“IBD is a life-changing diagnosis, especially with young patients. While the disease can be a very big part of their life, it doesn’t need to take over their life when using a proper individualized treatment plan.”
Dr. Cristina Hill Jensen
IBD – Crohn’s Disease
Crohn’s, an inflammatory bowel disease, results from an abnormal immune response to harmless bacteria in the digestive tract. The intestinal wall becomes inflamed and thickened. It can affect any part of the digestive tract, from mouth to anus. Crohn’s can also affect other organs and structures, such as the liver, vagina or bladder. Symptoms include diarrhea, bloody stools, abdominal pain, cramping, fever, fatigue, loss of appetite and weight loss. Arthritic conditions and skin manifestations can also signal Crohn’s.
In order to diagnose Crohn’s, the patient will undergo a combination of blood work, stool studies, colonoscopy and radiology/imaging studies. One strategy, the pill cam, images the small intestine for ulcers. A colonoscopy allows the physician to take biopsies to check for dysplasia. Computed tomographic enterography (CTE) and magnetic resonance enterography (MRE) are two other imaging tools commonly used in diagnosis.
Once Crohn’s is confirmed, an individualized treatment plan is set in place for the patient. If Crohn’s can be controlled by medication, treatment strategies may include:
- Step-up approach – Using less strong medication and then stepping up to stronger medication
- Top-down approach – Using stronger medications to attack inflammation, and then moving to less potent medications
- Aminosalicylates – Long-term medication that reduces inflammation
- Corticosteroids – Available orally or rectally, a short-term medication that treats moderate to severe disease
- Immunomodulators – Suppresses immune system response to prevent further inflammation
- Antibiotics – Used when abscesses or infections are present
- Biologic therapies – Antibodies attach to tumor necrosis factor agents, allowing the body to destroy these chemicals and reduce inflammation
If Crohn’s causes a narrowed area along the digestive tract and it cannot be controlled by medicine, patients may undergo minimally invasive surgery, including:
- Laparoscopy – Resects the inflamed portion of the bowel back together, allowing patients to recover faster with less pain
- Strictureplasty – Opens a narrowed section of the bowel by making a longitude cut and closing it transversely