Crohn’s disease

What is Crohn’s disease?

Crohn’s disease is a form of inflammatory bowel disease (IBD) where the digestive system (also called the gastrointestinal tract or gut) becomes inflamed. It can impact any part of the digestive system, but your small intestine and colon are often affected.

It’s a chronic condition, which means that it’s long-term. But symptoms often go through stages, where you may feel fine for a long period of time and then have a flare-up when symptoms get worse.

Crohn's disease affects people of all ages, and usually develops during childhood or as a young adult.

What causes Crohn’s disease?

The exact cause of Crohn’s disease isn’t known, but doctors think the following factors are linked to the condition:

• Family history of Crohn’s disease

• Problems with your immune system

• Smoking

• Certain medications, like the oral contraceptive pill and non-steroidal anti-inflammatory tablets

• Stress

• An imbalance of bacteria in your gut

What are the symptoms of Crohn’s disease?

Symptoms often go through periods when they are more active (called a flare-up or relapse), followed by a period of remission, when they go away. The length of these periods varies from person to person, but they can last for weeks, months or even years at a time.

The most common Crohn’s disease symptoms are:

• Stomach pain and cramps

• Diarrhoea

• Blood or mucus in your poo

• Constipation

• Loss of appetite and weight loss

• Feeling the need to poo very suddenly

• Tiredness and fatigue

Other symptoms can include:

• Mouth ulcers

• High temperature and fever

• Anaemia

How is Crohn’s disease diagnosed?

It’s not always easy to diagnose Crohn’s disease as the symptoms overlap with many other conditions, like irritable bowel syndrome (IBS), coeliac disease, and bowel infections.

To start with, a doctor will want to better understand your symptoms and ask about other important factors, like your diet, your family’s health, and whether you’re taking any medication.

They may also do some tests, like:

• Blood tests

• Stool (poo) samples

• A physical examination of your stomach

If they think you may have Crohn’s disease, you’ll be referred for further tests, which might include:

• An endoscopy – Using a long, thin, flexible tube with a camera (endoscope) to look at your digestive system. This can be inserted through the mouth to examine the top of the digestive system, or through your anus to look for inflammation in your bowel (a colonoscopy)

• A biopsy – Small samples of your bowel may need to be taken during a colonoscopy to be examined under a microscope for signs of Crohn’s

• A scan – You may have a special drink before an MRI scan or a CT scan, which will show the liquid up clearly in your bowel

How is Crohn’s disease treated?

There’s no cure for Crohn’s disease, but symptoms can often be reduced or managed with proper treatment. This might include:

• Steroids – these can help to reduce inflammation in your digestive system and may be recommended for certain periods

• Immunosuppressants – medicine that suppresses the activity of your immune system and can be taken as a long-term treatment

• Liquid diet – also known as enteral nutrition, this treatment replaces your usual diet with special, nutrient-rich drinks for a few weeks

• Biological medicines – these are stronger medicines given by injection or a drip in the vein that may be offered if another treatment isn’t working

• Surgery – the main surgical procedure for Crohn’s disease is called a resection. It involves keyhole surgery, where small cuts are made in your stomach and the inflamed area of your bowel is removed

Crohn's disease diet

Crohn’s disease is different for everyone, so there’s no set diet to treat symptoms. But many people find that adjusting their diet can help them manage certain symptoms. It’s helpful to get an understanding of the foods that can trigger your symptoms, and which ones can be beneficial.

Keeping a food diary is a handy way to build up a better picture of how your diet affects your condition. Make a note of what you eat at each meal and any snacks you eat in between. List any symptoms, how long they last and how severe they were. Over the course of a few weeks, this will help you to notice any patterns.

If certain foods seem to be triggering your symptoms, try eliminating them for a while, one by one, to see if it eases your symptoms.

Remember that cutting certain foods out of your diet can stop you from getting nutrients or vitamins that your body needs. It’s important to make sure you’re eating a healthy, balanced diet, so always discuss any changes in diet with a doctor.

When should I speak to a doctor?

Always seek medical advice if you experience any of the following:

• Blood in your poo

• Ongoing diarrhoea for a week or more

• Persistent stomach cramps that don’t go away

• Unexplained weight loss

A GP will offer advise about managing your symptoms and help find the cause. They may refer you for further tests to check for Crohn's disease.