Topic Overview
What is Crohn's disease?
Crohn's disease is a
lifelong
inflammatory bowel disease (IBD). Parts of the
digestive system get swollen and have deep sores
called
ulcers. Crohn’s disease usually is found in the last
part of the small intestine and the first part of the large intestine. But it
can develop anywhere in the digestive tract, from the mouth to the anus.
What causes Crohn's disease?
Doctors don't know
what causes Crohn’s disease. You may get it when the body’s
immune system has an abnormal response to normal
bacteria in your intestine. Other kinds of bacteria and viruses may also play a
role in causing the disease.
Crohn’s disease can run in families.
Your chances of getting it are higher if a close family member has it. People
of Eastern European (Ashkenazi) Jewish family background may have a higher
chance of getting Crohn’s disease. Smoking also puts you at a higher risk for
the disease.
What are the symptoms?
The main symptoms of
Crohn’s disease are belly pain and diarrhea (sometimes with blood). Some people
may have diarrhea 10 to 20 times a day. Losing weight without trying is another
common sign. Less common symptoms include mouth sores, bowel blockages, anal
tears (fissures), and openings (fistulas) between organs.
Infections,
hormonal changes, and smoking can cause your symptoms to flare up. You
may have only mild symptoms or go for long periods of time without any
symptoms. A few people have ongoing, severe symptoms.
It’s
important to be aware of signs that Crohn’s disease may be getting worse. Call
your doctor right away if you have any of these signs:
- You feel faint or have a fast and weak
pulse.
- You have severe belly pain.
- You have a fever or
shaking chills.
- You are vomiting again and again.
How is Crohn's disease diagnosed?
Your doctor will
ask you about your symptoms and do a physical exam. You may also have X-rays
and lab tests to find out if you have Crohn’s.
Tests that may be
done to diagnose Crohn's disease include:
- Barium X-rays of the small intestine or
colon.
- Colonoscopy or flexible sigmoidoscopy.
In these tests, the doctor uses a thin, lighted tube to look inside the colon.
- Biopsy. The doctor takes a sample of tissue and tests
it to find out if you have Crohn’s or another disease, such as
cancer.
- Stool analysis. This is a test to look for blood and signs
of infection in a sample of your stool.
How is it treated?
Your treatment will depend on
the type of symptoms you have and how bad they are.
There are a few steps you can take
to help yourself feel better. Take your medicine just as your doctor tells you
to. Exercise, and eat healthy meals. Don't smoke. Smoking makes Crohn’s disease
worse.
The most
common treatment for Crohn’s disease is medicine. Mild symptoms of Crohn's
disease may be treated with over-the-counter medicines to stop diarrhea. But
talk with your doctor before you take them, because they may cause side effects.
You may also use prescription medicines. They help control
inflammation in the intestines and keep the disease from causing symptoms.
(When you don't have symptoms, you are in
remission.) These medicines also help heal damaged
tissue and can postpone the need for surgery.
Crohn’s disease makes it hard for your body to absorb
nutrients from food. A meal plan that focuses on high-calorie, high-protein
foods can help you get the nutrients you need. Eating this way may be easier if
you have regular meals plus two or three snacks each day.
How do you cope with Crohn's disease?
Having
Crohn’s disease can be stressful. The disease affects every part of your life.
Seek support from family and friends to help you cope. Get counseling if you
need it.
Many people with inflammatory bowel diseases look to
alternative treatments to improve their well-being.
These treatments have not been proved effective for Crohn’s disease, but they
may help you cope. They include massage, supplements such as vitamins D and
B12, and herbs like aloe and ginseng.
Frequently Asked Questions
Learning about Crohn's disease: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Cause
The cause of
Crohn's disease is unknown. This disease may result from an
abnormal response by the body's
immune system to normal intestinal bacteria.1 Disease-causing bacteria and viruses also may play a role.
Crohn's disease can run in families, so
some people may be more likely than others to develop the condition when
exposed to something that triggers an immune reaction. Environmental factors
may also play a role in causing this disease.
Symptoms
The main symptoms of
Crohn's disease include:
- Abdominal pain. The pain often is described as
cramping and intermittent, and the abdomen may be sore when touched. Abdominal
pain may turn to a dull, constant ache as the condition
progresses.
