What is Crohn's disease?
Crohn's disease is a long-term (chronic) condition and belongs to a category of disease
known as Inflammatory Bowel Disease. Crohn's disease causes redness, swelling, and
sores along the digestive tract.
In most cases it affects the small intestine, most often the lower part called the
ileum. In some cases, both the small and large intestines are affected. Sometimes
the inflammation may affect the whole digestive tract. This includes the mouth, the
food pipe (esophagus), the stomach, the first part of the small intestine (duodenum),
the appendix, and the anus.
What causes Crohn's disease?
Researchers believe that Crohn's disease is caused by a combination of several factors.
Certain susceptibility genes have already been identified for IBD, two of them established
for Crohn's disease. Most IBD researchers believe that something in the environment
(such as a virus) triggers an inflammatory response in the gut. In people who may
not have the genetic predisposition to Crohn's disease, this inflammatory response
is self-limited, meaning it resolves on its own. However, in people with Crohn's disease,
there is genetic influence that maintains the inflammatory response.
Who is at risk for Crohn's disease?
Crohn's disease may happen at any age. It most often affects people ages 15 to 35.
But Crohn's may also occur in young children. It affects both males and females equally.
Children or teens may be more at risk for Crohn's disease if they:
Have a family history of Crohn's disease. In most cases this is a close relative such
as a parent, sister, or brother.
Are American Jews of European descent
Live in developed countries, in cities, and in northern climates
What are the symptoms of Crohn's disease?
Each child's symptoms may vary. Symptoms may include:
Belly (abdominal) pain, often in the lower right area
Loose stool (diarrhea), sometimes bloody
A cut or tear in the anus (anal fissure)
How is Crohn's disease diagnosed?
Your child may be checked for signs of Crohn's disease if he or she has had long-term:
Your child's healthcare provider will take a health history and do a physical exam.
Other tests for Crohn's disease may include:
Blood tests. These are done to see if your child has fewer healthy red blood cells because of blood
loss. This is called anemia. These tests also check if your child has a higher number
of white blood cells. That might mean there is an inflammation problem. Some of the
tests can also check for signs of acute (current) and chronic inflammation in the
blood stream. Sometimes long term gut inflammation can lead to poor absorption or
protein loss in the gut, which can also be checked in the blood.
Stool studies. This could be done to see if there is any blood in the stool, even if it is not visible
to the human eye. Some studies can check for infection by a parasite or bacteria.
Other tests could look for inflammation in the stool.
Upper Endoscopy. This test checks the inside of part of the digestive tract. It uses a small, flexible
tube called an endoscope. The tube has a light and a camera lens at the end. Tissue
samples or biopsies from inside the digestive tract may also be taken for testing.
Colonoscopy. This test looks at the full length of the large intestine. It can help check for
abnormal growths, inflamed tissue, sores or ulcers, and bleeding. It uses a long,
flexible, lighted tube called a colonoscope. The tube is put into your child's rectum
up into the colon. This tube lets the provider see the lining of the colon and take
out a tissue sample or biopsy to test it. Your child's provider may also be able to
treat some problems that may be found. Tissue samples or biopsies from inside the
digestive tract may also be taken for testing.
Capsule Endoscopy. This test uses a camera shaped like a pill to look at the inside of the digestive
tract that cannot be seen using the upper endoscopy and colonoscopy.
Upper GI series or barium swallow. This test looks at the organs of the top part of the digestive system. It checks
the food pipe (esophagus), the stomach, and the first part of the small intestine
(duodenum). Your child swallows a fluid called barium. This is a thick, chalky fluid.
It is used to coat the inside of organs so that they will show up on an X-ray. Then
X-rays are taken to check the digestive organs.
Small bowel follow through. This test evaluates the small intestine with an X-ray. Your child swallows a fluid
called barium. This is a thick, chalky fluid. It is used to coat the inside of organs
so that they will show up on an X-ray. Then X-rays are taken to check the digestive
organs for strictures or blockages or other problems.
Lower GI series or barium enema. This test checks the large intestine, including the colon and rectum. A thick, chalky
fluid called barium is put into a tube. It is inserted into your child's rectum as
an enema. Barium coats the organs, so they can be seen on an X-ray. An X-ray of your
child's belly will show if there are any narrowed areas called strictures. It will
also show any blockages or other problems.
How is Crohn's disease treated?
Crohn's disease is a long-term (chronic) disease. There is no cure for it. But there
are some things that can help to control it. Treatment for the disorder has 3 goals:
Correct nutritional problems
Control the swelling and inflammation
Ease symptoms such as belly pain, diarrhea, and rectal bleeding
Your child's healthcare provider will create a care plan based on:
Your child's age, overall health, and medical history
How serious your child's case is
How well your child handles certain medicines, treatments, or therapies
If your child's condition is expected to get worse
Your opinion and what you would like to do
Your child's treatment may include the following.
Changes in your child's diet may help to ease symptoms. In some cases, symptoms are
made worse by milk, hot spices, or fiber. In some patients, a specific diet could
be utilized as a treatment for Crohn's disease. Talk with your child's provider.
