What is Crohn's disease?
Crohn's disease (CD) is a type of inflammatory bowel disease (IBD). CD is a condition that causes inflammation in your gastrointestinal (GI) tract. Inflammation is when part of your body gets red, swollen and painful. When you have CD, all of the body parts that deal with processing what you eat from the time food goes into your mouth to the time it comes out of the other end can become inflamed.
The other main type of IBD is called ulcerative colitis (UC). CD and UC are very similar, but not exactly the same. In UC, inflammation only happens in the bowel (also called the large intestine or colon). Your doctor will ask you questions and do certain tests to determine if you have CD or UC and will suggest treatments based on which form of IBD you have. You can get either type of IBD at any age. There are over 5,900 children under 18 years old in Canada with IBD right now.
When it is too difficult to tell whether a patient has CD or UC, their IBD is classified as IBD-U. The "U" stands for unclassified; IBD-U may also be called indeterminate colitis.
Where does Crohn's disease happen?
CD can occur anywhere along the GI tract, from the mouth to anus. This means that parts of your child's GI tract can be healthy while other parts are inflamed. The walls of the inflamed area thicken and develop a cobblestone-like surface. Knowing where your child has inflammation can help you, your child and their doctor to understand your child's symptoms and choose the right treatment.
What does Crohn's disease feel like?
What does Crohn's disease feel like? Someone with CD can have many different symptoms, like stomach pain, vomiting, loss of appetite and even fevers. They may also experience diarrhea (which can be bloody), weight loss, poor growth, mouth ulcers, rashes, joint pain and/or eye redness. Some people may have just a few of these symptoms, while other people may experience them all.
Some people may have inflammation in the anus, which could cause fissures (fiz-urs) and fistulae (fist-u-lay). Fissures are like small tears inside the anus. Fistulae are like little tunnels that connect your colon to other areas of your body that they are normally not connected to. If a fistula forms between your bowel and the skin around the anus, you may have some fluid leaking from time to time. This might make it uncomfortable to sit down. A fistula may also connect to tissues around the anus, which can become infected. This is called an abscess (ab-ses), and it can be painful.
CD is a chronic condition; this means that it is for life. Although there is currently no cure, there are a lot of treatment options. When you find one that helps to keep your child's CD under control, they can be in remission (that means "symptom-free") for a long time.
What causes Crohn's Disease
Even though there have been many scientific studies, researchers do not know what causes CD. They do know that it can run in families. You are more likely to get CD if you have a first degree relative, like a brother or sister, who has it. You are even more likely to get it if that brother or sister is your identical twin. Anyone can get CD at any age. In children and teens, it occurs slightly more often in boys than in girls.
Researchers think CD is caused by a combination of three things.
- Genetics: Some people may have genes in their body that increase their chances of getting CD. Studies have shown that there are over 30 genes that may be linked with IBD.
- Environment: Our environment includes anything our body comes in contact with. Infections and food are the most common types of environmental "triggers" that may contribute to disease, but there may be others.
- Immune system: Our immune system protects us from harmful bacteria and viruses, but in some people, it can cause inflammation in the body (like in the GI tract).
What kinds of treatments are there for Crohn's Disease?
There are six classes of medicines used to treat the symptoms of CD. These medicines can come in pills, liquids, intravenously and in a suppository or enema. Check with your child's healthcare provider to learn more about their medications.
- 5-aminosalicylic acid (5-ASA): Used for milder forms of CD, 5-ASA decreases inflammation in the intestinal tract. It can be taken orally (by mouth) or rectally.
- Immunomodulators: Used for long-term treatment, these drugs work by suppressing the immune system to help reduce inflammation. Immunomodulators may also help patients stay in remission. They are not intended for acute flare-ups. Immunomodulators are given orally or by injection.
- Steroids: These drugs are used for moderate-to-severe CD for a short period of time to help decrease the amount of inflammation in the body. They can be taken orally, intravenously or rectally.
- Antibiotics: Antibiotics are generally effective for CD patients with an abscess, a fistula or an infection. They can be given orally or intravenously.
- Enteral nutrition: Enteral nutrition, used for short- or long-term treatment, can help rehabilitate patients who are malnourished because of their CD. It is also helpful for those who have small bowel disease. It can be given orally or by a nasogastric tube.
- Biologics: These drugs inhibit specific substances in the body to reduce inflammation. They are often administered intravenously.