About Crohn’s Disease

About Crohn’s Disease

Inflammatory bowel diseases are chronic inflammatory diseases of the bowel within which Crohn's disease and ulcerative colitis are the most important. Crohn's disease is a chronic inflammatory disease that can affect the entire gastrointestinal tract, but usually the last part of the small intestine and/or large intestine is affected.

The main symptoms are abdominal pain, chronic diarrhea, weight loss, and fatigue. Patients with Crohn's disease can also have symptoms outside the intestine due to the extraintestinal manifestations of the disease (e.g., joint pain, skin problems, liver problems).  Some patients also suffer from complications of Crohn's disease such as fistulas and strictures of the bowel. Crohn's disease is diagnosed by colonoscopy and histological findings. In some patients, MR enterography is also required to diagnose and follow up the disease.

The exact cause of this complex disease remains unknown. The most widely accepted theory is that the cause is multifactorial, involving genetic predisposition, barrier defects of the gut, dysregulated immune responses and environmental factors. In short, Crohn's disease is the result of an inappropriate immune system response against normal gut flora in genetically predisposed individuals.

The incidence of Crohn's disease has increased dramatically in recent years. This increase is evident in developing countries where Western lifestyle begin to have a significant impact. Thus, it is thought that a western lifestyle has an impact on the incidence of IBD.

The goal of treatment is to achieve remission without symptoms and endoscopic activity, and to prevent new flare-ups and complications such as fistula and strictures. Treatments for Crohn's disease include steroids, immunosuppressants such as azathioprine and advanced therapies, being biologic therapies (e.g. infliximab, adalimumab, vedolizumab, ustekinumab). In some patients, surgery is required.

Outside of this treatment, an active lifestyle and healthy diet with plenty of fruits and vegetables is still recommended. Patients with strictures of the bowel are the exception here, in these patients a high consumption of fiber is not recommended.

Currently, many new treatments are being tested and the treatment options will only increase in the future.