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Crohn’s disease is a recurring inflammatory bowel disease of the gastrointestinal (GI) tract. Crohn’s disease most commonly occurs in the ileum (the lower part of the small intestine) and the colon (large intestine), but it can occur anywhere in the GI tract from the mouth to the anus.

WakeMed’s gastroenterologists and colorectal surgeons understand the intricacies of this complex and chronic condition, and we have access to the latest therapies to provide customized treatment for each patient.

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What Are the Symptoms of Crohn’s Disease?

Crohn’s disease causes erosions, called ulcers, along the GI tract. In more severe cases, deeper and larger ulcers form.

Crohn’s disease symptoms resulting from these ulcers can be either mild or debilitating. Some patients will experience only mild experiences with the condition, while others will have severe complications. Symptoms can include:

  • Diarrhea
  • Cramps/abdominal pain
  • Fever
  • Rectal bleeding
  • Loss of appetite
  • Loss of energy
  • Weight loss
  • Anemia
  • Poor growth in children
  • Constipation
  • Skin tags in the rectal area that may resemble hemorrhoids
  • Abscesses (pockets of pus) and fistulas in the perianal area

In severe cases, larger ulcers and severe inflammation can stiffen in the bowels and cause obstruction (called strictures), or puncture the bowel walls, causing infection in the abdominal cavity and adjacent organs (called fistula). When inflammation is severe, it can also impact other organs in the body, most commonly the joints, liver and skin.

Crohn’s disease is a chronic condition, and symptoms can come and go over the course of a patient’s life. Some patients experience months or years of remission in between flare ups.

How Is Crohn’s Disease Diagnosed?

Our experts are experienced in accurately diagnosing Crohn’s disease, which can also present itself like other inflammatory bowel disease (IBD) including ulcerative colitis, as well as irritable bowel syndrome (IBS). We first take a full medical history and perform a physical examination. Diagnostic tests to confirm Crohn’s disease may include:

  • Blood tests
  • Stool studies
  • Computed tomography (CT) and magnetic resonance imaging (MRI) scans
  • Colonoscopy, in which a lighted, flexible tube looks at the inner lining of the colon to check for inflammation
  • Esophagogastroduodenoscopy (EGD), also known as upper endoscopy
  • Video capsule endoscopy (aka PillCam)

How Is Crohn’s Disease Treated?

There is no cure for Crohn’s disease — the goal of treatment is to control inflammation and relieve symptoms of pain and diarrhea.

Medications can not only relieve symptoms, but can also promote the healing of damaged tissue, postpone surgery, keep the disease from flaring up, and even put it in remission.

Medications used to treat Crohn’s disease include:

  • Anti-inflammatories: Including mesalamine, sulfasalazine and asacol, these can help decrease inflammation and help in maintaining disease remission.
  • Immunomodulators: Including Imuran, these reduce inflammation, by targeting the immune system.
  • Biologic medications: Including Remicade and Humira, these are given as IV infusions or injections, these medications reduce inflammation.
  • Steroids: Including prednisone and budesonide, steroids are most commonly used for patients who haven’t responded to other medications.
  • Antibiotics: May be given to patients who have complications like fistulas or abscesses.
  • Newer agents: Our physicians are experts in providing the newest medication treatments for Crohn’s disease, including Entyvio and Stelara.

When Is Surgery Needed for Crohn’s Disease?

In severe cases, or when a patient doesn’t respond to medication, surgery may be necessary to remove part or all of the colon. Because the inflammation of Crohn's disease can be patchy and noncontinuous and can deeply penetrate into the bowel wall, surgery is not the first choice of treatment, but it is very effective when medical therapy fails.

Surgery doesn’t cure Crohn’s disease, and the condition often recurs. However, in cases where surgery is recommended, WakeMed’s patients can benefit from minimally invasive, laparoscopic-assisted surgeries. This allows a patient to have less pain and discomfort, a smaller incision, quicker recovery and fewer complications. 

Learn more about what to expect from colorectal surgery.

Is Nutritional Counseling for Crohn's Disease Helpful?

Since Crohn’s disease can reduce the body's ability to absorb necessary nutrients, talking to a nutritionist can also be helpful. We offer our patients nutrition counseling to help them manage their conditions and make smart nutritional choices.