Crohn's Disease

Crohn’s disease is a chronic immune-mediated intestinal disorder, in which the body’s immune system is not regulated and therefore results in injury or destruction of the bowel wall and sometimes, the surrounding organs. Patients with Crohn’s disease have a course that is characterized by periods of active inflammation- and symptoms, and periods of remission – or feeling quite well. Because Crohn’s disease can involve any portion of the intestinal tract from the mouth all the way down to the anus, symptoms may vary substantially among patients. In the past, patients with Crohn’s often needed surgery for their condition, in order to remove an affected portion of bowel. More recently, better therapies have really improved our ability to control this condition.

The most common symptoms of Crohn’s disease are abdominal pain (often in the right lower quadrant) and diarrhea. Some patients will have nausea or vomiting due to bowel obstruction, and some will have blood in their bowel movements. In children, sometimes the only presenting problem is a failure to grow or to achieve developmental milestones. Because most people with Crohn’s disease are young when their symptoms start (most are between 15-30 years old at diagnosis), the diagnosis is often delayed or not pursued because people attribute their problems to an irritable bowel (Crohn’s is INFLAMMATORY BOWEL DISEASE not IRRITABLE BOWEL SYNDROME) or to “stress” or their diet. It’s common for patients with Crohn’s disease to have suffered from symptoms for a long time before the diagnosis is made, which is unfortunate, because we have learned that early diagnosis and effective treatment provide better outcomes of care and help patients achieve healthy, normal lives. The longer someone has symptoms that are not adequately investigated and diagnosed, the more likely it is that they will need hospitalization or surgeries, things that we hope to avoid in all our patients.

If you have intestinal irregularity or symptoms that have persisted beyond a week or two, you should see your doctor, and pursue an accurate diagnosis with a specialist if the problem persists.

Once diagnosed there are many thing that a patient can do to help live with Crohn's disease

• Crohn’s disease is a chronic condition, but it’s not a “life sentence”. Many people think that once they are diagnosed with a chronic bowel disease like Crohn’s, they should expect to live an unpredictable life in the bathroom and that they will be socially isolated. That couldn’t be further from the truth. Patients with Crohn’s should expect (and demand!) to live normal lives and pursue their dreams. Many of our patients are inspirations and their stories can be read in the Inside Tract, our in house newsletter which can be read her online under NEWS.
• Expect remission. Remission is the absence of inflammation and symptoms due to inflammation. The newest therapies for Crohn’s disease are effective at achieving that, and you shouldn’t settle for less than remission.
• Stay on your medications! The standard approach to managing Crohn’s disease includes a maintenance plan, which is designed to keep you in remission and prevent relapses. It’s difficult for any of us to take regular medication, but it takes much less energy and time to keep you in remission than it does to get you back if you relapse because you have not been taking your medications. It is well known that people who are non-adherent to their maintenance medications are more likely to relapse and more likely to have complications from their disease.

Crohn’s disease affects more than just the patient. Because it can affect an individual’s ability to function in social environments, it can result in strains on family and interpersonal relationships. Those who are closest to the person with Crohn’s disease should learn all that they can about the condition, attend patient education seminars with them, and be understanding and flexible when their loved one isn’t feeling well enough to go out or complete planned activities. They should also encourage them to seek the best treatments and achieve an unrestricted quality of life.

But we also teach our patients that it can be very helpful for them to attend patient-only support groups so they develop a broader network of support for their condition and can therefore not always lean on the same small circle of loved ones. This is a helpful coping strategy for anyone.