Do you suffer from chronic diarrhea? Diarrhea is quite a common symptom – almost all of us have experienced it at some time in our lives. However, there’s a subset of people, mostly young, who suffer from chronic diarrhea which might actually be caused by Crohn’s Disease. They may not even know it! What is Crohn’s Disease Crohn’s Disease is an auto-immune disorder of the gastrointestinal (GI) system -- which means that the body produces specific proteins that it erroneously regards as foreign and attacks the lining of the digestive tract. This creates little ulcerations, causing it to occasionally bleed. It can affect the GI lining from mouth to anus, commonly including both the small and large intestines. Crohn’s is often genetic and occurs in those with a family history of it. Symptoms of Crohn’s Disease Symptoms of Crohn’s Disease often appear in adolescence or in the 20’s – it’s often the young people that doctors think of when diagnosing Crohn’s. Because Crohn’s Disease attacks the GI tract, the symptoms are often related to the digestive system: Diarrhea Abdominal pain Bloody stools Fatty droplets in stool Fistulas (little “tunnels” between the colon and other organs nearby, such as the bladder) Anal fissures (small superficial openings on the surface of the anus) Recurrent oral ulcers Anemia (from bleeding) Vitamin B12 deficiency (from abnormal absorption in the gut) The proteins that attack the GI tract can also attack other organs, and therefore can cause: Arthritis Eye redness Liver disease Skin rashes As well as general symptoms such as: Fatigue Weight loss Fever What Else Could It Be? When first seeing patients with similar symptoms, doctors need to make sure it’s not something else that can mimic Crohn’s. Because of the overlap in symptoms, patients with Crohn’s can often be misdiagnosed with the following disorders: Ulcerative Colitis: Both Crohn’s and Ulcerative Colitis fall under the heading of “Inflammatory Bowel Disease” (IBD), in which the GI lining is inflamed However, Ulcerative Colitis occurs only in colon, and not in the small intestine as it does in Crohn’s. Bloody diarrhea is also much more common in Ulcerative Colitis, as is cancer of the colon, unfortunately. Lactose Intolerance: Patients with lactose intolerance often experience diarrhea after eating dairy. Make sure to listen to my previous podcast on lactose intolerance to learn more. Irritable Bowel Syndrome (IBS): Those with IBS also battle chronic diarrhea, however it is often alternating with constipation. The colonoscopy in patients with IBS often comes back normal. How to Test for Crohn’s Disease Doctors often run a routine blood test while investigating for Crohn’s, including a test for anemia. In addition, a stool test to check for bleeding may be considered, since microscopic bleeding may occur that is not visible to the eye. The mainstay of the diagnosis, however, is endoscopy. An endoscopy is a procedure in which a doctor inserts a camera into the GI tract (via the mouth or the rectum) and biopsies the lining of the intestinal tract to confirm the diagnosis. A diagnosis may entail having a colonoscopy, upper endoscopy, or capsule endoscopy of the small intestines. Treatment of Crohn’s Disease Crohn’s Disease is often a recurrent disease, unfortunately.Only up to 20% have a remission after the very first episode. So for many people, these are flare ups that come and go throughout their lives. Crohn’s can be treated in various ways: Decrease the Inflammation: Certain medications that calm down the immune system and steroids are often used to reduce the inflammation in the GI tract. Kill the bacteria in the gut: Antibiotics are often prescribed during flare ups to calm down the GI tract as well. Surgery: As many as 80% of those with Crohn’s Disease unfortunately end up requiring surgery of the intestine at some point in their lives. This means cutting out a specific segment of the intestines, or what’s called an “bowel resection.” Avoid smoking: Smoking has been shown to exacerbate Crohn’s Disease. Avoid anti-inflammatory drugs: Medications such as ibuprofen seem to worsen symptoms since they can further irritate the lining of the GI tract. Resources for Crohn’s Disease http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001295/ http://www.ccfa.org/info/about/crohns http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/ Source
