. You have more mucus, pus, and blood in your stool. Pain in your belly gets worse and more widespread, especially up the left side. It can also affect your desire to eat and cause you to lose weight.

And some of those symptoms may just be signs of a stronger flare-up. You’ll need to see your doctor to find out for sure. Read more on ulcerative colitis symptoms to look for.

What Makes It Worse?

The reasons why aren’t totally clear. Doctors don’t know why it affects only a small section in one person, but spreads through the entire colon in another. But certain triggers sometimes play a role. These include:

Food. It’s different for everyone, but certain foods can irritate your symptoms. For example:

• Caffeine can make severe diarrhea worse
• Dairy may lead to more diarrhea, gas, and pain
• Fizzy drinks can be a problem if you have gas
• Greasy and fried foods often lead to gas and diarrhea
• High-fiber foods, such as fresh fruits and veggies, whole grains, corn, nuts, and seeds, can be hard on you
• Spicy foods can be tough to handle

Stress. It can trigger flare-ups and make your symptoms much harder to deal with. It’s especially challenging because just having ulcerative colitis can bring on more of it.

Skipping meds. Even when you’re in remission, it’s very important to take your meds. In the best case, they prevent flare-ups. And even if not, they can help keep things under control.

Follow these 5 tips to help control your ulcerative colitis flare-ups.

Next Steps

If you think your symptoms are getting worse, call your doctor. Even if they’re the same, but they’ve come back after a remission, it’s best to check in. To figure out what to do next, your doctor will look at your history, treatments you’re on now, and what your symptoms are like.

You may need to:

Get tests done. You might have to get:

• Blood tests to look for signs of inflammation or anemia, a condition where you don’t have enough red blood cells
• Colonoscopy to look at your entire colon
• Sigmoidoscopy to look at just the lower part of your colon

Keep a food diary. Your doctor might suggest that for several weeks, you write down everything you eat and how you felt afterward. Then you can see if any specific foods cause you problems.

If it looks like they do, talk to your doctor about how to take them out of your diet. You want to make sure that as you remove foods, you still get all the nutrients you need.

Learn new ways to manage stress. Your doctor may also talk to you about how you can better keep your stress in check. You have lots of choices, such as exercise, meditation, relaxation techniques, breathing exercises, and counseling. Try some to see which ones work best for you.

Change your medicine. This could mean a new dose or a change in how often you take it. You might also need a different medicine altogether. Your doctor can check on what you’ve tried and what else might help.

Learn about more ways to manage your ulcerative colitis.

What to do if you have Crohn’s or Colitis and think you are having a flare-up

This guidance is for adults on what to do if you think you are having a flare-up.  

If you’ve got Crohn’s Disease or Ulcerative Colitis and you’re worried about coronavirus (COVID-19), please read the FAQs which are regularly reviewed and updated.

What is a flare-up? 

A flare-up is when symptoms come back and you feel unwell. It will be very personal to you. The symptoms will vary from person to person, over time and will depend where Crohn’s or Colitis is in your gut.

Signs of flare-up can include:     

• Going to the toilet more than 5 times in 24 hours – or more than is normal for you
• Loose poo or diarrhoea with any blood or mucus for more than three days
• Abdominal pain
• Just generally feel worse, especially if you have a fever
• Waking up at night to go to the toilet

You may also experience symptoms outside the gut during a flare-up such as:

• Joint pain and swelling (arthritis)
• Swelling in the eyes
• Mouth ulcers
• Skin rashes
• Fatigue
• Mental health problems

I’m having a flare-up – what should I do?

• If you have a written personalised care and support plan or your IBD team have agreed with you previously what to do if your symptoms get worse please follow the specific guidance given by your doctor or nurse.
• If you do not have a personalised plan contact your local IBD team Adviceline via telephone or email. 

Please be aware that our Helpline is not able to give individual advice on this.

Ulcerative Colitis

If you’re experiencing a flare-up, you may be able to temporarily increase the amount of 5-ASA medication you take. If you decide to do this, it’s important to inform your IBD team of any changes as soon as possible by telephone or email. You may also want to check with your healthcare professional first if you are pregnant or have another health condition. 

If you are taking 5-ASAs, you can take up to the amount stated below for 6 weeks, unless you have already been told by your healthcare professional not to increase your dose:

• Salofalk: maximum 3g per day                                         
• Asacol: maximum 4.8g per day
• Mezavant: maximum 4.8g per day              
• Pentasa: maximum 4g per day
• Octasa: maximum 4. 8g per day

Even if your symptoms settle quickly, continue taking your increased dose for 6 weeks then reduce back to your regular dose.

You may see your dose in g or mg: 1g = 1000mg, 0.8g = 800mg, 0.5g = 500mg.

If you are prescribed suppositories or enemas and you have a supply of these at home, start these as well as increasing your 5-ASA tablets. It is safe to take them every night to control your symptoms.

If you do not experience improvement contact your local IBD team Adviceline by telephone or email.

This advice does NOT apply if you have Crohn`s Disease or to any other medications you may be taking

When should I seek urgent or emergency care?

You will know your body and condition better than anyone. If you feel you need urgent care telephone 111. If you need emergency care call 999. It’s important to go to hosptial if you’re advised to.

Some signs could include:

• Stoma blockage: not passing wind or poo or passing watery poo, nausea, bloating or swelling tummy, tummy cramps, swollen stoma, nausea/vomiting or both.
• Severe dehydration, malnourishment and vomiting.
• Severe tummy pain, a high temperature and a rapid heartbeat.
• All medicines have a small risk of side effects, such as chest pain, rapid heartbeat or hives. If you experience any side effects that you are worried about while taking your medicine, contact your IBD team or your GP as soon as possible.

Staying well

We want people with Crohn’s and Colitis to feel empowered to manage their condition. Our information resources and videos give a wealth of advice on how to manage symptoms, stay as well as possible and where to find emotional and peer support.

