- Crohn’s disease is a chronic, inflammatory bowel disease (IBD) that causes inflammation of the gastrointestinal (GI) tract. It can affect any part of the digestive system, from the mouth to the anus, but most commonly involves the end of the small intestine (ileum) and the beginning of the colon.
- Unlike ulcerative colitis, which is limited to the colon and affects only the inner lining of the bowel, Crohn’s disease can impact the full thickness of the intestinal wall and occur in “patches,” with areas of healthy tissue in between inflamed segments. This can lead to a wide range of gastrointestinal and systemic symptoms, often varying in severity and progression.
- The exact cause of Crohn’s disease is not fully understood, but it is believed to involve a combination of genetic, environmental, immune, and microbial factors. Individuals with a family history of Crohn’s disease are at increased risk, and several genetic mutations—particularly in the NOD2 gene—have been linked to disease susceptibility. Environmental factors such as smoking, diet, gut microbiota imbalances, and early life exposures may also contribute. Crohn’s is considered an autoimmune condition in which the immune system mistakenly attacks the gastrointestinal tract, leading to chronic inflammation and tissue damage.
- Symptoms of Crohn’s disease can be highly variable, depending on the location and severity of inflammation. Common symptoms include abdominal pain and cramping, chronic diarrhea, fatigue, weight loss, loss of appetite, and fever. Inflammation may cause ulcers, strictures (narrowing of the bowel), fistulas (abnormal connections between organs), and abscesses. In children and adolescents, Crohn’s disease can interfere with growth and development. In addition to gastrointestinal symptoms, patients may experience extraintestinal manifestations, such as joint pain, skin rashes, eye inflammation, and liver disorders, highlighting the systemic nature of the disease.
- Diagnosis of Crohn’s disease involves a combination of medical history, physical examination, laboratory tests (including markers of inflammation such as CRP and fecal calprotectin), endoscopy, colonoscopy with biopsy, and imaging studies like CT or MRI enterography. These tools help assess the extent of disease, rule out other conditions, and guide treatment decisions.
- There is currently no cure for Crohn’s disease, but a variety of treatments aim to reduce inflammation, manage symptoms, and maintain long-term remission. Medications commonly used include aminosalicylates, corticosteroids, immunomodulators (such as azathioprine or methotrexate), and biologic therapies that target specific immune pathways, such as anti-TNF agents (infliximab, adalimumab), anti-integrins, or IL-12/23 inhibitors. In recent years, small-molecule drugs such as Janus kinase (JAK) inhibitors have also emerged as therapeutic options. Nutritional support, including special diets or enteral nutrition, may be needed, especially in pediatric patients or during active flare-ups.
- Surgical intervention becomes necessary in many cases, especially when complications such as strictures, fistulas, or bowel obstruction arise. However, surgery is not a cure and is typically followed by continued medical therapy to prevent recurrence. Long-term management focuses on monitoring disease activity, preventing flare-ups, and addressing quality-of-life issues through a multidisciplinary approach involving gastroenterologists, dietitians, mental health professionals, and sometimes surgeons.
