Approximately 170,000 Canadians suffer from Crohn’s disease or ulcerative colitis, two forms of inflammatory bowel disease, unfortunately giving Canada one of the highest rates of IBD, with one in every 180 people affected (approximately 0.5% of the population). Inflammatory bowel disease affects both men and women equally. Most people are diagnosed between the ages of 15 and 25, and about 10% of newly diagnosed cases are in children under age 10. However, Crohn’s disease can occur at any age.

Crohn’s disease is named after Dr. Burrill B. Crohn who, along with his colleagues, was the first to describe the disease in a paper published in 1932.

What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory disease that attacks the digestive tract. Although it can involve any area of the GI tract—from the mouth to the anus—it most commonly affects the small intestine (ileum) and the large intestine (colon). The inflammation can extend through all layers of the intestinal wall (called transmural), and generally presents as patches of diseased bowel separated by healthy tissue (“paved” appearance).

Signs and symptoms
The three classic symptoms of Crohn’s disease are abdominal pain, diarrhea and weight loss. Fever and anorexia are also very common symptoms of this disease.

Complications
Crohn’s disease can have specific complications, such as trouble maintaining an adequate diet during the most intense periods of the disease, leading to malnutrition and various dietary deficiencies. Some people will develop osteoporosis due to the lack of calcium and vitamin D. Other non-digestive complications can occur, including musculoskeletal disorders (ankylosing spondylitis), vision problems (uveitis), skin conditions, etc.

Causes
The causes of Crohn’s disease are unknown. Although there is a strong genetic component to the disease, genetics does not explain everything—environmental factors and lifestyle also play an important role. Accordingly, smokers have a higher risk of developing Crohn’s disease than non-smokers. Stress has been singled out as a trigger of acute attacks in certain patients with the disease.

How is Crohn’s disease diagnosed?
Crohn’s disease is currently diagnosed based on clinical presentation (the symptoms) and observations. Therefore, it can prove useful to do tests to examine the intestinal walls from the inside (endoscopy). Other tests include abdominal x rays, laboratory tests (blood tests, etc.) and, on occasion, new medical imaging techniques.

Treatment
Unfortunately, there is still no cure for Crohn’s disease. Nevertheless, drugs and/or surgery can help reduce the inflammation and relieve the symptoms. Treatment aims to send the disease into remission during “attacks” or “flare-ups” (acute phase). To maintain remission, sometimes different treatments are used, including anti inflammatories, corticosteroids, immunomodulators, and monoclonal antibodies (anti-TNF alpha). In certain cases, antibiotics can be prescribed and surgery may be recommended. A change in diet can also lessen some of the symptoms in certain people.