 Our top tips for keeping as well as possible are:

1. If you don’t have symptoms of coronavirus, continue taking your medication as normal unless your doctor or nurse have advised you otherwise. 
2. Ensure you have a good supply of medicines should you need to self-isolate or shield yourself.
3. Stay hydrated. If you are flaring and experiencing diarrhoea, it’s important to make sure you are drinking enough to replace what you have lost, and in doing so getting the right balance of sugars and essential salts into your body to keep hydrated. Our information gives tips and advice on how to stay hydrated.
4. Eat well. Living with Crohn’s or Colitis may mean making some changes to your diet. You may need to avoid certain foods to help your symptoms or take extra care to make sure you’re getting the right nutrients. There’s no single diet that works for everyone – our information will help you understand how food affects your condition, so you can make the choices that are right for you.
5. Take rest and sleep. Here are more tips on pacing, exercise and managing fatigue 
6. Wash your hands frequently and avoid touching your face.
7. Quit smoking as this increases the risk and severity of COVID19 infection.
8. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen.
9. Protect your emotional and mental well-being. There are a number of excellent resources being produced to support people during Coronavirus from organisations like MIND and the Mental Health Foundation. However, if you are struggling with your Crohn’s or Colitis, you may want to read our information on managing mental health and wellbeing.

The Royal College of General Practitioners (RCGP) and Crohn’s & Colitis UK have created a number of Podcasts for people living with Crohn’s or Colitis on topics such as flare management, the role of the clinical nurse specialist and pregnancy.  You can download these from the IBD toolkit 

For more detailed information on which to assess your individual risk of Coronavirus and the most appropriate actions for you to take please go to our coronavirus FAQs 

Clinical guidance given by the Chair of the IBD Section of the British Society of Gastroenterology

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Symptoms, Causes, Management & Treatment

Overview

What is Crohn’s disease?

Crohn’s disease, also called regional enteritis or ileitis, is a lifelong form of inflammatory bowel disease (IBD). The condition inflames and irritates the digestive tract — specifically the small and large intestines. Crohn’s disease can cause diarrhea and stomach cramps. It’s common to experience periodic disease flare-ups.

Crohn’s disease gets its name from American gastroenterologist Dr. Burrill Crohn (1884-1983). He was one of the first physicians to describe the illness in 1932. Ulcerative colitis is another commonly diagnosed IBD.

How common is Crohn’s disease?

An estimated half a million Americans have Crohn’s disease. This can include men, women and children.

Who might get Crohn’s disease?

Crohn’s disease typically appears in younger people – often in their late teens, 20s or early 30s. However, this condition can happen at any age. It’s equally common in men and women. Crohn’s disease can also be see in young children.

If you’re a cigarette smoker, your risk of Crohn’s disease might be higher than non-smokers.

What are the types of Crohn’s disease?

Crohn’s disease can affect different sections of the digestive tract. Types of Crohn’s disease include:

• Ileocolitis: Inflammation occurs in the small intestine and part of the large intestine, or colon. Ileocolitis is the most common type of Crohn’s disease.
• Ileitis: Swelling and inflammation develop in the small intestine (ileum).
• Gastroduodenal: Inflammation and irritation affect the stomach and the top of the small intestine (the duodenum).
• Jejunoileitis: Patchy areas of inflammation develop in the upper half of the small intestine (called the jejunum).

Symptoms and Causes

What causes Crohn’s disease?

There’s no known cause of Crohn’s disease. Certain factors may increase your risk of developing the condition, including:

• Autoimmune disease: Bacteria in the digestive tract may cause the body’s immune system to attack your healthy cells.
• Genes: Inflammatory bowel disease (IBD) often runs in families. If you have a parent, sibling or other family member with Crohn’s, you may be at an increased risk of also having it. There are several specific mutations (changes) to your genes that can predispose people to developing Crohn’s disease.
• Smoking: Cigarette smoking could as much as double your risk of Crohn’s disease.

What are the symptoms of Crohn’s disease?

People with Crohn’s disease can experience periods of severe symptoms (flare-ups) followed by periods of no or very mild symptoms (remission). Remission can last weeks or even years. There’s no way to predict when flare-ups will happen.

If you have Crohn’s disease, symptoms you might have can include:

Diagnosis and Tests

How is Crohn’s disease diagnosed?

Most people with Crohn’s first see a healthcare provider because of ongoing diarrhea, belly cramping or unexplained weight loss. If you have a child who has been experiencing the symptoms of Crohn’s disease, reach out to your pediatrician.

To find the cause of your symptoms, your healthcare provider may order one or more of these tests:

• Blood test: A blood test checks for high numbers of white blood cells that may indicate inflammation or infection. The test also checks for low red blood cell count, or anemia. Approximately one in three people with Crohn’s disease have anemia.
• Stool test: This test looks at a sample of your stool to check for bacteria or parasites. It can rule out infections that cause chronic diarrhea.
• Colonoscopy: During a colonoscopy, your doctor uses an endoscope (thin tube with an attached light and camera) to examine the inside of your colon. Your doctor may take a tissue sample (biopsy) from the colon to test for signs of inflammation.
• Computed tomography (CT) scan: A CT scan creates images of the digestive tract. It tells your healthcare provider how severe the intestinal inflammation is.
• Upper gastrointestinal (GI) endoscopy: Your doctor threads a long, thin tube called an endoscope through your mouth and into your throat. An attached camera allows your doctor to see inside. During an upper endoscopy, your doctor may also take tissue samples.
• Upper gastrointestinal (GI) exam: X-ray images used during an upper GI exam allow your doctor to watch as a swallowed barium liquid moves through your digestive tract.

Management and Treatment

How is Crohn’s disease managed or treated?

