Am Fam Physician. 2018;98(11):online
See related article on Crohn's disease
What is Crohn's disease?
It is a condition that causes long-term inflammation in the gastrointestinal (GI) tract. It can affect any part of the GI tract from mouth to anus. Crohn's disease usually happens in young adults, but it can also affect children and older adults. The exact cause of the disease is not known. It runs in families, so genetics may play a part.
What are the symptoms?
Common symptoms include diarrhea, stomach pain, weight loss, fever, fatigue, and bleeding from the rectum. Symptoms may be mild or severe. They can start suddenly or be more gradual, and can come and go. Patients with the disease can also have problems with their skin, joints, or eyes. Complications can include blockages of the GI tract, fistulas (abnormal passages from the GI tract to other organs), abscesses, anal fissures (tears), ulcers, and nutrition problems. Patients with Crohn's disease also have a higher risk of colon cancer.
How is it diagnosed?
The first step is a complete physical exam. Next, the doctor may order tests to sample blood and stool. Usually, the doctor will also order a test called a colonoscopy. During this procedure, a small flexible tube is used to look directly at the colon and ileum (parts of the GI tract) for signs of inflammation. The tube can also be used to take a sample (called a biopsy) of the GI tract to test for the disease. Imaging tests such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography are also used to help with diagnosis.
How is it treated?
The goal of treatment is to stop the symptoms and correct other problems the disease is causing. Medicines can help reduce inflammation and suppress the immune system. Antibiotics can help treat complications, and dietary supplements can help correct nutritional problems. When disease is severe, patients may need to go to the hospital for IV treatments or surgery. Because colon cancer is more common with Crohn's disease, screening may need to be done more often.
Usually, a team of doctors is used to treat Crohn's disease. The team may include a family physician, a gastroenterologist, and a surgeon.
Where can I get more information?
Your doctor
AAFP's Patient Information Resource
Crohn's & Colitis Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
U.S. National Library of Medicine
December 2018