- Diarrhea. Some people may have diarrhea 10 to 20 times
a day. They may wake up at night and need to go to the bathroom. Crohn's
disease may cause blood in stools, but not always.
- Loss of
appetite.
- Fever. In severe cases, fever or other symptoms that
affect the entire body may develop. A high fever may mean that you have a
complication involving infection, such as an
abscess.
- Weight loss. Ongoing symptoms,
such as diarrhea, can lead to weight loss.
- Too few red blood cells
(anemia). Some people with Crohn's disease develop
anemia because of low iron levels caused by bloody stools or the intestinal
inflammation itself.
People with Crohn's disease also may have:
- Sores in the mouth.
- Nutritional
deficiencies, such as lowered levels of vitamin B12, folic acid, iron, and
fat-soluble vitamins, because the intestines may not be able to absorb
nutrients from food.
- Bowel obstruction.
- Signs of
disease in or around the
anus. These may include:
- Abnormal tunnels or openings called
fistulas that sometimes form between organs. These
develop because Crohn's disease causes inflammation and ulcers in the deep
layers of the intestinal wall.
Fistulas may form between parts of the intestine or
between the intestine and another organ such as the bladder, vagina, or skin. A
fistula may be the
first sign of Crohn's disease.
- Pockets of infection (abscesses).
- Small tears in the anus (anal fissures).
- Skin tags that may resemble
hemorrhoids. These are caused by inflamed skin.
Because there is some immune system involvement, you also
may have symptoms outside the digestive tract, such as
joint pain, eye problems, a skin rash, or liver disease.
Other conditions with symptoms similar to Crohn's disease include
diverticulitis and
ulcerative colitis.
What Happens
Crohn's disease
is an ongoing (chronic) condition that may flare up throughout your life. The
course of the disease varies greatly from one person to another. Some people
may have only mild symptoms, while others may have severe symptoms or
complications that, in unusual cases, may be life-threatening.
Crohn's disease may be mild, moderate, severe, or not
active (in
remission). It may be defined by the part of the
digestive tract involved, such as the rectum and anus (perianal disease) or the
area where the small intestine joins the large intestine (ileocecal disease).
Some people may have features of both Crohn's disease and
ulcerative colitis, the other major type of
inflammatory bowel disease (IBD).
Crohn's disease can cause symptoms outside the digestive tract, such as joint pain, eye
problems, a skin rash, or liver disease.
Because Crohn's disease can cause inflammation in parts
of the intestines that absorb nutrients from food, it can cause deficiencies in
vitamin B12, folic acid, or other nutrients. The disease can increase the risk
of
gallstones,
kidney stones, and certain uncommon forms of
anemia.
In long-term Crohn's disease,
scar tissue may replace some of the inflamed or ulcerated intestines, forming
blockages (bowel obstructions) or narrowed areas (strictures) that can prevent
stool from passing through the intestines. Blockages in the intestines also can
be caused by inflammation and swelling, which may improve with medicines.
Sometimes blockages can only be treated with surgery.
If sores
break through the wall of the intestines, abnormal connections or openings
(fistulas) may develop between two parts of the
intestines, between the intestines and other organs (such as the bladder or
vagina), or between the intestines and the skin. In rare cases, this can lead
to infection of the abdominal wall.
Crohn's disease of the colon
and rectum that has been present for 8 years or longer increases the
risk of cancer. With regular screening, some cancers can be
detected early and treated successfully.
Most women who have
Crohn's disease can have a normal pregnancy and deliver a healthy baby. The best idea is to wait until the disease is in remission before becoming pregnant. Women who become pregnant when their disease is under control are more likely to avoid flare-ups during pregnancy. Some medicines used to treat the disease
can be used during pregnancy.
What Increases Your Risk
Factors that may increase your
risk of developing
Crohn's disease include:
- Having a family history of Crohn's disease.
Your risk increases if an immediate family member, such as a parent, brother,
or sister, has the disease.
- Having Ashkenazi Jewish
ancestry.
- Smoking cigarettes.
Factors that may cause Crohn's disease symptoms to flare up
include:
- Medicines.
- Infections.
- Hormonal
changes.
- Lifestyle changes.
- Smoking.