Treatment for Crohn’s disease varies depending on what’s causing your symptoms and how severe they are for you. In children, the goal in treatment is to induce remission (the time between symptom flare-ups), maintain remission and manage any complications of Crohn’s disease over time.

Your healthcare provider may recommend one or more of these treatments for Crohn’s disease:

• Antibiotics: Antibiotics can prevent or treat infections. Severe infections can lead to abscesses (pockets of pus). Or they can cause fistulas (openings or tunnels that connect two organs that don’t normally connect).
• Antidiarrheal medication: Prescription medications like loperamide (Imodium A-D®) can stop severe diarrhea.
• Biologics: These medications include monoclonal antibodies to suppress the immune response.
• Bowel rest: To give your intestines a chance to heal, your provider may recommend going without food or drink for several days or longer. To get the nutrition you need, you may receive intravenous (parenteral) nutrition. Only drink a prescribed liquid or have a feeding tube during this time.
• Corticosteroids: Cortisone, prednisone and other corticosteroids ease inflammation brought on by autoimmune disease.
• Immunomodulators: These drugs calm inflammation by suppressing an overactive immune system. They include azathioprine and cyclosporine.
• Surgery: Surgery won’t cure Crohn’s disease, but it can treat complications. You may need surgery to correct intestinal perforations (holes), blockages or bleeding.

What are the complications of Crohn’s disease?

Crohn’s disease can lead to serious complications, including:

• Abscesses: Infected pus-filled pockets form in the digestive tract or abdomen.
• Anal fissures: Small tears in the anus (anal fissures) can cause pain, itching and bleeding.
• Bowel obstructions: Scar tissue from inflammation, fistulas or a narrowed intestine can block the bowel partially or completely. Waste matter and gases build up. A blockage in the small bowel or large bowel requires surgery.
• Colon cancer: Crohn’s disease in the large intestine increases the risk of colon cancer.
• Fistulas: IBD can cause abnormal tunnel-like openings, called fistulas, to form in the intestinal walls. These fistulas sometimes become infected.
• Malnutrition: Chronic diarrhea can make it hard for your body to absorb nutrients. One common problem in people with Crohn’s disease is a lack of iron. Too little iron can lead to anemia (low red blood cell count) when your organs can’t get enough oxygen.
• Ulcers: Open sores called ulcers can form in your mouth, stomach or rectum.

How does Crohn’s disease affect pregnancy?

Women with Crohn’s disease can, and usually do, have normal pregnancies. Your healthcare provider may recommend trying to conceive while the disease is in remission. Flare-ups during pregnancy may increase the risk of:

• Miscarriage (loss of pregnancy before the baby fully develops).
• Premature labor (childbirth before the 37th week of pregnancy).
• Low birth weight (newborn weight of less than 5 pounds, 8 ounces).

Prevention

How can I prevent Crohn’s disease?

There’s no way to prevent Crohn’s disease. These healthy lifestyle changes can ease symptoms and reduce flare-ups:

Outlook / Prognosis

What is the prognosis (outlook) for people with Crohn’s disease?

Most people with Crohn’s disease enjoy healthy, active lives. While there isn’t a cure for Crohn’s disease, treatments and lifestyle changes can keep the disease in remission and prevent complications.

Lifestyle changes can include changes to your diet. People with Crohn’s disease often need to adapt their diets so that they get enough calories each day. Lactose intolerance can also be an issue for those with Crohn’s disease. You may need to avoid certain dairy products if you find that you’re having issues with this dietary intolerance. You should also avoid smoking if you have Crohn’s disease. Smoking can only make your condition worse.

Your healthcare provider might recommend you receive preventative colonoscopies after you’re diagnosed with Crohn’s disease. Talk to your provider about how often you should have colonoscopies and what your risks are for other medical conditions.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Blood in stool.
• Constipation.
• Extreme weight loss.
• Fever.
• Inability to pass gas.
• Nausea and vomiting.
• Severe abdominal pain.
• Signs of a flare-up.
• Uncontrollable diarrhea.
• Weakness or fatigue that may be signs of anemia.

What questions should I ask my doctor?

If you have Crohn’s disease, you may want to ask your healthcare provider:

• Why did I get Crohn’s disease?
• What form of Crohn’s disease do I have?
• What’s the best treatment for this disease type?
• How can I prevent flare-ups?
• If I have a genetic form, what steps can my family members take to lower their risk of Crohn’s disease?
• Should I make any dietary changes?
• What medications should I avoid?
• Should I take supplements?
• Should I get tested for anemia?
• Do I need to cut out alcohol?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Crohn’s disease flare-ups are unpredictable and can disrupt your daily life. Talk to your healthcare provider about the steps you can take to keep the disease in check. With the right treatment and lifestyle changes, you can manage symptoms, avoid complications and live an active life.

Resources

Cleveland Clinic Podcasts

Visit our Butts & Guts Podcasts page to learn more about digestive conditions and treatment options from Cleveland Clinic experts.

Where can I go for more information?

The following organizations can provide more information about Crohn’s disease:

Crohn’s and Colitis Foundation of America, Inc. IBD help Center.

ClinicalTrials.gov

7 Tips for Managing a Crohn’s Disease Flare-Up

A flare-up of Crohn’s disease can be a real letdown, especially after you’ve been symptom-free for a while. But rest assured there are many steps you can take to ease distress and speed up healing.

1. Check In With Your Doctor

Taking medications as prescribed is the number one way you can manage your Crohn’s disease. Recurrence can be a sign that your medications need an adjustment, so make an appointment with your primary care doctor or gastroenterologist as soon as possible. Some people need to take more or different medications (for example, corticosteroids) during flare-ups to heal the body and relieve symptoms.

