“The inflammation caused by Crohn’s Disease often spreads deep into the layers of affected bowel tissue. Crohn’s disease can be both painful and debilitating, and sometimes may lead to life-threatening complications.” ~ Mayo Clinic
What is Crohn’s Disease?
Crohn’s disease is one of the most “underappreciated” diseases in existence. By “underappreciated,” we mean that many do not understand the severity or the difficulties it inflicts on those who suffer from the condition. (Should you have any doubts, ask someone with Crohn’s.)
Crohn’s disease is a potentially debilitating inflammatory disease of the gastrointestinal (GI) tract. Scientists do not know what causes Crohn’s, though speculation exists that point to a specific bacteria (called mycobacterium).
Crohn’s disease may not be as well-known as cancer or heart disease, but it can consume a person’s life just as much, if not more so. Crohn’s is a chronic inflammatory disease of the gastrointestinal (GI) tract. It most often affects the large and small bowels, though it can wreak havoc on any part of the GI tract.
Here are 14 things doctors want you to know about this disease.
1. There are flare and remission phases
Most people with Crohn’s disease cycle through flare-ups and remissions. Symptoms related to GI inflammation are at their worst during a Crohn’s flare-up. During a remission phase, Crohn’s sufferers feel pretty normal.
Common symptoms of a Crohn’s flare-up include:
- abdominal pain (which typically worsens after meals)
- painful bowel movements
- blood in stool
- weight loss
Crohn’s disease can also manifest in other ways, such as joint pain, eye inflammation, and skin lesions, says Aline Charabaty, M.D., director of the Center for Inflammatory Bowel Diseases at MedStar Georgetown University Hospital.
In 1932, Dr. Burrill Crohn and two colleagues presented a paper to the American Medical Association describing the details of what we now call Crohn’s disease. Since then, treatment options have evolved to include biologics, which are drugs made from living cells that are designed to target inflammation.
Inflammation is the core cause of Crohn’s disease’s symptoms and complications. When you’re in remission, your inflammation fades. When you’re experiencing a Crohn’s flare, your inflammation returns. While there is no cure for Crohn’s, the goal of treatment is to reduce inflammation to put the disease into remission, and to keep it there.
How biologics target inflammation
Tumor necrosis factor, or TNF, is a protein that induces inflammation as part of an immune system response. Anti-TNF biologics work by targeting this protein to reduce its inflammatory properties. If you take Remicade (infliximab), Humira (adalimumab), or Simponi (golimumab), you’re taking an anti-TNF biologic.
With Crohn’s disease, your immune system produces too many white blood cells, which trigger inflammation. Another way that biologics target inflammation is by addressing the issue of having too many white blood cells. Entyvio (vedolizumab) is an integrin blocker that works this way. Integrin blockers and selective adhesion molecule inhibitors (SAM) stop white blood cells from entering the stomach. This blocking action keeps the white blood cells away from the gut, where they would otherwise cause inflammation. In turn, this allows the area to heal.
Crohn’s disease is an autoimmune disorder that causes long-term irritation and swelling of the gastrointestinal (GI) tract. It is a type of inflammatory bowel disease (IBD). There’s no cure, but treatments are available to control inflammation and help prevent flare-ups.
In the past, powerful anti-inflammatory drugs called aminosalicylates (5-ASAs) and corticosteroids have traditionally been the first go-to options. Yet these treatments don’t target the specific immune system problems that lead to Crohn’s inflammation. That means they don’t always work well, and your symptoms could come back.
The good news is targeted therapy is now a realistic option for many patients with Crohn’s. Genetically engineered drugs called biologics are the newest class of Crohn’s drugs and are made from the products of living organisms, including proteins, genes, and antibodies. Biologics interfere with the IBD inflammatory response by targeting specific proteins that play a role in increasing or decreasing inflammation. Today, biologics like infliximab (Remicade) and the newly approved vedolizumab (Entyvio) are helping patients reach and remain in remission without steroids.
If you have Crohn’s, you might be wondering if a biologic might work for you. Here are four signs it might be time to give them a try.
The loss of control you feel during a Crohn’s flare can be one of the most frustrating parts of dealing with the condition. Some factors that lead to flares are out of your hands. But adopting healthy lifestyle habits and ridding your routine of the not-so-healthy ones can help you take back some of the power when it comes to managing Crohn’s.