When To Call a Doctor
Call a doctor immediately if you have been diagnosed with
Crohn's disease and you have one or more of the
following:
- Fever or shaking
chills
- Lightheadedness, passing out, or rapid heart
rate
- Stools that are almost always bloody
- Severe
dehydration
- Severe abdominal pain or
severe pain and bloating
- Evidence of pus draining from the area
around the anus or pain and swelling in the anal area
- Repeated
vomiting
- Not passing any stools or gas
If you have any of these symptoms and you have been
diagnosed with Crohn's disease, your condition may have become significantly
worse. Some of these symptoms also may be signs of
toxic megacolon, a rare complication of Crohn's
disease that requires emergency treatment. Untreated toxic megacolon can cause
the colon to leak or rupture, which can be fatal.
People who have
Crohn's disease usually know their normal pattern of symptoms. Call your doctor
if there is a change in your usual symptoms or if:
- Your symptoms become significantly worse than
usual.
- You have persistent diarrhea for more than 2
weeks.
- You have lost weight.
Watchful Waiting
Watchful waiting is a period of time during
which you and your doctor observe your symptoms or condition without using
medical treatment. Watchful waiting is not appropriate when you have any of the
above symptoms. If your symptoms are caused by Crohn's disease, delaying the
diagnosis and treatment may make the disease worse and increase your risk of
complications.
Even when the disease is not active (in remission),
your doctor will want to see you regularly to check for complications, some of
which can be hard to detect. It is always appropriate to call your doctor's
office for advice.
Who To See
The following doctors can diagnose most cases of Crohn's disease:
To help you manage Crohn's disease, you will probably be
referred to a
gastroenterologist.
To be evaluated for surgery, you may be referred to a:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Crohn's disease
is diagnosed through a
medical history and physical exam, imaging tests to
look at the intestines, and laboratory tests.
Crohn's disease can
be difficult to diagnose. The disease may go undiagnosed for years because
symptoms usually develop gradually and the same part of the intestine is not
always involved. Other diseases can also have the same symptoms as Crohn's
disease. But Crohn's disease tends to cause the intestine to have a cobblestone
appearance, which can help doctors diagnose it. The pattern results from the
repeated formation and healing of sores (ulcers) in the intestine.
Tests used to diagnose Crohn's disease include:
- Flexible sigmoidoscopy or
colonoscopy, in which a lighted viewing instrument is
used to look at the inside of the colon. In general, colonoscopy is the
preferred test because it can be used to examine the entire colon.
Sigmoidoscopy reaches only the last
part of the colon.
- Abdominal X-ray, which provides a picture of possible obstruction in the
abdomen.
- Upper gastrointestinal (UGI) series
with small-bowel follow-through to examine all of the small intestine. In this
test the doctor examines the upper and part of the middle portions of the
digestive tract. After you swallow a "shake" made of a white liquid (barium)
and water, continuous X-rays (fluoroscopy) are taken to track the
movement of the barium through the esophagus, stomach, and the small intestine.
A video monitor displays the images.
- Upper gastrointestinal endoscopy, which allows your doctor to look at the
interior lining of your esophagus, stomach, and duodenum with a thin, flexible
imaging instrument called an endoscope.
- Barium enema, a test that allows the doctor to examine the large intestine
(colon). For a barium enema, a white liquid (barium) is inserted through the
rectum into the colon. The barium outlines the inside of the colon so that it
can be more clearly seen on an X-ray.
- Computed tomography (CT) scan, which uses
X-rays to produce detailed pictures of structures
inside the body. A CT enterography may be done. This type of CT scan looks specifically at your small intestine for signs of Crohn's disease.
- Magnetic resonance imaging (MRI), which
uses a magnetic field and pulses of radio wave energy to provide pictures of
organs and structures inside the body.
- Standard blood tests and urine tests, which may be used to check
for
anemia, inflammation, or malnutrition. Depending on
the symptoms, an
erythrocyte sedimentation rate (ESR, or sed rate) or
C-reactive protein (CRP) blood test may be done to
look for infection or inflammation.
