What is it, symptoms and treatment

By Cara Murez HealthDay Reporter

MONDAY, May 8, 2023 (HealthDay News) — Crohn’s disease, a type of inflammatory bowel disease, has no cure. But there are many treatments, specific to the type, and it is possible to control the symptoms.

A gastroenterologist offers some advice to newly diagnosed people.

“It is important to get a proper diagnosis and see an experienced inflammatory bowel disease (IBD) provider, preferably at a center that specializes in the management of these conditions,” said Dr Matthew Coateswho treats diseases of the digestive system at Penn State Health Milton S. Hershey Medical Center.

Crohn’s disease and ulcerative colitis are two types of IBD, diseases involving chronic inflammation of the gastrointestinal tract.

Crohn’s disease is caused by an overactive immune system. Cases are on the rise, but it’s unclear if that’s because doctors are getting better at diagnosing it or if environment and diet play a role.

“There is a genetic component, but genetics alone does not mean you will develop IBD,” Coates said in a press release from Penn State Health. “It takes some type of genetic background mixed with environmental exposure, such as an infection or change in the microbiome – or the fungi, bacteria, and viruses that reside in the gastrointestinal tract.”

Crohn’s disease usually begins in young people. Early symptoms may include abdominal pain, diarrhea, weight loss, and fatigue. Affected individuals may have nutritional deficiencies. They may feel anxious or depressed.

Continued inflammation can lead to narrowing of the intestine which makes it difficult for food to pass. People with Crohn’s disease can also have abscesses and fistulas, which are abnormal connections between diseased areas and other parts of the body, Coates explained.

Other symptoms may include skin rashes and eye or joint problems.

“A big part of our strategy is focused on disease control and managing disease activity and the complications it is known to cause,” Coates said.

Symptoms mimic many conditions, so it can be difficult to identify Crohn’s disease.

“Diagnosis is usually based on a mix of symptoms, clinical findings on examination, and results of stool tests, blood tests, endoscopies, and imaging,” Coates said.

Treatments usually consist of calming the immune system. They can include pills called immunomodulators or small molecules, and infusions or injections called biologics.

“There are a wide variety of treatments, which is why it’s so important to make sure your doctor carefully diagnoses and characterizes the type of Crohn’s disease you have, including the location, severity, and types of complications,” Coates said.

Small molecules target particular aspects of the immune system and are among the newest treatments. The United States Food and Drug Administration has approved them for ulcerative colitis. They are being studied for Crohn’s disease.

“This is a large area of ​​active investigation, and there are a large number of drugs in the works that will likely be approved in the years to come,” Coates said.

Diet can also help relieve symptoms.

Evidence suggests that something called a low-FODMAP diet may make IBD patients in remission less symptomatic, Coates said. FODMAP is an acronym for fermentable sugars found in many types of fruit and artificial sweeteners. The small intestine absorbs them poorly.

Studies have not proven that one diet is superior to another. Some eat whole or unprocessed foods well.

Coates said patients should feel encouraged by the possibility of living a normal, healthy life after receiving appropriate therapy.

“We have drugs that work in different ways and more therapies available to us today than ever before,” he said. “These give more people the ability to take control of their disease process.”

SOURCE: Penn State Health, press release, May 4, 2023

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