Learn more about Crohn's disease, including possible causes, symptoms & treatment options
What is Crohn’s disease?
Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes chronic inflammation, swelling and ulcers in the digestive system. It’s not to be confused with ulcerative colitis, which is the other main type of inflammatory bowel disease.
Crohn’s disease most commonly affects the small bowel and colon but can also affect other parts of the digestive system including the mouth, gut and anus (bottom). It’s a lifelong condition, but there are several ways to manage symptoms to help keep you feeling well, including medicines and sometimes surgery.
What causes Crohn’s disease?
There are multiple causes of Crohn's disease, including:
• Genetics– if a close family member has Crohn’s disease, you’re more likely to get it too
• A problem with your immune system – usually the immune system helps your body fight off infections, but if you have Crohn's disease, your immune system will start to attack the gut, which causes inflammation
• Smoking increases your risk of getting crohn's disease, but we've got plenty of tips to help you stop smoking, if you do smoke
• An imbalance of gut bacteria – research suggests people with Crohn’s disease are missing some of the bacteria which help your gut and they may have fewer varieties of helpful bacteria in their gut
• A previous stomach virus
What are the signs & symptoms of Crohn’s disease?
Symptoms of Crohn’s disease often start as a child or young adult, but it can affect people of any age. Symptoms can range from mild to severe and may be there all the time or only some of the time. When your symptoms are active it’s known as a flare-up or relapse, and when your symptoms go away it’s known as remission.
Crohn’s disease affects everyone differently and symptoms will vary depending on which part of the digestive system is affected. Some of the most common Crohn’s disease symptoms include:
• Diarrhoea - which might be sudden
• Blood in your stool
• Stomach aches and cramps – usually in the lower-right part of your tummy
• Tiredness and fatigue
• Unexplained weight loss and loss of appetite
Other symptoms can include:
• A high temperature and feeling feverish
• Feeling and being sick
• Anaemia (caused by a lack of iron for example if your body is unable to fully absorb nutrients from food)
• Inflammation in other areas of your body such as joint pain, mouth ulcers, sore or red eyes and patches of painful, red and swollen skin (usually on the legs)
• Growing more slowly than usual (in children with Crohn’s disease)
When to see a GP for Crohn’s disease?
You should see a GP if you or your child experience any of the following signs and symptoms of Crohn’s disease:
• Stool that contains blood
• Diarrhoea that lasts for more than seven days
• Frequent stomach aches or cramps
• Unexplained weight loss, or your child is not growing as fast as expected
How is Crohn’s disease diagnosed?
A GP can assess your symptoms and refer you for further tests if necessary to diagnose Crohn’s disease. It can sometimes be difficult to diagnose because symptoms can be similar to those of several other conditions such as IBS.
At an appointment, you may be asked about your symptoms, your diet and whether you have a family history of Crohn’s disease. A GP might also ask you about other considerations including whether you’ve been abroad recently where you might have got an infection, or if you’re taking any medication.
They may also feel and examine your tummy, ask you to provide a stool sample and take a blood sample. Both blood and stool can be tested for things like inflammation or infection.
If Crohn’s disease is suspected, you may be referred to a gastroenterologist (a medical professional who specialises in the digestive system) for further tests to confirm a diagnosis. Tests for Crohn’s disease include:
• A colonoscopy – when a long, thin flexible tube (endoscope) with a tiny camera attached to it is inserted into your bottom to look in your bowel for signs of inflammation
• A biopsy – when small pieces of your bowel are removed during a colonoscopy and then checked for Crohn’s disease
• An MRI scan or CT scan – these produce detailed images of the inside of your body so they can be examined. When checking for Crohn’s disease you may have a special drink beforehand to help the bowel show up clearly
How is Crohn’s disease treated?
Although there’s no cure for Crohn’s disease, there are treatment options that can help manage and reduce symptoms. It’s most often treated with medications which can include:
• Steroids – the most common Crohn’s disease medication which helps reduce inflammation in the digestive system
• A liquid diet – children and young adults with Crohn’s disease may need to have special drinks that contain all the essential nutrients they need for a few weeks instead of their usual diet
• Immunosuppressants – these help to reduce the activity of your immune system
• Biological medicines – these are stronger Crohn’s disease medicines that are sometimes given when other medicines aren’t helping
As with all medication, there are side effects to be aware of, but your Crohn’s disease care team or GP will be able to provide more advice and information on suitable treatment for you.
In some cases, surgery is recommended, such as when medicines aren’t likely to work. The most common operations for Crohn’s disease are:
• A resection – removing the damaged part of the gut
• A strictureplasty – widening a narrowed part of the gut (which is known as a stricture)
Sometimes you may need a stoma which is where the end of the bowel is brought outside of the body through an opening in the tummy. Poo then passes out of here into a disposable bag worn over the opening called a stoma bag. These can be temporary or permanent.
As with any surgery, there will be recovery time and side effects to consider. Your Crohn’s disease care team or GP will be able to advise on whether surgery is a suitable option for you.
Living with Crohn’s disease
As Crohn’s disease is a lifelong condition, it can be hard to come to terms with a diagnosis and to cope with the ongoing changes it can make to your life.
It’s normal for Crohn’s disease to affect your mental health as well as your physical health, and it’s important to talk to your GP or care team about any concerns you may have. They can advise on support and treatment or refer you to a counsellor if necessary. Or you can self-refer via the NHS if you prefer.
Alternatively, we offer private on-demand talking therapy from SupportRoom* via our Boots Health Hub services.
You can also find support through Crohn's & Colitis UK, who advise on many aspects of living with Crohn’s disease from telling friends, family and colleagues to coping with flare-ups.
Outside of symptoms, there are other practical ways Crohn’s disease can affect your life and health, including:
Diet
It’s recommended to eat a healthy, balanced diet to give your body the nutrients it needs. Some people find that certain foods make their symptoms worse, so it can be helpful to try avoiding these, but always speak to your GP or care team before making changes to your diet.
Pharmacy medicines
Some pharmacy medicines can interfere with your Crohn’s disease medication or trigger symptoms. Always speak to a pharmacist, GP or your care team before taking any pharmacy medicines.
Vaccinations
Certain Crohn’s disease medicines can increase your risk of catching the flu. It’s recommended to have an annual flu jab and a one-off pneumococcal vaccination. You may be eligible to have these for free on the NHS. Alternatively, we offer both a private flu vaccination service* and pneumonia vaccination service* at Boots.
Certain vaccines can make you ill when you have Crohn’s disease, so you should speak to your GP or care team for more information on these.
Pregnancy & contraception
Some Crohn’s disease medicines can harm an unborn baby and temporarily reduce sperm count. You should speak to your GP or care team for further advice if you’re planning for a baby or if you accidently get pregnant.
Some types of contraception may not work as well for people with Crohn’s disease, so you should ask your GP or care team for further advice on suitable types.
Other complications of Crohn’s disease
Crohn’s disease can cause other health-related complications, including:
• Damage to your bowel – sometimes this may require surgery
• Difficulty absorbing nutrients from food – sometimes this can lead to problems like osteoporosis (weak bones) or iron-deficiency anaemia (a lack of iron)
• Bowel cancer – your GP or care team may advise regular screenings for this
If you’re concerned about any of your symptoms or the impact Crohn’s disease is having on your life, speak to your GP or care team for further support.
