I'm Dr. Bill Faubion,
a gastroenterologist at Mayo Clinic.
In this video, we'll cover
the basics of Crohn's disease.
What it is? Who gets it?
The symptom, diagnosis and treatment.
Whether you're looking for answers for
yourself or someone you love,
we're here to give you
the best information available.
Crohn's disease is an
inflammatory bowel disease
that causes chronic inflammation
of the GI tract,
which extends from your stomach
all the way down to your anus.
Different areas of the GI
tract can be affected in
different people, and it often
spreads into the deeper layers of the bowel.
It's estimated that over half a
million Americans are
living with Crohn's disease.
It can be painful and debilitating,
occasionally leading to severe complications,
as well as emotionally stressful.
And while there is no cure,
once you've been diagnosed,
treatment can help you get back to
a more normal and comfortable life.
There are a lot of particulars that figure
into or aggravate Crohn's disease,
but the exact cause is still unknown.
It may involve an abnormal
immune response against
some microorganism in which
your tissues are also attacked.
Genetics might also play a role. And it's true
that you're at higher risk if
a first-degree relative has it.
But that's really only seen in
about 20% of cases.
There is a correlation with age.
Although it can show up at any stage of life,
most people are diagnosed before 30.
Ethnicity is a risk factor.
Whites have the highest risk,
especially among
people of Ashkenazi Jewish descent.
However, incidence is increasing
among black people in North
America and the UK.
Non-steroidal anti-inflammatory medications
or NSAIDS...
they don't cause Crohn's disease,
but they are known to trigger inflammation
of the bowel and make it worse.
They include common over-the-counter
painkillers like ibuprofen,
naproxen sodium,
diclofenac sodium, and others.
So if you've been diagnosed with Crohn's,
make sure you talk to your doctor
about what medications should be avoided.
Many of these elements are out of our hands,
but smoking is the most
important controllable risk factor
for developing Crohn's disease.
It also leads to more severe disease
and increased need for surgery.
So if you smoke and you're diagnosed,
now is a good time to quit.
Crohn's disease can affect
any area in the GI tract,
but it's mostly found in the large and
the small intestine. It can also
be confined to one area
or found in multiple segments.
Symptoms can range in severity and it
can depend on the area of
the GI tract that's affected.
You also may experience periods of
remission when you have no
symptoms or issues at all.
The symptoms can come on gradually,
but they can also show up suddenly.
And these can include diarrhea,
fever, fatigue, abdominal pain and cramping,
blood in your stool,
mouth sores,
reduced appetite and weight loss.
If your Crohn's disease has caused
fistulas or inflamed tunnels in the skin
near the anal area,
you may notice pain or drainage.
And in more severe cases,
you may have inflammation of the eyes, skin,
joints, liver or bile ducts,
kidney stones, and anemia.
In children, it can
delay growth and development.
Over time,
Crohn's disease can lead
to other complications,
including bowel obstruction, ulcers,
fistulas, anal fissures, malnutrition,
and other health problems. It can also
increase your risk for blood
clots and colon cancer.
Having these symptoms doesn't
automatically mean you have Crohn's.
But if you're experiencing
anything that concerns you,
it's a good idea to make
an appointment with your doctor.
There's no single test for
Crohn's disease, and it
has similar symptoms to
a lot of other conditions,
so it can take a little time
to get a diagnosis.
First, your doctor is going to
consider your medical history.
Then your doctor may want to run
a variety of tests or procedures.
And at some point,
your general practitioner may
want to refer you
to a specialist called
a gastroenterologist like myself.
A blood test can check for
anemia and check for signs of infection.
A stool study can test if there's
blood present or rule out certain pathogens.
A colonoscopy may be needed.
This also allows your doctor to view
your entire colon and
the very end of the ileum using an endoscope,
a small camera mounted
on a thin flexible tube.
They can take tissue samples
for a biopsy at the same time.
And the presence of
granulomas or clusters of
inflammatory cells
can essentially confirm the diagnosis.
A CT scan might be ordered for
a better look at the bowel
and all of the surrounding tissues;
or an MRI, which is especially good for
evaluating fistulas around
the anus or the small intestine.
A capsule endoscopy can be done.
Here you actually swallow
the camera about the size
of a large vitamin and it
takes images of your digestive tract
as it travels through. And a balloon-
assisted enteroscopy
may be done to get further into
the bowel than a standard endoscope
can if abnormalities have been found
that need further investigation.
Your doctor can work with you to find
therapies that alleviate your symptoms.
One of the main goals is to reduce
the inflammation that produces
painful and disruptive issues.
Another is to limit
complications over the long-term.
There is currently no cure,
but many treatments can
provide a lot of relief,
and in some cases, even long-term remission.
These may include
anti-inflammatory drugs like
corticosteroids, immune system suppressants,
and antibiotics.
Certain biologics, which target
proteins made by the immune system,
can help. Antidiarrheals,
pain relievers, and supplements
can help counter other symptoms.
Nutritional therapy and
a special diet may be recommended.
And in some cases where other
measures aren't effective,
surgery may be required.
And that's to remove the damaged tissue.
Some of these therapies
may have side effects themselves.
So be sure and review
the risks and benefits with your doctor.
Crohn's disease can be
physically and emotionally challenging,
but there are things that can help.
Although there's no firm evidence that
any particular foods cause Crohn's disease,
certain things seem to aggravate flare-ups.
So a food diary can help you
identify personal triggers. Beyond that,
limit dairy products, eating smaller meals,
stay hydrated, and try to avoid
caffeine, alcohol, and carbonation.
Consider
multivitamins if you're concerned about
weight loss. Or if
your diet has become too limited,
talk to a registered dietitian.
And again, if you smoke, you should stop.
It's important to take
care of your mental health too.
Find ways to manage stress, like exercise,
breathing,
relaxation techniques or biofeedback.
Some symptoms like abdominal pain,
gas, and diarrhea...
they can cause anxiety and frustration.
They can make it difficult to go out in
public for any amount of time.
It can feel limiting and
isolating and lead to depression.
So learn as much as you can about Crohn's.
Staying informed can help a lot in
feeling like you're in
control of your condition.
Talk to a therapist, especially
one familiar with inflammatory bowel disease.
Your doctor can give
you some recommendations.
And you might want to find a support group of
people going through
the same thing that you are.
Crohn's disease is a complex disease.
But having expert medical care
and developing a treatment strategy
can make it more manageable and even help you
get back to the freedom of your normal life.
Meanwhile,
significant advances continue to be
made in understanding
and treating the disease,
getting us closer to
curing it or preventing it entirely.
If you'd like to learn
more about Crohn's disease,
here are other related videos
or visit Mayo Clinic.org.
We wish you well.