Unfortunately, many Crohn’s disease medications take time to work, so you may still experience diarrhea, cramping, nausea and fever for a while. For relief of mild to moderate symptoms, ask your doctor about:

• Acetaminophen (Tylenol ) for pain and fever

• Balneol, Desitin, and vitamin A & D ointment for anal soreness and rawness

• Loperamide (Imodium) for diarrhea

Always double-check with your doctor before buying anything from the pharmacy aisle. Some over-the-counter medications—notably anti-inflammatory drugs such as ibuprofen (Advil), naproxen (Aleve), and aspirin—can aggravate your symptoms. Others can interact with your prescriptions.

Having a chronic illness like Crohn’s disease means your body may actually need more calories to function. At the same time, symptoms such as decreased appetite and abdominal pain can make eating uncomfortable. Some types of Crohn’s disease also interfere with the absorption of protein, fat, carbs, vitamins and minerals from food.

For these reasons, good nutrition is important during a flare. Eating well helps you feel better and may prevent future complications such as osteoporosis. Also, many medications work best when you’re well nourished.

There’s no magic diet that works for everyone with Crohn’s disease, and your needs may change with time. Unless your doctor or dietitian recommends a specialized diet, try to keep things balanced and varied. Include foods from each food group, and aim for a mix of carbohydrates, protein and fats.

While there’s no evidence that food causes or worsens inflammation in your digestive tract, some foods can aggravate symptoms such as cramping and diarrhea. Food intolerances in Crohn’s disease are highly individual: What upsets one person’s system may be fine for another.

Common food triggers include:

Bear in mind that eating too restrictively during a flare can lead to poor nutrition. It’s important to eliminate only foods that consistently cause discomfort. Keeping a food diary can help you make connections between your food intake and your symptoms.
Eating large meals can also trigger Crohn’s disease symptoms. If this is a problem for you, try eating fist-sized portions every three to four hours for a total of five meals per day.

People with Crohn’s disease have an increased risk for vitamin and mineral deficiencies, so consider taking a daily multivitamin. Your doctor or dietitian may also recommend supplements for:

• Calcium

• Folic acid

• Iron

• Magnesium

• Potassium

• Vitamin B12

• Vitamin D

People with Crohn’s disease are more likely to have low bone density, so do your best to include some calcium in your diet. If dairy is a trigger for you, try yogurt, which contains less lactose than other milk products.

Diarrhea and rectal bleeding during a flare can speed up water loss from your body. The resulting dehydration may cause feelings of weakness and increases your risk for kidney stones.

To ensure you’re getting enough fluids, aim to drink one-half ounce of clear liquid per pound of body weight each day. Add a little extra after sweating due to exercise or hot weather.

Having a chronic illness like Crohn’s disease means making adjustments now and then. However, getting out, seeing friends, and keeping life as normal as possible can be a great psychological boost.

Before heading out, pack extra underwear and clothing and your favorite moist towelettes. When possible, call ahead or use a mobile app to locate toilet options at your destination.

• A flare-up can mean that your medications need adjustment, so see your doctor as soon as possible.

• For relief of mild to moderate symptoms, ask your doctor about using acetaminophen for pain, ointment for anal soreness, or loperamide for diarrhea.

• Eating too restrictively during a flare can lead to poor nutrition. Eliminate only foods that consistently cause discomfort.

• Diarrhea and rectal bleeding during a flare can speed up water loss from your body. Aim to drink one-half ounce of clear liquid per pound of body weight each day.

Treatment for Crohn’s Disease | NIDDK

How do doctors treat Crohn’s disease?

Doctors treat Crohn’s disease with medicines, bowel rest, and surgery.

No single treatment works for everyone with Crohn’s disease. The goals of treatment are to decrease the inflammation in your intestines, to prevent flare-ups of your symptoms, and to keep you in remission.

Medicines

Many people with Crohn’s disease need medicines. Which medicines your doctor prescribes will depend on your symptoms.

Many people with Crohn’s disease need medicines. Which
medicines your doctor prescribes will depend on your symptoms.

Although no medicine cures Crohn’s disease, many can reduce symptoms.

Aminosalicylates. These medicines contain 5-aminosalicylic acid (5-ASA), which helps control inflammation. Doctors use aminosalicylates to treat people newly diagnosed with Crohn’s disease who have mild symptoms. Aminosalicylates include

Some of the common side effects of aminosalicylates include

Corticosteroids. Corticosteroids, also known as steroids, help reduce the activity of your immune system and decrease inflammation. Doctors prescribe corticosteroids for people with moderate to severe symptoms. Corticosteroids include

Side effects of corticosteroids include

In most cases, doctors do not prescribe corticosteroids for long-term use.

Immunomodulators. These medicines reduce immune system activity, resulting in less inflammation in your digestive tract. Immunomodulators can take several weeks to 3 months to start working. Immunomodulators include

Doctors prescribe these medicines to help you go into remission or help you if you do not respond to other treatments. You may have the following side effects:

• a low white blood cell count, which can lead to a higher chance of infection
• feeling tired
• nausea and vomiting
• pancreatitis

Doctors most often prescribe cyclosporine only if you have severe Crohn’s disease because of the medicine’s serious side effects. Talk with your doctor about the risks and benefits of cyclosporine.

Biologic therapies. These medicines target proteins made by the immune system. Neutralizing these proteins decreases inflammation in the intestines. Biologic therapies work to help you go into remission, especially if you do not respond to other medicines. Biologic therapies include

Doctors most often give patients infliximab every 6 to 8 weeks at a hospital or an outpatient center. Side effects may include a toxic reaction to the medicine and a higher chance of developing infections, particularly tuberculosis.

Other medicines. Other medicines doctors prescribe for symptoms or complications may include

• acetaminophen for mild pain. You should avoid using ibuprofen, naproxen, and aspirin because these medicines can make your symptoms worse.
• antibiotics to prevent or treat complications that involve infection, such as abscesses and fistulas.
• loperamide to help slow or stop severe diarrhea. In most cases, people only take this medicine for short periods of time because it can increase the chance of developing megacolon.