A
biopsy of a sample of tissue from the lining of the
intestine, collected during sigmoidoscopy or colonoscopy, can be used to
confirm the diagnosis of Crohn's disease. A biopsy also may be done to find out
whether a tumor is present. Multiple biopsies for cancer screening are often
done in people who have had Crohn's disease of the colon or rectum for 8 years or more. Bowel biopsies are painless (other than the potential discomfort
of the scope procedure) and remove only a tiny piece of tissue.
A
stool analysis is often done, depending on symptoms,
to look for blood, signs of bacterial infection, malabsorption, parasites, or
the presence of white blood cells. This test can be used to distinguish Crohn's
disease from
irritable bowel syndrome (IBS), which is a less
serious condition that sometimes has similar symptoms.
Other exams and tests that may also be used to
evaluate Crohn's disease include:
- Video capsule endoscopy (VCE), in which you swallow a
tiny camera that records its trip through your digestive tract by sending
images to a recording device that you wear on a belt. Your doctor later
examines the images by downloading them from the recording device. The camera
passes out of your body in stool within 10 to 48 hours. VCE is particularly
useful in examining the small intestine, which is difficult to see with other
endoscopic tests.
- Small bowel enteroscopy, which uses a longer, lighted flexible
tube with a tiny camera that sends pictures of the small intestine to a video
screen. This helps the doctor look at the small intestine. The doctor can also
take small samples (biopsy) of the tissue.
- Blood tests to find antibodies, which can sometimes help the doctor tell if you have Crohn's disease or ulcerative colitis. These tests include anti-neutrophil cytoplasmic antibody with perinuclear staining (pANCA), anti-Saccharomyces cerevisiae antibody (ASCA), and outer membrane porin C (Omp C).
Early Detection
No screening test exists for Crohn's disease at
this time. But if you have had Crohn's disease affecting the colon or rectum
for 8 years or longer, discuss with your doctor whether you need
screening for colon cancer. Screening usually involves taking multiple-tissue
biopsies during routine colonoscopy.
Treatment Overview
The main treatment for
Crohn's disease is medicine to stop the inflammation
in the intestine and medicine to prevent flare-ups and keep you in
remission. A few people have severe, persistent
symptoms or complications that may require a stronger medicine, a combination
of medicines, or surgery. The type of symptoms you have and how bad they are
will determine the treatment you need.
Initial treatment
Your doctor will most likely
start with the traditional first-line treatment for
Crohn's disease. He or she will then add or change
medicines if you are not getting better.
Mild symptoms may respond to an
antidiarrheal medicine such as loperamide (Imodium, for example), which slows or stops the painful spasms in your intestines
that cause symptoms.
For mild to moderate symptoms, your doctor will probably have you take:
- Aminosalicylates (such as sulfasalazine
or mesalamine). These medicines help manage symptoms for many people who have
Crohn's disease.
- Antibiotics (such as ciprofloxacin or metronidazole). These may be tried if aminosalicylates are not helping. They are also used to treat fistulas and abscesses.
- Corticosteroids (such as budesonide or prednisone).
These may be given by mouth for a few weeks or months to control inflammation.
But corticosteroids have serious side effects, such as high blood pressure,
osteoporosis, and increased risk of infection.
- Medicines that suppress the
immune system (called
immunomodulator medicines), such as azathioprine or mercaptopurine. You may take these if the
medicines listed above do not work, if your symptoms come back when you stop
taking corticosteroids, or if your symptoms come back often, even with
treatment.
- Biologics (such as
infliximab or adalimumab). Your doctor may have you try these medicines if you have
not had success with other medicines for Crohn's disease. In some cases, these
medicines are tried before some of the other medicines that are listed above.
They are also used to treat fistulas.
Severe symptoms may be treated
with corticosteroids given through a vein (intravenous, IV) or biologics.
With severe symptoms, the first step is to control the disease. When your
symptoms are gone, your doctor will probably have you start taking one of the
medicines listed above to keep you symptom-free (in remission).
Ongoing treatment
Ongoing treatment is designed to
find a medicine or combination of medicines that keeps
Crohn's disease in remission.
If
aminosalicylates or immune system
suppressors keep your disease in remission, you will continue taking the
medicines. Your doctor will want to see you about every 6 months if your
condition is stable or more frequently if you have flare-ups. You may have
lab tests every 2 to 3 months.
