Crohn’s disease is a long-term condition that causes inflammation in the digestive tract. It is a type of inflammatory bowel disease (IBD) and can affect any part of the digestive system, from the mouth to the anus. This guide explains Crohn’s disease, its causes, symptoms, treatments, and how to manage living with it.

What is Crohn’s Disease?

Crohn’s disease is a chronic condition that leads to inflammation in the digestive tract. The inflammation can affect all layers of the bowel wall and may occur in patches, with healthy tissue between inflamed areas. It most commonly affects the small intestine and the beginning of the large intestine (colon).

Unlike some other conditions, Crohn’s disease has periods of flare-ups (when symptoms worsen) and remission (when symptoms improve or disappear). While there is no cure, treatments can help manage symptoms and improve quality of life.

Background on Crohn’s Disease

• History: Crohn’s disease was first described by Dr Burrill Crohn and colleagues in 1932.
• Global Impact: It is one of the two main types of IBD, along with ulcerative colitis, and affects millions of people worldwide.

Causes, Incidence, and Prevalence

Causes

The exact cause of Crohn’s disease is unknown, but it is thought to result from a combination of factors:

• Immune System Dysfunction: The immune system mistakenly attacks healthy cells in the digestive tract.
• Genetics: A family history of Crohn’s disease increases your risk. Specific genetic mutations have been linked to the condition.
• Environmental Factors: Smoking, diet, stress, and exposure to certain infections may trigger or worsen symptoms.

Incidence and Prevalence

• Incidence: Around 10–20 new cases per 100,000 people are diagnosed annually worldwide.
• Prevalence: Approximately 1 in 250 people in Europe and North America live with Crohn’s disease. Rates are increasing globally, particularly in newly industrialised countries due to changes in diet and lifestyle.

Who is Affected?

1. Age of Onset: Most commonly diagnosed between ages 15 and 35 but can occur at any age.
2. Gender: Both men and women are equally affected.
3. Ethnicity: People of European descent have higher rates of Crohn’s disease, but it is increasingly being diagnosed in other populations as well.

Geographic Distribution

Crohn’s disease is more prevalent in developed countries, particularly in North America and Europe.

How Does Crohn’s Disease Impact You?

Symptoms

Symptoms vary depending on which part of the digestive tract is affected but may include:

• Persistent diarrhoea (sometimes with blood or mucus).
• Abdominal pain or cramping (often in the lower right side).
• Fatigue or low energy levels.
• Unintended weight loss.
• Fever during flare-ups.

Other symptoms may include joint pain, skin problems, or eye inflammation due to the systemic nature of Crohn’s disease.

Living With Crohn’s Disease

Living with Crohn’s disease often involves managing flare-ups and periods of remission. The condition can affect daily activities, work, relationships, and mental health.

Expected Life Expectancy

With appropriate treatment and management, most people with Crohn’s disease have a normal life expectancy.

Managing and Treating Crohn’s Disease

Available Treatments

While there is no cure for Crohn’s disease, treatments aim to reduce inflammation, relieve symptoms, and prevent complications:

1. Medications:
   1. Aminosalicylates (5-ASAs): Reduce inflammation in mild-to-moderate cases (e.g., mesalazine).
   2. Corticosteroids: Used for short-term relief during flare-ups but not recommended for long-term use due to side effects.
   3. Immunosuppressants: Suppress the immune system to reduce inflammation (e.g., azathioprine).
   4. Biologic Therapies: Target specific molecules involved in inflammation (e.g., infliximab or adalimumab). These are often used for moderate-to-severe cases.
   5. JAK Inhibitors: Newer oral medications like tofacitinib are available for some patients.

2. Lifestyle Changes:
   1. Eat a balanced diet tailored to your needs during flare-ups or remission.
   2. Quit smoking; smoking worsens symptoms.
   3. Manage stress through relaxation techniques or counselling.

3. Surgery:
   1. Surgery may be needed to remove damaged sections of the digestive tract if medications are not effective.
   2. Common surgeries include resection (removing part of the intestine) or strictureplasty (widening narrowed areas).

Ongoing Clinical Research

Research into Crohn’s disease continues to explore new treatments and ways to improve quality of life for patients:

• Microbiome Studies: Investigating how gut bacteria influence inflammation in Crohn’s disease.
• Stem Cell Therapy: Exploring whether stem cells can repair damaged tissue.
• Personalised Medicine: Tailoring treatments based on genetic or molecular markers.
• For information on clinical trials related to Crohn’s disease, visit clinicaltrials.gov.

Support Groups and Resources

If you have been diagnosed with Crohn’s disease, connecting with support groups can provide valuable information and emotional support:

1. Crohn’s & Colitis UK (crohnsandcolitis.org.uk) – Offers resources for managing life with IBD.
2. European Federation of Crohn’s & Ulcerative Colitis Associations (EFCCA) (efcca.org) – Provides advocacy for people living with IBD across Europe.
3. Crohn’s & Colitis Foundation (USA) (crohnscolitisfoundation.org) – Focuses on education and research for those affected by IBD.
4. IBD Relief (ibdrelief.com) – An online community offering practical advice for living with IBD.

Remember:

This information is intended for general knowledge and educational purposes only and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.