Medicines are often used reduce the inflammation in the colon. This may help ease
belly cramps and diarrhea. Examples of medications include steroids, antibiotics,
or drugs that affect the body's immune system.
If your child's symptoms are severe, he or she may need to stay in the hospital. This
can help make sure your child is getting the nutrition he or she needs. It can also
stop diarrhea and the loss of blood, fluids, and minerals. Your child may need a special
diet, feeding through a vein or tube, or intravenous medicines. Some children may
also need surgery.
Vitamins may help prevent some problems or help maintain a remission. Talk with your
child's provider about any vitamin supplements. These treatments have risks and may
cause harmful side effects.
Your child's provider may suggest nutritional supplements or special high-calorie
liquid formulas. These may be helpful if your child has delayed growth.
IV or intravenous feeding
In rare cases IV feeding may be used for children who need extra nutrition for a short
Surgery may help Crohn's disease, but it can't cure it. Surgery may help to reduce
long-term symptoms that don't get better with medicine. Surgery may also fix some
problems. These include a blocked intestine, a hole or perforation, a sore or abscess,
or bleeding. Types of surgery may include:
Draining abscesses in or near fistulas. An abscess is a collection of pus or infection. Treatment includes antibiotics, but
surgery may be needed.
Bowel or intestinal resection. The diseased section of intestine is removed. This surgery shortens your child's intestines.
Ostomy. When part of the intestines is removed, anew way of removing stool from the body is
created. The surgery to create the new opening is called an ostomy.
What are the complications of Crohn's disease?
Children with Crohn's disease may lose weight because they don't get enough calories.
This can happen because a child:
May try to avoid eating, to prevent the pain that is linked to digestion
May not want to eat if he or she can't have any favorite foods
May not absorb nutrients well through the inflamed digestive tract
Has greater nutritional needs than normal because of the disease
Nutritional supplements or special high-calorie liquid formulas may be suggested.
This is often recommended if a child has delayed growth.
Crohn's disease may also cause other health problems such as:
A blocked intestine
A type of tunnel, called a fistula, in nearby tissues. This can get infected.
Rips or tears, called fissures, in the anus
Problems with liver function
A lack of some nutrients, such as calories, proteins, and vitamins
Too few red blood cells or too little hemoglobin in the blood (anemia)
Bone weakness, either because bones are brittle (osteoporosis) or because bones are
A nervous system disorder where legs feel painful, called restless leg syndrome
Eye or mouth redness or swelling (inflammation)
After bowel resection surgery, a condition called short bowel syndrome can occur.
It often happens after a large part of the small intestine is removed. The body then
may not be able to digest and absorb some vitamins, foods, and nutrients, including
water. This poor absorption of food and nutrients is called malabsorption. It causes
diarrhea. It can also lead to poor growth and development. Common symptoms of malabsorption
Loose stool (diarrhea)
Large amounts of fat in the stool (steatorrhea)
Weight loss or poor growth
Fluid loss or dehydration
Lack of vitamins and minerals
Living with Crohn's disease
Crohn's disease is a long-term (chronic) condition. It may come and go at different
times during your child's life. Children may have physical, emotional, social, and
family problems as a result of the disease. It's important to work closely with your
child's healthcare provider to manage and treat the condition.
Be sure to have the provider check your child's health on a regular basis. This includes
checking your child's:
Many children with the disorder can eat a fairly normal diet when their disease is
stable. Talk with your child's healthcare provider. When your child is having symptoms,
it may be helpful to follow these suggestions:
Eat smaller, frequent meals
Limit foods with milk or milk products containing lactose, if there is a history of
Avoid greasy foods
Avoid certain high-fiber foods such as popcorn, nuts, and seeds
Avoid any foods that seem to have triggered your symptoms in the past
Drink liquids at room temperature
Drink liquids between meals, not with meals
Avoid foods with sorbitol, xylitol, and mannitol
Avoid sweets such as candy, cakes, and pies
Avoid foods that produce more gas, such as:
Add foods that have more soluble fiber. This is fiber that absorbs water. Foods that
are good sources of soluble fiber include:
Children who have short bowel syndrome after surgery for Crohn's often have problems
with diarrhea and malabsorption. Talk with your child's healthcare provider about
how to treat this.
Children with short bowel syndrome often need help getting all the nutrition they
need. Supplemental liquid feedings are sometimes done using TPN, or total parenteral
nutrition. TPN is a special mix of glucose, protein, fat, vitamins, and minerals.
It is given by IV or intravenously in the vein.
When should I call my child's healthcare provider?
Call your child's healthcare provider if your child has symptoms of Crohn's disease,
Call your child's provider right away if your child has Crohn's disease and regular
symptoms change or new symptoms appear.
Key points about Crohn's disease
Crohn's disease is when there is redness, swelling (inflammation), and sores along
the digestive tract.
It is a type of inflammatory bowel disease (IBD).
In most cases it affects the small intestine. But it may also affect the whole digestive
It is a long-term (chronic) condition. It may come and go at different times in your
There is no cure. Making some diet changes may help ease symptoms.
Medicine may help. Surgery may be needed.
Online Medical Reviewers:
- Chan, Albert, MD
- Hanrahan, John, MD
- Lehrer, Jenifer, MD