Bowel rest

If your Crohn’s disease symptoms are severe, you may need to rest your bowel for a few days to several weeks. Bowel rest involves drinking only certain liquids or not eating or drinking anything. During bowel rest, your doctor may

• ask you to drink a liquid that contains nutrients
• give you a liquid that contains nutrients through a feeding tube inserted into your stomach or small intestine
• give you intravenous (IV) nutrition through a special tube inserted into a vein in your arm

You may stay in the hospital, or you may be able to receive the treatment at home. In most cases, your intestines will heal during bowel rest.

Surgery

Even with medicines, many people will need surgery to treat their Crohn’s disease. One study found that nearly 60 percent of people had surgery within 20 years of having Crohn’s disease.⁸ Although surgery will not cure Crohn’s disease, it can treat complications and improve symptoms. Doctors most often recommend surgery to treat

• fistulas
• bleeding that is life threatening
• intestinal obstructions
• side effects from medicines when they threaten your health
• symptoms when medicines do not improve your condition

A surgeon can perform different types of operations to treat Crohn’s disease.

For any surgery, you will receive general anesthesia. You will most likely stay in the hospital for 3 to 7 days following the surgery. Full recovery may take 4 to 6 weeks.

Small bowel resection. Small bowel resection is surgery to remove part of your small intestine. When you have an intestinal obstruction or severe Crohn’s disease in your small intestine, a surgeon may need to remove that section of your intestine. The two types of small bowel resection are

• laparoscopic—when a surgeon makes several small, half-inch incisions in your abdomen. The surgeon inserts a laparoscope—a thin tube with a tiny light and video camera on the end—through the small incisions. The camera sends a magnified image from inside your body to a video monitor, giving the surgeon a close-up view of your small intestine. While watching the monitor, the surgeon inserts tools through the small incisions and removes the diseased or blocked section of small intestine. The surgeon will reconnect the ends of your intestine.
• open surgery—when a surgeon makes one incision about 6 inches long in your abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove or repair that section. The surgeon will reconnect the ends of your intestine.

Subtotal colectomy. A subtotal colectomy, also called a large bowel resection, is surgery to remove part of your large intestine. When you have an intestinal obstruction, a fistula, or severe Crohn’s disease in your large intestine, a surgeon may need to remove that section of intestine. A surgeon can perform a subtotal colectomy by

• laparoscopic colectomy—when a surgeon makes several small, half-inch incisions in your abdomen. While watching the monitor, the surgeon removes the diseased or blocked section of your large intestine. The surgeon will reconnect the ends of your intestine.
• open surgery—when a surgeon makes one incision about 6 to 8 inches long in your abdomen. The surgeon will locate the diseased or blocked section of large intestine and remove that section. The surgeon will reconnect the ends of your intestine.

Proctocolectomy and ileostomy. A proctocolectomy is surgery to remove your entire colon and rectum. An ileostomy is a stoma, or opening in your abdomen, that a surgeon creates from a part of your ileum. The surgeon brings the end of your ileum through an opening in your abdomen and attaches it to your skin, creating an opening outside your body. The stoma is about three-quarters of an inch to a little less than 2 inches wide and is most often located in the lower part of your abdomen, just below the beltline.

A removable external collection pouch, called an ostomy pouch or ostomy appliance, connects to the stoma and collects stool outside your body. Stool passes through the stoma instead of passing through your anus. The stoma has no muscle, so it cannot control the flow of stool, and the flow occurs whenever occurs.

If you have this type of surgery, you will have the ileostomy for the rest of your life.

How do doctors treat the complications of Crohn’s disease?

Your doctor may recommend treatments for the following complications of Crohn’s disease:

• Intestinal obstruction. A complete intestinal obstruction is life threatening. If you have a complete obstruction, you will need medical attention right away. Doctors often treat complete intestinal obstruction with surgery.
• Fistulas. How your doctor treats fistulas will depend on what type of fistulas you have and how severe they are. For some people, fistulas heal with medicine and diet changes, whereas other people will need to have surgery.
• Abscesses. Doctors prescribe antibiotics and drain abscesses. A doctor may drain an abscess with a needle inserted through your skin or with surgery.
• Anal fissures. Most anal fissures heal with medical treatment, including ointments, warm baths, and diet changes.
• Ulcers. In most cases, the treatment for Crohn’s disease will also treat your ulcers.
• Malnutrition. You may need IV fluids or feeding tubes to replace lost nutrients and fluids.
• Inflammation in other areas of your body. Your doctor can treat inflammation by changing your medicines or prescribing new medicines.

References

[8] Peyrin-Biroulet L, Harmsen WS, Tremaine WJ, Zinsmeister AR, Sandborn WJ, Loftus EV. Surgery in a population-based cohort of Crohn’s disease from Olmsted County, Minnesota (1970–2004). American Journal of Gastroenterology. 2012;107(11):1639–1701.

Ulcerative Colitis Flare-Ups: Symptoms and Treatment

• Hormones
• Eating foods that trigger symptoms
• Missing your medications (or taking the wrong dose)
• Drinking (especially too much)
• Smoking
• Stomach bugs
• OTC drugs
• Mood

Let’s take a closer look at these potential flare-up causes.

Hormones

Your period can bring on cramping and diarrhea, which can make it confusing to tell if it’s your UC or just that time of the month.

“This is thought to be related to hormonal changes,” Tanvi Dhere, M.D., a gastroenterologist and Director of IBD at Emory Healthcare in Atlanta, tells SELF. For instance, some research suggests that spikes in estrogen can lead to worse symptoms in people with ulcerative colitis.²

You might be wondering: How could this hormonal aspect potentially affect ulcerative colitis flare-ups during pregnancy? Unfortunately, it is possible to experience UC symptoms during pregnancy, and IBD that isn’t under control during pregnancy may raise the risk of birth outcomes like premature labor.³ This is why experts recommend that people with ulcerative colitis who want to get pregnant only conceive when their disease is under control. If you are thinking of getting pregnant, it’s a good idea to talk to your doctor about the medicines you take so you can either get the all-clear to keep taking them or figure out whether other meds may be better.