Corticosteroids may be given to stop inflammation if
you have flare-ups of symptoms. If you need to take corticosteroids for an
extended time, you also may receive calcium, vitamin D, and prescription
medicine to prevent
osteoporosis.
Biologics are also used
as maintenance medicines.
Treatment if the condition gets worse
If you
have a very bad flare-up of Crohn's disease, you will most likely need IV
corticosteroids (like hydrocortisone) to get the disease under control.
Some severe cases of Crohn's disease need to be treated in the hospital
where you would receive
supplemental nutrition through a tube placed in your
nose and down into the stomach (enteral nutrition). In other cases, the bowel
may need to rest, and you will be fed liquid nutrients in a vein (total
parenteral nutrition, TPN). Supplemental nutrition may be needed if you are
malnourished because of severe Crohn's disease in the small intestine.
Nutritional support is especially important for children who are not growing
normally because of severe disease.
Surgery may be needed if no
medicine is effective, if you have serious side effects from medicine, if your
symptoms can be controlled only with long-term use of corticosteroids, or if
you develop complications such as fistulas, abscesses, or bowel obstructions.
Surgery involves removing the affected portion of the intestines, preserving as
much of the intestines as possible to maintain normal function. Crohn's disease
tends to return to other areas of the intestines after surgery.
Prevention
Crohn's disease
cannot be prevented, because the cause is unknown. But you can take steps to
reduce the severity of the disease.
- Medicines taken regularly may reduce sudden
(acute) attacks and keep the disease in
remission (a period without
symptoms).
- Most experts recommend acetaminophen (Tylenol, for
example) for pain relief rather than nonsteroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen or naproxen. NSAIDs have been linked to
flare-ups.
- Do not smoke. Smoking makes
Crohn's disease worse.
- Eat a healthy diet.
- Never use
antibiotics unless they have been prescribed for you by a
doctor.
- Get regular exercise.
Home Treatment
If
Crohn's disease does not cause symptoms, no treatment
is needed. Mild symptoms may respond to
antidiarrheal medicines or changes in
diet and nutrition. For more information about making good food choices,
see:
Bowel Disease: Changing Your Diet.
In general, doctors recommend that you do not use
nonsteroidal anti-inflammatory drugs (NSAIDs), such as
ibuprofen or naproxen. These medicines may cause flare-ups
of Crohn's disease. But some people may be more
likely to have flare-ups from NSAIDs than others. Talk to your doctor about
whether to avoid these medicines.
If you have had or are planning
to have surgery that will create an opening from the intestines to the outside
of the body through which stool passes (ostomy), you may feel self-conscious or
embarrassed. After a period of adjustment, most people are able to resume all
of their usual activities. In fact, life may be better than it was before
surgery because you may no longer suffer painful symptoms. Support groups are
available for people with ostomies. For more information on taking care of your ostomy, see:
- Bowel Disease: Caring for Your Ostomy
Children who have Crohn's disease may feel self-conscious
if they do not grow as fast as other children their age. Encourage your child
to take medicine as prescribed. Offer help with the treatment so that your
child can feel better, start growing again, and lead a more normal life.
Children tend to have a harder time managing the disease than adults, so your
support is especially important.
Medications
Medicines usually are the treatment of
choice for
Crohn's disease. They can control or prevent
inflammation in the intestines and help:
- Relieve symptoms.
- Promote healing
of damaged tissues.
- Put the disease into
remission and keep it from flaring up
again.
- Postpone the need for surgery.
Medication Choices
The choice of medicine usually depends on the severity of
the disease, the part of the intestines that is affected, and whether
complications are present. Medicines that are used for Crohn's disease include:
- Aminosalicylates (such as sulfasalazine or
mesalamine).
- Antibiotics (such as ciprofloxacin or metronidazole). Antibiotics are used to treat fistulas.
- Corticosteroids (such as budesonide or prednisone). Corticosteroids usually stop symptoms and put
the disease in remission. But they are not used as long-term treatment to keep
symptoms from coming back.
- Medicines that suppress the immune system (such as
azathioprine, mercaptopurine, and methotrexate). These may be needed to
help keep the disease in remission.
- Biologics (such as infliximab or adalimumab). These may be used
for people who develop abnormal connections between the intestines and other
organs (fistulas) or who have severe Crohn's disease that does not respond to
other medicines.
