Crohn’s disease is a chronic inflammatory bowel disease (IBD) characterized by inflammation of the digestive, or gastrointestinal (GI) tract. In fact, Crohn’s can affect any part of the GI tract, from the mouth to the anus, but it is more commonly found at the end of the small intestine (the ileum) where it joins the beginning of the large intestine (or colon). It can also affect the skin, eyes and joints.
What Causes Crohn’s?
Researchers are still not sure what causes Crohn’s disease. Earlier diet and stress were considered, but now doctors know that diet and stress may aggravate but don’t cause Crohn’s disease. A number of factors, such as heredity and a malfunctioning immune system, likely play a role in its development.
- Immune system. It’s possible that a virus or bacterium may trigger Crohn’s disease. When your immune system tries to fight off the invading microorganism, an abnormal immune response causes the immune system to attack the cells in the digestive tract, too.
- Heredity. Crohn’s is more common in people who have family members with the disease, so genes may play a role in making people more susceptible. However, most people with Crohn’s disease don’t have a family history of the disease.
Risk factors for Crohn’s disease may include:
- Age. Crohn’s disease can occur at any age, but you’re likely to develop the condition when you’re young. Most people who develop Crohn’s disease are diagnosed before they’re 30 years old.
- Ethnicity. Although Crohn’s disease can affect any ethnic group, whites and people of Eastern European (Ashkenazi) Jewish descent have the highest risk.
- Family history. You’re at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn’s disease has a family member with the disease.
- Cigarette smoking. Cigarette smoking is the most important controllable risk factor for developing Crohn’s disease. Smoking also leads to more severe disease and a greater risk of having surgery. If you smoke, it’s important to stop.
- Nonsteroidal anti-inflammatory medications. These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox), diclofenac sodium (Voltaren, Solaraze) and others. While they do not cause Crohn’s disease, they can lead to inflammation of the bowel that makes Crohn’s disease worse.
- Where you live. If you live in an urban area or in an industrialized country, you’re more likely to develop Crohn’s disease. This suggests that environmental factors, including a diet high in fat or refined foods, play a role in Crohn’s disease. People living in northern climates also seem to be at greater risk.
Crohn’s disease may lead to one or more of the following complications:
- Inflammation. Inflammation may be confined to the bowel wall, which can lead to scarring and narrowing (stenosis), or may spread through the bowel wall (fistula).
- Bowel obstruction. Crohn’s disease affects the thickness of the intestinal wall. Over time, parts of the bowel can thicken and narrow, which may block the flow of digestive contents. You may require surgery to remove the diseased portion of your bowel.
- Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).
- Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind.
When fistulas develop in the abdomen, food may bypass areas of the bowel that are necessary for absorption. Fistulas may occur between loops of bowel, into the bladder or vagina, or out through the skin, causing continuous drainage of bowel contents to your skin.
In some cases, a fistula may become infected and form an abscess, which can be life-threatening if not treated.
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Great resources from the Crohn’s and Colitis Foundation