“Most of the medications, including many of the immunosuppressives that we use in IBD, are considered safe in pregnancy,” Dr. Dhere says. “There are a few that should be avoided. It is important to discuss this with your IBD care-provider team prior to conception and to ensure that you have an open and honest relationship with them and have a treatment plan in place.”

Diet

The relationship between ulcerative colitis and diet is pretty complex and calls for much more research. But what’s clear is that many people with ulcerative colitis have trigger foods that can bring on flare-ups or make an ulcerative colitis episode worse. Some common ulcerative colitis food triggers include:

• Beans
• Broccoli
• Cabbage
• Carbonated drinks
• Dairy products
• High-fiber foods like fruits, vegetables, and whole grains

None of this is to say you absolutely can’t have any of these foods if you have ulcerative colitis. (And, in fact, you shouldn’t wholesale cut out a bunch of food groups in an effort to manage your conditions—at least not without medical guidance.) But if you start to notice consistent ulcerative colitis symptoms after eating or drinking certain items, it’s worth bringing up with your care team.

Skipping your medications 

It’s easy to think that missing a dose here or there won’t impact your ulcerative colitis. But a medication holiday isn’t the kind of holiday you want to take. From app-based pill reminders to rewarding yourself with a fun activity every time you’re done with an injection, do whatever you need to do to remember to take your meds as prescribed.

Drinking (especially too much) 

Excess alcohol consumption can worsen your symptoms. You may not have to skip it entirely, but it’s true that even drinking in moderation can be hard for those with ulcerative colitis. As with many aspects of life with this condition, it may take some trial and error to figure out exactly what’s right for you here.

Smoking

Smoking can worsen symptoms of certain inflammatory bowel conditions, such as Crohn’s disease, and make it harder for you to manage your condition. While research has shown that smoking can have a protective effect when it comes to the development and progression of ulcerative colitis, doctors say the harmful effects of smoking still don’t outweigh any potential benefits.⁴ Ask your doctor about treatments to help (like smoking cessation programs in your area and nicotine patches). You can also call the toll-free national smoking quitline at 1-800-QUIT-NOW (1-800-784-8669).

Stomach bugs 

Gut infections can add insult to injury for those with ulcerative colitis. When you have an infection with stomach-upset side effects, your ulcerative colitis can naturally flare up. Add that to the long list of reasons why it’s a good idea to do your best to avoid coming down with things like food poisoning or the stomach flu. (Wash your hands thoroughly, especially when doing food prep, cook food thoroughly, avoid others who are ill whenever possible, etc.) 

OTC pain relievers

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium are go-tos for headaches, period pains, and more. But some NSAIDs can trigger ulcerative colitis flares. Making the swap to other kinds of pain relievers, like acetaminophen, can help.

Mood

As if you didn’t already know, stress affects a whole host of bodily functions. Ulcerative colitis is no exception. Mood changes that stress you mentally can in turn stress you physically.

Crohn’s Disease | Crohn’s Disease Treatment in Moscow

What is Crohn’s disease?

Crohn’s disease is a severe chronic disease of the gastrointestinal tract (GIT) that affects its mucous membranes. Crohn’s disease is a chronic inflammatory bowel disease and can affect any part of the gastrointestinal tract from the mouth to the rectum, but most often it affects the end of the small intestine (ileum) and / or the large intestine (colon and rectum).

Crohn’s disease can begin at any age, but most often occurs between 15 and 35 years of age, with the same frequency in men and women.The disease can exacerbate many times throughout life, while the period between exacerbations can be quite long, without accompanied by any symptoms.

Why does Crohn’s disease develop?

Currently, most researchers are inclined towards the autoimmune nature of the disease: the immune system of people with a genetic predisposition to Crohn’s disease begins to attack their own cells of the intestinal mucosa, causing non-infectious inflammation in them.First-line relatives (children, siblings of patients with Crohn’s disease) are at 10 times more likely to develop this disease than the general population. If both parents are sick, then in 50% of cases their children develop Crohn’s disease before the age of 20 years.

Symptoms and complications of Crohn’s disease

The most common symptoms are: cramps, abdominal pain (usually colicky, especially in the lower abdomen, often worse after eating), diarrhea (diarrhea) mixed with blood and mucus, bloating, fever, weight loss.Not all patients experience all of these symptoms, some do not experience any of them, and signs of damage to the perianal region come to the fore: pain in the anus or discharge from it, skin lesions in the anus. Sometimes the leading ones are extraintestinal symptoms: joint pain, the formation of ulcers in the oral cavity, diseases of the skin and eyes, inflammation of the liver and bile ducts.

Crohn’s disease is often complicated by intestinal obstruction due to the formation of strictures (narrowing of the intestinal area), the formation of intestinal fistulas, both internal (into the abdominal cavity) and external (percutaneous), paraproctitis (inflammation of the tissue surrounding the rectum), rectal abscesses , anal fissure.

The duration and extent of the inflammatory process increases the risk of developing bowel malignancies. The risk increases approximately 8–10 years after the onset of inflammatory bowel disease and reaches 15–20% after 30 years.

What methods of diagnosing Crohn’s disease do EMC doctors use?

The disease is difficult to diagnose because the symptoms of Crohn’s disease have much in common with other bowel diseases. Crohn’s disease should be distinguished from diseases with similar symptoms – ulcerative colitis, irritable bowel syndrome, diverticulitis, colon cancer, intestinal infections, helminthic invasions, appendicitis, etc.bowel diseases.

