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Digestive Disorders

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Crohn Disease

Symptoms

Spasms of abdominal pain or cramps, often located near the navel or in the lower right abdomen.

Persistent watery diarrhea.

Rectal bleeding or blood in the stool.

Anal fissures.

Nausea.

Fever.

Fatigue.

Loss of appetite and weight.

Systemic complications such as joint pain from arthritis, inflammation of the eyes, and skin lesions.

When To Call Your Doctor

Call a doctor if you experience symptoms of Crohn disease (especially lower-right abdominal pain, which may signal appendicitis).

Call a doctor if you experience black or bloody stools, a swollen abdomen, or a fever over 101° F.


What Is It?

Crohn disease, also known as regional ileitis, is a chronic inflammation of the intestinal wall, most commonly in the final portion of the small intestine or the colon. Less often, the upper digestive tract may also be affected. The inflammation involves deep layers of the intestinal wall, where ulcers and abscesses may form. The ulcers may erode the wall completely, creating abnormal passages (fistulas) to other parts of the intestine, to other organs such as the bladder, or to the skin. Deep cracks may also develop in and around the anus (anal fissures). Inflammation may thicken the intestinal wall until the passageway becomes blocked. Symptoms of Crohn disease appear during flare-ups, which alternate with periods of remission. Some people suffer only one or two attacks before entering into permanent remission; others experience recurrent attacks over a lifetime. Crohn disease is relatively rare, but the incidence among the general population has been increasing in recent decades.

What Causes It?

The cause of Crohn disease is unknown.

Hereditary factors seem to play some role in the development of this disorder.

Various theories suggest these possible causes: viral or bacterial infections, autoimmune disorders, food allergies, or lymphatic obstruction.

Prevention

At present there is no known way to prevent Crohn disease.

Diagnosis

Patient history and physical exam are necessary.

Blood tests may be taken.

Upper gastrointestinal (GI) series of x-rays are taken to view the small intestine.

A barium enema may be performed. The barium creates a sharp image of the colon on x-ray.

Sigmoidoscopy (to inspect the lower large intestine) or colonoscopy (to view the entire large intestine) may be performed.

A biopsy of the colon lining is generally taken during the sigmoidoscopy or colonoscopy to distinguish Crohn disease from ulcerative colitis.

How To Treat It

For mild attacks, over-the-counter antidiarrheal medications and pain relievers may be taken.

Anti-inflammatory medications, such as sulfasalazine or corticosteroids, may be recommended.

Antibiotics may be prescribed to suppress secondary infections.

Enemas containing corticosteroids or aspirin-like drugs may be used to treat internal inflammation.

Immunosuppressive drugs may be prescribed on a long-term basis to quell autoimmune activity.

Dietary changes, vitamin or mineral supplements, or vitamin B12 injections, to replace nutrients lost from poor bowel absorption, may be advised.

In some cases of extremely severe attacks, periods of intravenous feeding may be necessary to allow the bowel to rest.

Surgery may be required to repair blockages, fistulas, or abscesses in the rectum or intestine.

In advanced, long-standing cases of Crohn disease, the damaged portion of the bowel may be removed.

 

From Johns Hopkins Symptoms and Remedies, the complete home medical reference. You can order this book now on our secure server.

 

 


 


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2005
WHITE PAPERS
Digestive Disorders

The Digestive Disorders White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.


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Johns Hopkins Symptoms and Remedies
An easy-to-use reference work that can help you pinpoint the cause of hundreds of symptoms, from abdominal pain to skin rash to swollen glands.

 

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