- Cyclosporine and intravenous (IV) corticosteroids may
be needed for severe cases.
What To Think About
Most of these medicines also can
be used in children.
If you are pregnant or planning to become
pregnant, talk to your doctor about which medicines might be okay to take for
Crohn's disease. Sometimes, severe Crohn's disease can
harm your baby more than the medicines you are taking to keep it under control.
Some medicines, though, should never be taken when you are pregnant. Your
doctor can tell you which medicines are okay for you while you are pregnant and
nursing.
Surgery
Surgery is rarely done for
Crohn's disease and it is not a cure. When surgery is
needed, as little of the intestines as possible is removed to preserve normal
function. The disease tends to return in areas that were previously not
affected, and you may need surgery again.
Surgery may be needed
for Crohn's disease if no medicine can control your symptoms, if you have
serious side effects from medicines, if your symptoms can be controlled only
with long-term use of corticosteroids, or if you develop complications.
Surgery Choices
Surgery is not usually done for Crohn's disease. If you
do have surgery, it will most likely be one of the following:
- Resection: The diseased portion of the intestines is removed,
and the healthy ends of the intestine are reattached. Resection surgery does
not cure Crohn's disease, which often comes back near the site of
surgery.
- Strictureplasty: The surgeon makes a lengthwise cut in the
intestine and then sews the opening together in the opposite direction. This
makes the intestine wider and helps with obstruction of the bowels. This is
sometimes done at the same time as resection or when a person has had resection
in the past. Strictureplasty is used when the doctor is trying to save as much
of the intestine as possible.
- Proctocolectomy and ileostomy: The surgeon removes the
large intestine and rectum, leaving the lower end of the small intestine (the
ileum). The anus is sewn closed, and a small opening called a stoma is made in
the skin of the lower abdomen. The ileum is connected to the stoma, creating an
opening to the outside of the body, where stool empties into a small plastic
pouch called an ostomy bag that is applied to the skin around the stoma.
- Bowel Disease: Caring for Your Ostomy
Another procedure that may be done is balloon dilation.
This is not a surgery. The doctor runs an
endoscope through your intestines from your anus. The
endoscope is a long, thin tube that has a video camera on the end. Next, the
doctor uses the endoscope to thread an uninflated balloon across the stricture
(the narrowed part of the intestine). When the balloon is inflated, it makes
that part of the intestine wider. The balloon is deflated and then removed.
Balloon dilation is a new technique and not as much is known about its
long-term success compared to the surgical procedures listed above. Balloon
dilation might be done if you want to put off a more complicated surgery for a
while or if you have had surgery before and the doctor wants to save as much of
the intestines as possible.
What To Think About
These surgeries can be done on
children. Surgery can improve a child's well-being and quality of life and
restore normal growth and sexual development.
In rare cases,
intestinal transplant is used to treat Crohn's
disease. In this complex procedure, the small intestine is removed and replaced
with the small intestine of a person who has recently died and donated his or
her organs.
Other Treatment
Some people who have
Crohn's disease need additional nutrition because
severe disease prevents their small intestine from absorbing nutrients.
Supplemental liquid feedings may be done through a tube placed in the nose and
down into the stomach (enteral nutrition) or through a vein (total parenteral
nutrition, or TPN). Supplemental feeding may be needed when:
- Crohn's disease is not controlled with standard
treatment.
- Short bowel syndrome occurs. This
happens when so much of the small intestine has been surgically removed or is
affected by the disease that you cannot properly digest food and absorb enough
nutrients.
- Bowel blockage occurs.
Nutritional therapy may restore good nutrition to children
who are growing more slowly than normal. It also can build strength if you need
surgery or have been weakened because of severe diarrhea and poor
nutrition.
Total parenteral nutrition allows the intestines to
rest and heal. But it is common for symptoms to return when TPN is stopped and you
go back to a regular diet. TPN does not change the long-term outcome of Crohn's
disease.
Counseling for Crohn's disease
Crohn's disease can
affect every aspect of your life. It may make you feel isolated or depressed.
But you can take steps to improve your outlook and coping skills. You may want
to seek professional counseling and social support from family, friends, or
clergy.