To confirm the diagnosis, the doctor may prescribe the following examinations:

Colonoscopy – an endoscopic method for diagnosing diseases of the colon. A flexible elastic probe with a camera (endoscope) is inserted through the anus into the rectum, then into the large intestine, which allows you to study their condition almost throughout (about 2 meters) and, if necessary, take tissue samples for biopsy. The resulting material is sent for histological examination.

Virtual Colonoscopy (Computer Colonography, CT Colonography): A non-invasive procedure that uses X-rays to scan the abdominal cavity layer by layer, giving the physician a three-dimensional view of the lumen of the colon.

Gastroscopy : A gastroscope is inserted through the mouth / nose into the stomach, allowing a detailed examination of the condition of the esophagus, stomach and duodenum.

Fecal occult blood test : The presence of blood in the stool may indicate the presence of ulcerative lesions of the gastrointestinal tract.

MRI (magnetic resonance imaging): detailed visualization of organs and tissues is achieved using a magnetic field without radiation exposure to the patient. This test is especially effective for finding fistulas in the anal region (MRI of the pelvis) and the small intestine (MRI enterography).

Ultrasound of the abdominal cavity organs, retroperitoneal space, small pelvis.

Irrigography , an X-ray method for examining the state of the colon, in which a radiopaque substance is injected into the intestine.Allows you to evaluate the shape, internal size of the intestine, the ability to stretch, “filling defects” – damage to the intestinal wall (ulcers, diverticula, polyps, tumors).

Analysis of feces bacteriological – to exclude AEI in acute onset of the disease.

Blood tests : general, biochemical (necessarily C-reactive protein, iron, vitamin B12).

Urinalysis .

What treatment options for Crohn’s disease do doctors at EMC use?

Treatment of Crohn’s disease and other inflammatory bowel diseases is carried out jointly by a coloproctologist and a gastroenterologist.

There is no specific treatment for Crohn’s disease. Most patients with Crohn’s disease require lifelong therapy. The disease proceeds with exacerbations, therefore, the task of drug therapy is to relieve acute manifestations of the disease and bring the patient into long-term remission.

To relieve inflammation, relieve symptoms, increase the relapse-free period and prevent complications, hormonal drugs (corticosteroids), immunosuppressants (drugs that suppress immunity), anti-inflammatory drugs, and antibiotics are used to prevent and treat purulent complications.Be sure to follow dietary recommendations.

In a severe course of Crohn’s disease, biological agents of a new generation can be prescribed – the so-called monoclonal antibodies (immunosuppressants by the mechanism of action).

Surgical treatment is used only if all other methods did not give any result and the disease progresses, is accompanied by complications, and also if the disease leads to a delay in physical development. Usually this is a resection (removal) of the inflamed part of the intestine.In some cases, the doctor decides to form an ileostomy (a surgically created hole in the abdominal wall that drains the contents of the intestine to the outside) to exclude part of the intestine from digestion and allow the mucous membrane to heal. During the second operation, the terms of which are set by the attending physician based on the examination of the patient, the stoma is closed and the intestinal continuity is restored. Also, surgical treatment requires fistula or stricture (narrowing) of the intestine.

Surgery does not cure Crohn’s disease because it does not address the underlying cause, but it often results in long-term relief of symptoms, reduces or eliminates the need for continued medication, and allows patients to feel much better and lead a normal life.

The modern tactics of surgical treatment of Crohn’s disease in EMC is aimed at performing limited resections, and, if possible, carrying out organ-preserving operations (stricturoplasty, dilatation (expansion) of strictures).The volume of the operation depends on the prevalence of the pathological process, the presence of complications and the general condition of the patient.

Indications for emergency surgery are intestinal bleeding and perforation of the small intestine into the abdominal cavity.

Help for patients with perianal lesions (in the perineum and anus)

Perianal lesions develop in 25-50% of patients with Crohn’s disease and are more common in the colon. For uncomplicated forms of anal fissures and asymptomatic fistulas, conservative therapy is performed.Acute purulent lesions require special attention and require urgent surgical treatment.

In the EMC Coloproctology Clinic, during the surgical treatment of pararectal fistulas, setons are installed (thin silicone or latex drainage that prevents the fistula from closing) to ensure a constant outflow from the infected cavity of the abscess. This reduces the frequency of relapses and significantly alleviates the patient’s physical condition.

In case of severe damage to the perianal region with complex perianal fistulas, often leading to the development of purulent complications, the question of the formation of an ileostomy is resolved in order to turn off the large intestine from the digestion process.

Living with Crohn’s Disease: What is Required from a Patient?

Outside of periods of exacerbation (when there are no symptoms of the disease), you should be observed by a gastroenterologist and coloproctologist, observing the schedule of visiting the clinic prescribed by the doctor, while you can lead an active lifestyle.

Take your medications as directed by your doctor. Tell your doctor about the side effects of your medications. Avoid taking non-steroidal anti-inflammatory drugs (such as ibuprofen, ketoprofen, diclofenac, acetylsalicylic acid).

Follow your doctor’s recommendations on diet, avoid fatty foods, as well as foods that irritate the gastrointestinal tract, incl. coffee and alcoholic drinks.

If you smoke, it is recommended to quit this habit: smoking aggravates the symptoms of the disease.

Even in a relapse-free period, one should be attentive to any deviations in the state of health; the slightest change in well-being should be reported to the attending physician.

When do you need to immediately contact a coloproctologist?

Call a doctor immediately if

• acute abdominal pain occurred;

• is found not associated with defecation, the discharge of stool through fistulas in the anus and perineum;

• the frequency of bowel movements increases, the stool becomes dark in color;

• there is a discharge of blood from the rectum;

• , bloating appears, including asymmetric;

• chills appear, body temperature rises.

