Crohn's Disease Symptoms Vary Widely Among Individuals

by William Tremaine, M.D., Gastroenterology and Hepatology

Crohn's disease is an inflammatory bowel disease that causes inflammation of the lining in the digestive tract. Anyone can get Crohn's disease but it develops more often in young people than in older adults. Most individuals who have Crohn's are diagnosed between the ages of 15 and 30. Evidence suggests that a hereditary component can be associated with the disease.

The exact cause of Crohn's disease isn't known. It would seem logical that a disease of the digestive tract would be affected by a person's diet. Yet, no foods have been proven to cause Crohn's disease, nor can any foods heal the damage caused by the condition. Stress may intensify symptoms, but researchers don't believe that stress causes Crohn's.

Genetics appear to play a role in development of the disease. So far, more than 30 different chromosomal areas have been associated with Crohn's. Researchers are looking into the role genetics has in the disease process.

The inflammation in the intestines caused by Crohn's disease can result in symptoms that include diarrhea, abdominal pain and cramping, blood in the stool, ulcers and fatigue. Crohn's may also result in reduced appetite and weight loss due to abdominal pain.

The disease's symptoms can range from mild to severe, and they may come and go. Your grandson could have long periods without any signs of the disease, or he might have frequent episodes of troublesome symptoms. Because the disease varies widely from one person to another, predicting how often someone will experience Crohn's-related symptoms or the severity of symptoms is impossible.

Currently, no cure exists for Crohn's disease. The goal of your grandson's treatment should be to reduce the inflammation that triggers his symptoms. Many medications that control inflammation can be used to treat Crohn's, including anti-inflammatory drugs, antibiotics, steroids, immune system suppressors and biological agents. Depending on your grandson's situation, his physician might prescribe medications targeted specifically at decreasing his symptoms, such as anti-diarrheal medication, laxatives and pain relievers.

Despite medical treatment, about 70 percent of patients with Crohn's disease eventually require surgery to remove a segment of intestine that is causing symptoms. The surgeon removes the damaged portion of the digestive tract and reconnects the healthy sections. But even surgery can't provide a cure for Crohn's, and any benefits of surgery are only temporary. The disease often recurs, frequently near the reconnected bowel or elsewhere in the digestive tract. Many people with Crohn's disease require multiple surgeries. Often, the best approach is to follow surgery with medication to minimize the risk of recurrent symptoms.

Dealing with a chronic condition such as Crohn's disease can be challenging, but your grandson can take steps that may make it easier for him to cope.

First, he should work closely with his physician to make sure he understands what medications to take and how often to take them. He should also be in contact with his physician regularly, so the physician knows that medications are being taken as prescribed, and, if necessary, changes can be made.

Second, no firm evidence indicates that a person's diet can cause Crohn's disease, but certain foods and beverages can aggravate its signs and symptoms. Dairy products, high-fat, high-fiber or spicy foods, and food and drinks containing caffeine can cause problems for people with Crohn's disease. For guidance on his diet, your grandson may also want to talk with a registered dietitian.

Third, if your grandson smokes, encourage him to stop. Smoking makes Crohn's disease worse. If he doesn't think he can stop on his own, he should ask the doctor about medicines and other measures to help him stop smoking.

Finally, it helps to be well informed. I recommend that people with Crohn's and their families learn as much as possible about the disease. On the Web, Mayo Clinic (www.mayoclinic.com) has accurate information. The Crohn's and Colitis Foundation of America (www.ccfa.org or 1-800-932-2423 toll-free) is also a reliable resource.

-- William Tremaine, M.D., Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn.

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care.

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