Crohn’s (or Crohn) disease is a disease that usually affects the small intestine and less commonly the colon, but it is capable of involving the remainder of the gastrointestinal tract – the mouth, esophagus, and stomach. The chronic inflammation that is the basis of Crohn’s disease causes ulceration, swelling, and scarring of the parts of the intestine that it involves. Other names for Crohn’s disease include granulomatous enteritis, regional enteritis, ileitis, and granulomatous colitis when it involves the colon.
What Causes Crohn’s Disease?
The cause of the chronic inflammation in Crohn’s disease is unknown. The leading theory is that inflammation is initiated by bacteria that reside within the intestine. Whereas most inflammation usually is suppressed and the disease caused by the inflammation subsides, in Crohn’s disease the inflammation is not suppressed, and the inflammation continues. The continuing inflammation probably occurs because of environmental factors (i.e., the bacteria) as well as genetic factors that affect the immune system.
Crohn’s Disease in Children & Teens
Crohn’s disease most commonly affects children in their late teens and young adults in their 20s and 30s. Nevertheless, it can affect infants and young children as well. Crohn’s disease is not rare; 100,000 teens and preteens in the U.S. have Crohn’s disease. For children, the social problems created by the symptoms of Crohn’s disease are difficult to deal with since the disease can restrict activities. The chronic inflammation also stunts growth and delays puberty that add to the social difficulties. Emotional and psychological factors always must be considered in young people with Crohn’s disease.
How Does Crohn’s Disease Affect the Intestines?
The first signs of Crohn’s disease are small ulcers, called aphthous ulcers, caused by breaks in the lining of the intestine due to inflammation. The ulcers become larger and deeper. With the expansion of the ulcers comes swelling of the tissue, and finally scarring of the intestine that causes stiffness and narrowing. Ultimately, the narrowing can cause obstruction to the flow of digesting food through the intestines. The deepening ulcers can fully penetrate the intestinal wall and enter nearby structures such as the urinary bladder, vagina, and other parts of the intestine. These penetrating tracts of inflammation are called fistulas.
How is Crohn’s Disease Different from Ulcerative Colitis?
Both Crohn’s disease and ulcerative colitis are chronic diseases of intestinal inflammation. Whereas ulcerative colitis only involves the colonic portion of the gastrointestinal tract, Crohn’s disease can affect any portion of the gastrointestinal tract from mouth to anus.
Whereas the inflammation of ulcerative colitis involves only the superficial lining of the colon, the inflammation of Crohn’s disease goes deeper into the intestinal walls and, as previously mentioned, even beyond the walls.
Inflammation in ulcerative colitis is continuous, that is, the inflammation does not skip areas. Thus, the colon is involved from the most proximal margin of the inflammation – be that ascending, transverse or sigmoid colon – all the way to the anus. On the other hand, the inflammation of Crohn’s disease can be present in several portions of the intestines with skipped areas without inflammation in between.
Symptoms of Crohn’s Disease
The most common symptoms of Crohn’s disease are abdominal pain and diarrhea. Other signs of inflammation frequently are present including fever and abdominal tenderness. Because symptoms can be worsened by eating, the intake of food is reduced, and this leads to loss of weight, and, less commonly, nutritional deficiencies. Slow continuous loss of blood into the intestine that may not even be recognizable in the stool can lead to iron deficiency anemia.