90,000 Crohn’s disease: exacerbation, probably preceded by intestinal dysbiosis

Crohn’s disease is a recurrent chronic disease, the course of which varies from patient to patient. Although the causes of this inflammatory disease are not yet fully understood, it has been observed that in some patients the gut microbiota is less balanced than in healthy individuals. But is this the cause of the disease or is it just the adaptation of the microbiota to the inflammatory environment?

Two-year non-experimental study

To get a clearer picture, a team of scientists from Israel and the United States monitored the microbiota of forty-five patients in remission of the disease.During this prospective, non-experimental study, gut microbiota analysis, C-reactive protein measurements (every 3 months) and fecal calprotectin levels, and endoscopic examinations (every 6 months) were performed. The researchers compared the results obtained in 17 patients in the inflammatory phase of the disease with those in 22 control subjects. The aim of the study was to find out whether the exacerbation of the inflammatory process is actually preceded by a disturbance in the state of the intestinal microbiota.To optimize the analysis process, scientists used machine learning – computer technology in which analytical models are created from collected data, rather than preliminary programming.

Aggravations and instability of microbiota

Results confirm that Crohn’s disease patients generally have less abundant and less balanced microbiota (higher dysbiosis index) than healthy people. It is mainly emphasized that in 27 out of 45 patients who had an exacerbation over the next two years, the inflammatory phase was preceded by a significant reduction in the number of some bacteria (families Christensenellaceae and S24.7 ) and an increase in the number of other bacteria ( Gemellaceae ) compared with patients in remission. Moreover, in patients whose microbiota was less stable in the remission stage of the disease, exacerbation occurred 11 times more often in the future. The change in the relative abundance of the above three taxa and the general instability of the intestinal microbiota appear to precede the exacerbation, thus indicating that the gastrointestinal flora plays a role in the pathogenesis of inflammation.Despite the errors commonly found in machine learning (excessive individual variation versus clinical factors), these findings open the way for the development of treatment options that will help predict (and potentially prevent) an impending exacerbation of the disease.

90,000 Patient Notes | p4spb

CROWN DISEASE.

Crohn’s disease is a chronic inflammatory disease that mainly affects the gastrointestinal tract.Although any part of the gastrointestinal tract, from the mouth to the anal canal (anus), can be involved, the end part of the small intestine (ileum) and / or the large intestine (colon and rectum) is most often affected.

Crohn’s disease is a chronic disease and can be exacerbated many times during a

life. Some patients have long-term remissions, sometimes for several years, without any symptoms of the disease. It is impossible to predict when remission will begin or when symptoms of the disease will return.What are the symptoms of Crohn’s disease?

Since Crohn’s disease can affect any part of the digestive tract, symptoms of the disease can vary dramatically from one patient to another. The most common symptoms are cramps, abdominal pain, diarrhea (diarrhea) mixed with blood and mucus, fever, weight loss, and bloating. However, not all patients experience all of these symptoms, and some do not experience any of them. Other symptoms may include pain in or out of the anus, skin lesions, rectal abscess, anal fissure, and joint pain (arthritis).

Common symptoms of Crohn’s disease:

• Abdominal pain

• Diarrhea

• Fever

• Weight loss

• Abdominal distension

• Pain in the anus during bowel movements

• Lesions of the perianal skin

• Abscesses of the rectum

• Anal fissure

• Joint pain

Who is affected by the disease?

The disease affects all age groups, but most of the patients are young people between the ages of 16 and 40.Crohn’s disease occurs most commonly in people living in northern countries. The disease affects men and women equally and is often common in some families. About 20 percent of people with Crohn’s disease have a relative, most often a brother or sister, and sometimes a parent or child, with some form of inflammatory bowel disease.

Crohn’s disease and a related condition ulcerative colitis are often described collectively as inflammatory bowel disease.About two million people in the United States alone have Crohn’s disease or ulcerative colitis.
What causes Crohn’s disease?

The exact cause of the disease is not known. Today, the most common theories of the onset of the disease are based on immunological and / or bacterial causes. Crohn’s disease is not contagious; it has a minor genetic (hereditary) predisposition. An x-ray of the small intestine can be used to diagnose Crohn’s disease.
How is Crohn’s disease treated?

Initial treatment is almost always conservative (non-surgical). Currently, there is no universal treatment for Crohn’s disease, but therapy with one or more drugs is aimed at treating the disease early and relieving its symptoms. The most common drugs are corticosteroids, such as prednisolone and methylprednisolone, and various anti-inflammatories.

Other drugs are often used, such as 6-mercaptopurine and azathioprine, which have an immunosuppressive effect. Metronidazole, an antibiotic that acts on the immune system, is often effective in patients with perianal Crohn’s disease.

Surgery may be indicated for more common and complex cases of Crohn’s disease. Sometimes, with the development of formidable complications of the disease, such as bleeding, acute intestinal obstruction or bowel perforation, it is necessary to perform emergency surgical interventions.

Other, less urgent indications for surgery include the formation of abscesses, intestinal fistulas (pathological messages from various parts of the gastrointestinal tract), severe forms of perianal lesions, and the absence of the effect of conservative treatment.

Not all patients with complicated Crohn’s disease require surgery. This decision is best made after consulting a gastroenterologist and coloproctologist surgeon.
Should we try to avoid CD surgery at all costs?

Although medical (conservative) treatment is preferred as an initial step, it is important to understand that about 3/4 of all patients eventually need surgical treatment.Many patients mistakenly believe that surgery for Crohn’s disease is dangerous or inevitably leads to complications.

Surgery is not a “panacea”, but after one operation many patients will not need additional surgeries. The most common treatment is conservative therapy with limited bowel resection (removal of only the affected area of ​​the bowel).

Surgical treatment often results in long-term relief of Crohn’s disease symptoms, reducing or eliminating the need for continued medication.Surgical treatment is best carried out by a coloproctologist surgeon who works in a clinic that has experience in the complex treatment of patients with Crohn’s disease.