Crohn's Disease

Crohn’s disease is one of the inflammatory bowel diseases.  It can affect almost any part of the gastrointestinal system, but most commonly affects the end of the small bowel (terminal ileum) and the colon (or both).  It tends to occur mostly in young people (between teenage years and 40) but can occasionally occur in older patients.  The initial symptoms may be quite vague, with excess gas, bloating, abdominal discomfort and intermittent diarrhea, fevers and sweats.  In others it may present with severe abdominal pain, bloody diarrhea, fevers, chills, nausea,  vomiting and bowel obstruction.  Complications can include intra-abdominal abscesses, fistulas (connections) between the large and small bowel, or rectal abscesses or fistulas.  The disease may be mild, intermittent, persistent or severe.  In a small percent, the disease remits and may never recur.  Gallstones often form in these patients, cause gallbladder pain or infection.

While the cause of Crohn’s disease is unknown, there is much that can be done to treat this disease.  Depending upon which part of the bowel is effected, the medical treatment may vary.  Medications such as Flagyl, Dipentum, Prednisone, Imuran, 6-MP and Azasan may be used.  For refractory cases,  Remicade and Cyclosporin IV may be utilized, the former, often being used in cases complicated with fistulas. 

Surgery may be necessary in severe, acute cases that do not respond to medical treatment when there are intra-abdominal abscesses or bowel obstruction.  Unfortunately, even after the Crohn’s segment is removed, the disease may recur, weeks or decades later.

Despite the fact that Crohn’s disease may be a terribly frustrating disease, it is totally unpredictable, and may go into remissions or flares for months or years at a time.  Stress tends to exacerbate the activity of the disease, especially the kind of “life-stresses” that people tend to hold inside of themselves.

Contrary to what has been suggested in the medical and lay literature, we have not found any increased risk of cancer associated with long term disease.

Today there are many potential treatments for Crohn’s disease.  Newer drugs are being worked on right now, that may benefit even the toughest cases in the future.