Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes swelling and inflammation in the gut. According to Crohn’s and Colitis UK, 540,000 people in the UK are living with IBD – the equivalent of one in every 123 people.
Crohn’s is a lifelong condition and its symptoms can significantly affect daily life. However, while there’s currently no cure, treatment can help people to manage their symptoms.
Here, we’ll take a closer look at Crohn’s disease, including symptoms, causes, treatment options, and ways to cope.
What is Crohn’s disease?
Crohn’s disease is a type of inflammatory bowel disease (IBD). When you have Crohn’s, your immune system attacks itself – causing inflammation and painful ulcers in the gut.
Other forms of IBD include ulcerative colitis and microscopic colitis. Although similar, the conditions differ. While colitis causes inflammation in the colon (large bowel) and anus only; Crohn’s disease can cause inflammation anywhere along the digestive tract – from the mouth to the anus.
Crohn’s also differs from irritable bowel syndrome (IBS), which is classified as a functional disease rather than an autoimmune disorder and doesn’t cause permanent damage to the gastrointestinal tract.
The type of Crohn’s disease a person has is determined by which area of the gut is affected. Most people develop Crohn’s in the last part of the small intestine and/or the large intestine and anus.
What are the symptoms of Crohn’s disease?
Everyone experiences Crohn’s differently and symptoms can vary depending on which area of the gut is affected.
It’s also common for people to fluctuate between periods of good health – known as remission – and flare-ups, when symptoms are more active. This means you may sometimes feel well with no or very few symptoms; while, at other times, the condition may be more difficult to manage.
Some of the most common symptoms include…
- Severe abdominal pain, the location of which can depend on which area of your gut is affected.
- Frequent diarrhoea that may also contain pus, mucus, or blood. You may need to go to the toilet quickly or often – known as toilet urgency or frequency.
- Anaemia. A lack of iron can lead to anaemia, where the body has fewer red blood cells to transport oxygen to cells. The risk of anaemia increases if you’re losing blood, aren’t eating enough, or your body can’t fully absorb nutrients from food.
- Loss of appetite and weight loss. Inflammation in the gut can make it more difficult for the body to absorb nutrients from food, often leading to weight loss.
- Extreme fatigue. This can be caused by the condition itself or from weight loss (due to flare-ups or surgery), a lack of iron, or poor sleep if the condition causes you to wake in the night with pain or diarrhoea.
- Feeling generally unwell, for example, having a high temperature or feeling feverish.
While Crohn’s is a gut condition, ongoing inflammation can also lead to other health issues.
According to Crohn’s and Colitis UK, around one in two people with Crohn’s develop issues in other areas of the body. This most commonly occurs as swelling and inflammation of the eyes, joints, and skin.
Other potential complications can include hair loss, gallstones, kidney stones, and fistulas (when a tunnel develops that connects an organ to another part of the body).
Crohn’s disease and mental health
When you have a chronic health condition, it’s easy to prioritise looking after your physical health – but Crohn’s can impact your mental and emotional well-being too.
In fact, research has identified a significant link between IBD and mental health. According to Crohn’s & Colitis UK, people with Crohn’s or Colitis are twice as likely to experience mental health problems than those without the condition – and there are a few reasons why.
Living with regular pain, fatigue, and unpredictable bowel movements can be distressing. Some people experience disrupted sleep, low mood, poor body image, and may fear leaving the house due to worrying about having an accident. And, because many symptoms aren’t visible, people often feel inclined to play down how much the condition affects them.
Plus, being diagnosed with Crohn’s disease can come as a shock – particularly if you’ve never struggled with gastrointestinal issues before.
Experts are also increasingly finding that the relationship between mental health and IBD works both ways. For example, there’s evidence that poor mental health can increase the risk of flare-ups and complications in people with IBD.
The gut-brain connection, which refers to the relationship between the gut and the central nervous system, helps to explain this.
Crohn’s disease and bowel cancer risk
In some cases, Crohn’s disease can increase the risk of bowel cancer. However, the risk is relatively small.
According to Crohn’s and Colitis UK, the risk increases if Crohn’s has affected the large bowel for more than eight to 10 years, or there are strictures in the gut (an abnormal narrowing of the gastrointestinal tract).
If you have an increased risk of bowel cancer, you’ll be offered regular colonoscopies to look for early warning signs. Keeping your symptoms under control can also help to prevent future risks.
What causes Crohn’s disease?
Crohn’s disease is caused by changes to the immune system. Usually, our immune system protects us against infection and harmful substances. But, when you have Crohn’s, the immune system starts attacking the gut.
Experts don’t yet fully understand why this happens, but it’s believed several factors could be at play.
For example, researchers have identified over 200 genetic variations that may increase the risk of developing Crohn’s. Many of these changes are in genes that control the immune system, potentially altering its response to bacteria in the gut.
Other research has linked the development of Crohn’s with a lack of healthy bacteria in the gut, a faulty gut barrier, and environmental factors like stress, smoking, and certain medicines.