Diet is a major issue in IBD, and patients have been telling doctors for years that certain foods trigger their flares. Interestingly enough, a study published in January 2016 in Inflammatory Bowel Diseases that assessed the dietary beliefs and habits of 400 IBD patients reported a high level of consistency around certain perceived triggers. Of the 39 percent of patients who had Crohn’s disease, and 58 percent who had ulcerative colitis, nearly half of them felt that diet could be the reason for IBD and 57 percent were convinced it could set off a flare.
I have Crohn’s disease. It’s not something I’m embarrassed to talk about, but it’s not something I like to put out there because, frankly, once I mention that I have Crohn’s disease to people who have a vague notion as to what it is, I’m pretty sure all they can think about for at least a while afterward is the idea of me pooping. Sure, everyone does it, but those of us with Crohn’s tend to do it a lot more, like plan-our-day-around-bathroom-accessibility a lot more or like build-an-extra-hour-into-our-schedules-to-accommodate-it a lot more. As you can imagine, this doesn’t make us a popular disease, and we’re often confused with our similarly bowel-distraught, equally sexy cousin, IBS (irritable bowel syndrome). But, whereas IBS is technically a “functional disorder” and doesn’t cause damage to the bowel, Crohn’s is an IBD (irritable bowel disease), and as such is an actual disease and far more serious.
I was only diagnosed with crohn’s five years ago. One day I was perfectly healthy, and then after a random bout of unrelated Bell’s Palsy that preceded a series of symptoms to stump nine specialists and put me through every test imaginable, I couldn’t walk. My knees locked, or, at least, that’s how it felt. Within a few days of that my hands furled, rendering them useless as well. I’d developed arthritis when I’d never before in my life experienced any joint pain. Because specialists kept thinking the Bell’s Palsy had been a trigger instead of a random occurrence, I became my own episode of House, and just like the show, it wasn’t Lupus.
To help ease my incredible pain and other symptoms (like migraines, nausea, vomiting, and the inability to keep things down), I was put on massive doses of Prednisone and even Methotrexate, an immunosuppressant taken for inflammation. While both drugs helped, the doctors still didn’t know what would cause an otherwise healthy adult to develop crippling arthritis entirely without warning. Eventually my rheumatologist happened to run a blood test for an inflammation marker typically associated with Crohn’s. When it came back positive, he sent me to a gastroenterologist, and after a colonoscopy and upper endoscopy, I was diagnosed with Crohn’s.
I am a full-time marketer for a corporate software company. It’s a great place, with amazing people. When I was hospitalized and then healing, they were so unbelievably supportive and understanding, which is hard to say for a lot of companies. My team surprised me by decorating my entire desk in Iron Man gear when I returned from getting my iron infusion.
If you have Crohn’s disease, you know it’s such a pain in the ass… literally.
Symptoms differ from person to person, but for the most part, you can expect to deal with:
1. Abdominal Cramping
5. Loud Intestinal Noise
So, how do you deal with the above while trying to live a “normal” life in the office? All of those symptoms make daily life pretty difficult, but there are ways to make it easier on yourself and those around you.
Flare-ups are a sudden reactivation of symptoms for people living with Crohn’s disease. A flare-up can cause active inflammation anywhere along the gastrointestinal tract with:
- mouth sores
- abdominal cramps
- rectal pain
- joint pain
Some possible causes of flares may include:
- smoking tobacco
- disruptions or changes in medication
- chronic stress
- nonsteroidal anti-inflammatory drugs
However, it’s important to note that research is often inconsistent on the precise cause of Crohn’s disease flares. Crohn’s is a complex condition, and scientists don’t fully understand it. Research is ongoing on how to predict flares. Multiple factors have been shown to play a role in the disease, including:
- healthy intestinal bacteria
- immune system health
- To help prevent flare-ups, you should take the medications recommended by your doctor regularly and as directed. You should also work with your doctor to create a treatment plan for flare-ups. Research suggests that treatment is most effective when focused on the specific symptoms and severity of the flare-up.
When doctors encounter a chronic disease, that’s where they tend to put their focus, such as trying to help an organ work more effectively or to reduce the severity of symptoms. For someone with arthritis, for instance, the focus may be on reducing pain and joint damage. For someone with heart disease, the main goal may be to ensure the heart receives steady blood flow and improves the person’s ability to walk around.
What often doesn’t get talked about is how to cope with the stress of living with a chronic disease. The discomfort and challenges of a chronic disease can be quite stressful, and this stress, in turn, can affect the severity of the disease. A study in the journal Frontline Gastroenterology, conducted by Swiss researchers, put a spotlight on this topic.