Am Fam Physician. 2003;68(4):717-718
What is Crohn's disease?
Crohn's disease causes ulcers to form in the gastrointestinal (GI) tract anywhere from the mouth to the anus. Symptoms include stomach cramps and pain that comes and goes, diarrhea, and blood in your stool. Other symptoms include weight loss, nausea, joint pain, and feeling tired. Some people with Crohn's disease have severe symptoms, while others have less severe symptoms. Some people with the disease have long periods without symptoms, even without needing treatment. Others with more severe disease will need long-term treatment or even surgery.
Who gets Crohn's disease?
Almost 500,000 people in the United States have Crohn's disease. Anyone can get Crohn's disease, but it's more common in women, whites, and Jewish people. It is not known what causes Crohn's disease. It seems to run in families, but there is no known pattern of inheritance.
How can my doctor tell if I have Crohn's disease?
If your doctor thinks you may have Crohn's disease, he or she will ask you about your symptoms and do a complete exam to look for signs of the illness. If your symptoms and exam findings suggest that you may have Crohn's disease, your doctor may do some blood work. While no blood test can prove you have Crohn's disease, your blood might show anemia, salt imbalance, vitamin deficiency, or increased signs of inflammation. Your doctor also may order special x-rays or a procedure called endoscopy, which lets your doctor look at your colon or stomach to check for ulcers.
How is Crohn's disease treated?
The treatment of Crohn's disease depends on how bad it is and where it is in your GI tract. When the disease is mild, medicines called salicylates may help. Sulfasalazine (brand name: Azulfidine) and mesalamine (brand name: Rowasa) are the most common salicylates. Antibiotics such as metronidazole (brand name: Flagyl) and ciprofloxacin (brand name: Cipro) are also used to treat mild Crohn's disease.
Steroids are generally used for persons with more severe disease. In more aggressive disease, steroids may be used with immunosuppressants, or with a newer medicine called infliximab (brand name: Remicade). If you have very severe disease, you may need to stay in the hospital. Sometimes, surgery is needed, but it does not cure the disease.
What can I expect after treatment?
The success of treatment for Crohn's disease varies. While there is no known cure for the illness, many people have long periods without symptoms. Your doctor will need to see you regularly to check for signs of active disease or any disease complications. People with long-term disease may become depressed or have other mood disorders. Your doctor will check you for these problems as well.
Where can I get more information?
Crohn's and Colitis Foundation of America
386 Park Avenue South, 17th Floor
New York, NY 10016-8804
Telephone: 1-800-932-2423 or 1-212-685-3440
In addition, you can visit the National Digestive Diseases Information Clearinghouse atwww.niddk.nih.gov/health/digest/pubs/crohns/crohns.htm.