However, there’s currently no definitive evidence to confirm the role of these factors in the development of Crohn’s and experts are keen to emphasise that there’s nothing you could have done to prevent yourself from developing the disease.
How is Crohn’s disease diagnosed?
If you suspect you may be living with Crohn’s disease or have been struggling with unexplained bowel symptoms, it’s important to speak to your GP.
Because some symptoms of Crohn’s can be similar to other bowel conditions, you’ll likely need to undergo tests to rule these out. Your GP will discuss your symptoms and check for external signs of the condition, such as stomach tenderness. They may also take a stool sample to check for signs of infection, such as gastroenteritis, which sometimes causes similar symptoms to Crohn’s.
If your GP suspects you may have IBD, they’ll refer you to a specialist for further tests. This may include a CT scan, X-ray, or examination of your colon and rectum through a colonoscopy or sigmoidoscopy, during which a small sample of bowel tissue may be taken.
Crohn’s and Colitis UK has more information on their website about how Crohn’s disease is diagnosed.
Note: Being diagnosed with Crohn’s can come as a shock, and it’s normal to feel worried about the next steps and how your life might change. But you’re not alone. If you’re struggling to come to terms with your diagnosis and would like to speak to someone about any questions or worries you have, Crohn’s and Colitis UK have a confidential helpline.
What are the treatment options for Crohn’s disease?
Anyone diagnosed with Crohn’s disease will be cared for by an IBD specialist and a team of health professionals. They’ll be there to support you with everything from treatment information to providing rapid care during flare-ups.
There’s currently no cure for Crohn’s disease, but treatment can help people reduce or control symptoms. The right treatment for you will depend on the severity of your symptoms and which area of your gut is affected.
Treatment typically involves medication, surgery, or a combination of both. We’ll cover these below.
Medication for Crohn’s disease
Most people with Crohn’s will be given medication to control their symptoms. This can include steroids, immunosuppressants, and a liquid diet (special drinks that contain the nutrients you need).
If other medicines aren’t helping, stronger medicines called biological medicines may be prescribed.
Surgery for Crohn’s disease
If Crohn’s is significantly affecting your quality of life, your symptoms aren’t responding to medication, or you develop severe complications, surgery may be an option.
Surgery can help relieve your symptoms and stop them returning for a while. However, they’ll usually return eventually.
The main surgery used for Crohn’s is called a resection. This involves removing inflamed sections of the bowel and stitching healthy parts back together.
Some people may need ileostomy surgery for a few months to allow the bowel to recover before it’s stitched back together. In ileostomy surgery, a hole is made in your tummy and the small intestine is diverted out of it. After surgery, stoma bags are placed over the opening of the hole to collect waste.
You can read more about treatment for Crohn’s on the NHS website.
3 tips for living with Crohn’s disease
Living with Crohn’s disease can be difficult, but it’s important to do what you can to take care of yourself. We’ll cover some things that can help below.
1. Take care of your mental health
Being diagnosed with a long-term health condition like Crohn’s can take time to come to terms with. The impact of symptoms on everyday life can also leave people feeling anxious, frustrated, or worried about the future.
This is normal and it’s important to allow yourself the space and time to process your feelings.
If you’re struggling with your mental health, you might find it helpful to read our articles: 7 tips for coping with stress and anxiety and 10 things you can do to help yourself through feelings of depression. The healthy mind section of our website also has information on counselling and therapy services if you feel you’d benefit from extra support.
2. Learn what works for you
Everyone’s experience of Crohn’s is different, which means there’s no one-size-fits-all formula for managing symptoms. Often, it’s a case of trial and error to find out what works best for you.
For example, some people find that lifestyle factors like stress and diet affect their symptoms, while others say they have no impact at all. There’s also evidence that complementary therapies, such as yoga, mindfulness, acupuncture, and taking probiotics can sometimes help with Crohn’s symptoms.
Using a diary to record and track your symptoms can be a useful way to identify potential triggers.
3. Build a support network
Some people with Crohn’s find it difficult to open up to others about the condition, as some of the symptoms can feel a bit taboo. But, having a strong support network of people you trust and rely on can make a huge difference.
If you’re finding it difficult to speak about your condition, Crohn’s and Colitis UK’s online resources may help. For example, they’ve created a personalised talking toolkit, which offers tips if you’re struggling to open up.
Crohn’s and Colitis UK also have local networks where you can connect with others going through the same thing. These networks aim to bring people affected by IBD together through educational talks and social events – empowering them with the support and confidence to live freer, fuller lives.
Final thoughts…
Being diagnosed with Crohn’s disease can come as a shock, and it’s normal to feel overwhelmed or worried about what life with the condition will look like. But, with the right support, treatment, and care, it’s entirely possible to live a full and happy life with Crohn’s.
For further reading, head over to the general health section of our website.
Do you have any experience of living with Crohn’s disease that you’d like to share? We’d be interested to hear from you in the comments below.
