What is Crohn’s Disease?
Crohn’s disease is a chronic, relapsing inflammatory condition of the digestive tract. It can affect any part from the mouth to the anus, most commonly the terminal ileum and/or the colon, and the inflammation is transmural (penetrates all layers of the intestinal wall). It is characterized by periods of flare-ups and remission. Although it cannot be permanently cured, with modern monitoring and targeted treatment, long-term remission and a normal quality of life can be achieved.
What symptoms does it cause?
Crohn's Disease
Causes & Risk Factors
Crohn’s disease arises from an immune system dysfunction in genetically predisposed individuals, triggered by microbial and environmental factors.
Risk Factors:
Age: Most common under 30 (but also >50–60)
Smoking: A strong aggravating factor for Crohn’s
Use of NSAIDs: Such as ibuprofen
Western lifestyle & northern climates
Genetic predisposition / family history
Microbiome disturbances, stress (worsening factors, not direct causes)
The main therapeutic categories include:
1. Corticosteroids (e.g. prednisolone, budesonide)
➜ Used for induction of remission in active disease, not for long-term maintenance due to side effects.
2. Immunomodulators (azathioprine, 6-mercaptopurine, methotrexate)
3. Biologic Agents
Anti-TNF: Infliximab, Adalimumab
Anti-Integrin: Vedolizumab (gut-selective agent, with lower systemic risk)
Anti-IL-12/23: Ustekinumab
Anti-IL-23: Risankizumab
➜ Targeted therapies that modulate the inflammatory response, achieving high rates of remission and mucosal healing.
4. Targeted Small Molecule Therapies
5. Antibiotics
6. Surgical Management
➜ When there is stricturing or fistulizing disease, uncontrolled abscesses, or treatment-resistant inflammation.
Goal: bowel-sparing approaches and preservation of quality of life.
Perianal Disease
This is a particularly challenging form of Crohn’s disease that requires a multidisciplinary approach:
- Endoscopic and imaging-based staging
- Abscess drainage
- Seton placement (when indicated)
- Systemic biologic therapy (usually anti-TNF)
Treatment of Crohn’s disease is continuously evolving, with the goal of achieving deep remission at all levels through personalized therapy and close monitoring to allow timely adjustments.
Complications
- Intestinal Complications:
- Strictures / Obstruction: Resulting from chronic inflammation and scarring, which may lead to abdominal pain, bloating, and vomiting.
- Fistulas: Abnormal connections between the intestine and other organs or the skin (entero-enteric, entero-cutaneous, perianal). Often associated with abscess formation.
- Malnutrition / Malabsorption: Due to reduced nutrient absorption. Common deficiencies include iron, vitamin B12, and folic acid.
- Perforation / Rupture: A rare but serious complication requiring urgent medical intervention.
- Extraintestinal Manifestations:
Crohn’s disease is a systemic inflammatory disorder, meaning it can affect other organs beyond the digestive tract:
- Arthritis (peripheral or axial)
- Skin lesions such as erythema nodosum and pyoderma gangrenosum
- Uveitis (inflammation of the eyes)
- Hepatobiliary diseases — gallstones, primary sclerosing cholangitis
- Nephrolithiasis (oxalate kidney stones)
- Thromboembolic disease (increased risk of blood clots)
- Osteopenia / Osteoporosis, often due to corticosteroid use or malabsorption.
Frequently Asked Questions (FAQ)
Will I need to take medication forever?
Crohn’s disease is chronic. Maintenance therapy significantly reduces flare-ups, hospitalizations, and complications.
The duration of treatment is individualized, depending on the severity, location, and the patient’s response.
What can I do to feel better?
Follow an anti-inflammatory diet and avoid foods that worsen your symptoms.
Quit smoking.
Manage stress through exercise, quality sleep, and psychological support.
Maintain regular communication with your gastroenterologist.
Does Crohn’s disease increase cancer risk?
Does the risk of genital warts increase?
Is Crohn’s disease related to irritable bowel syndrome (IBS)?
Yes, they often coexist.
More than two-thirds of patients with inflammatory bowel disease experience IBS-like symptoms.
This does not worsen the inflammation, but it can affect quality of life, mood, and daily functioning.
Is Crohn’s disease related to celiac disease?
Yes, there is an association.
Patients with Crohn’s disease have a threefold higher risk of developing celiac disease compared to the general population.
If malabsorption or unexplained anemia is present, celiac screening is recommended.
What will my life be like with Crohn’s disease?
Most patients live a normal, active life.
With proper treatment, regular monitoring, and support, flare-ups are reduced and quality of life remains high.
Can I get pregnant?
In most cases, yes.
Crohn’s disease does not reduce fertility when the disease is in remission.
Before trying to conceive, consult your doctor to plan the pregnancy and adjust medication if necessary.
I’m on treatment and developed an infection — should I stop my medication?
Not without medical guidance.
Management depends on:
The type of infection (viral, bacterial, fungal, Clostridium difficile)
The type of therapy (thiopurines, anti-TNF agents, anti-integrins, etc.)
Your treating physician will decide whether treatment should be temporarily paused or adjusted based on your condition.
