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Crohn's disease

Published by Bupa's health information team, February 2008.

This factsheet is for people with Crohn's disease, or who would like information about it.

Crohn's disease is an inflammatory bowel disease and can have both short- and long-term effects. It affects about one in 700 people, mostly adults, and develops in both men and women. Crohn's disease isn't caused by an infection and you can't catch the illness from someone else.

What is Crohn's disease?

Crohn's disease is due to inflammation of the wall of your bowel. It can affect any part of your digestive system, from your mouth down through your stomach and bowel to your anus. However, it's most common in your small bowel or the first part of your large bowel. It may affect more than one section leaving unaffected areas in-between.

If you have Crohn's disease, you will have inflammation and swelling in affected areas of your bowel and ulcers may form. These are raw areas of the bowel lining which can bleed. Your bowel wall will be thickened and this may cause blockages.

Illustration showing the areas of the bowel commonly affected by Crohn's disease
The areas of the bowel commonly affected by Crohn's disease

Symptoms

Crohn's disease is a chronic condition. This means that it lasts a long time, sometimes for the rest of the affected person's life. The term chronic refers to time, not to how serious a condition is. Crohn's disease is characterised by flare-ups of symptoms. These alternate with periods of no symptoms at all - this is called remission. Usually there is no obvious trigger for the symptoms coming back (a relapse). When you have symptoms, the disease is said to be active. Symptoms include:

Active Crohn's disease may cause other problems such as:

Complications

With severe, long-term inflammation, you may develop complications. These include:

Causes

The exact reasons why you may develop Crohn's disease are not fully understood at present. However, it's thought that you are more likely to have Crohn's disease if your immune system (your body's defence system) overreacts to bacteria within the bowel leading to ongoing inflammation. Crohn's disease tends to run in families and researchers have identified genes associated with it.

Certain lifestyle factors, such as smoking, mean you are more likely to develop Crohn's disease. The role of diet in causing Crohn's disease isn't fully understood. However, it's possible that you are more likely to develop the condition if you eat a diet that is high in sugar and low in fibre.

Diagnosis

Your GP will ask about your symptoms and examine you. He or she may refer you to a gastroenterologist, a doctor specialising in conditions that affect the digestive system. You may have further tests including:

You won't need to have a general anaesthetic for these tests and they are usually carried out as out-patient procedures. This means you have the test in hospital, but you won't need to stay overnight.

Treatment

If you have Crohn's disease, you will usually be seen regularly by a specialist team. Treatment will aim to increase your quality of life as much as possible, but there is no cure.

Diet

If you have Crohn's disease it's important that you eat a healthy, balanced diet with a high fibre content, unless you are prone to blockages. This is especially true when your symptoms flare up, as you will need to replace lost nutrients, although you may not feel like it. If you can eat a normal diet, you should continue to do so. However, you may find that certain foods disagree with you or that you need to eat more of particular types of food such as starchy carbohydrates (eg potatoes, bread and pasta).

When your Crohn's disease is active, your doctor may recommend that you have a liquid diet, made up of simple forms of protein, carbohydrates and fats. This is called an elemental diet and is commonly used to treat children.

Medicines

Many people with Crohn's disease find that treatment with medicines is effective. Medicines used to treat Crohn's disease include:

During flare-ups you may consider taking painkillers, but your GP may advise you not to take certain medicines such as ibuprofen (eg Nurofen) as they can make Crohn's disease worse. It's usually fine to take paracetamol as a painkiller, but check with your GP first. It's not a good idea to take antidiarrhoeal medicines all the time as they may cover up signs that your disease has become more severe. Speak to your GP if diarrhoea is a problem.

Surgery

You may need surgery to treat complications or if medicines aren't controlling the disease. Your surgeon will aim to remove as little of your bowel as possible and expand any parts that have become narrowed.

Living with Crohn's disease

Some people with Crohn's disease have frequent flare-ups, whereas others have only one or two attacks during their lifetime. Flare-ups are unpredictable, but with good management your symptoms can be controlled. You are likely to be able to enjoy a normal lifestyle.

Further information

Related topics

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Ian Arnott BSc MBChB FRCP (Edin) MD, Consultant Gastroenterologist at Western General Hospital, Edinburgh and Dr Steven Mann MB ChB MRCP, Consultant Gastroenterologist at Barnet Hospital, London, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February 2008.