Other Treatment Choices
Nutritional supplements
Complementary medicine
Many people with
inflammatory bowel disease consider nontraditional or complementary medicine in
addition to prescription medicines. They may turn to these alternatives because
there is no cure for Crohn's disease. People may also use complementary
medicine to help in coping with:
- The difficult side effects from standard
medicines.
- The emotional strain of dealing with a chronic
illness.
- The negative impact of severe disease on daily
life.
These therapies have not been proven effective for
Crohn's disease, but they may improve your overall well-being.
The
various complementary therapies include:
- Special diets or nutritional supplements,
such as
probiotics, evening primrose, and fish
oils.
- Vitamin supplements, such as vitamins D and
B12.
- Herbs, such as aloe and ginseng.
- Massage.
- Stimulation of the feet, hands,
and ears to try to affect parts of the body (reflexology).
What To Think About
Nutritional supplements can help
people receive enough essential nutrients, but they are expensive.
TPN can cause metabolic imbalances. It also can raise the risk of a
bloodstream infection from the catheter in the vein, which is needed to give
TPN. Long-term use of TPN may raise the risk of liver problems or liver
failure.
Other Places To Get Help
Organizations
| American Society of Colon and Rectal
Surgeons |
| 85 West Algonquin Road |
| Suite 550 |
| Arlington Heights, IL 60005 |
| Phone: | (847) 290-9184 |
| Fax: | (847) 290-9203 |
| Email: | ascrs@fascrs.org |
| Web Address: | www.fascrs.org |
| |
The American Society of Colon and Rectal Surgeons is the leading
professional society representing more than 1,000 board-certified colon and
rectal surgeons and other surgeons dedicated to treating people with diseases
and disorders affecting the colon, rectum, and anus. |
|
| Children's Digestive Health and Nutrition Foundation
(CDHNF) |
| P.O. Box 6 |
| Flourtown, PA 19031 |
| Phone: | (215) 233-0808 |
| Email: | cdhnf@cdhnf.org |
| Web Address: | www.cdhnf.org |
| |
The Children's Digestive Health and Nutrition Foundation (CDHNF) Web site helps parents, children, and teens learn more
about reflux and GERD, celiac disease, inflammatory bowel disease, and other
digestive disorders in children. |
|
| National Digestive Diseases Information Clearinghouse
(NDDIC) |
| 2 Information Way |
| Bethesda, MD 20892-3570 |
| Phone: | 1-800-891-5389 |
| Fax: | (703) 738-4929 |
| Email: | nddic@info.niddk.nih.gov |
| Web Address: | www.digestive.niddk.nih.gov |
| |
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
|
|
| Wound, Ostomy and Continence Nurses Society
(WOCN) |
| 15000 Commerce Parkway |
| Suite C |
| Mt. Laurel, NJ 08054 |
| Phone: | 1-888-224-WOCN (1-888-224-9626) |
| Web Address: | www.wocn.org |
| |
The Wound, Ostomy and Continence Nurses Society (WOCN)
is a professional, international nursing society of more than 4,200 health
professionals who are experts in the care of people who have wounds, ostomies,
and incontinence. The Web site offers a way to search for a Wound, Ostomy and
Continence Nurse in your area. WOCN also publishes patient guides, lists other
related Web sites, and has information about specialty clothing and accessories
for people who have wounds, ostomies, and continence disorders. |
|
References
Citations
- Sands BE (2006). Crohn's disease. In M Feldman et al.,
eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 2459–2498. Philadelphia: Saunders Elsevier.
Other Works Consulted
- Ali M, et al. (2004). Video capsule endoscopy: A
voyage beyond the end of the scope. Cleveland Clinic Journal of Medicine, 71(5): 415–425.
- American Gastroenterological Association (2006). American Gastroenterological Association Institute medical position statement on corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease. Gastroenterology, 130(3): 935–939. Available online: http://www.gastro.org/practice/medical-position-statements.
- American Gastroenterological Association (2010). AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology, 138(2): 738–745. Available online: http://www.gastro.org/practice/medical-position-statements.
- Strong SA, et al. (2007). Practice parameters for the surgical management of Crohn's disease. Diseases of the Colon and Rectum, 50(11): 1735–1746.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Arvydas D. Vanagunas, MD - Gastroenterology |
|---|
| Last Revised | October 8, 2010 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.