Crohn's disease is a chronic and serious inflammatory disease of the gastrointestinal (GI) tract that affects more than 500,000 Americans. People with Crohn's disease may experience a number of symptoms including diarrhea, abdominal cramps and pain, fever, rectal bleeding, loss of appetite, and weight loss. The range and frequency of these symptoms varies. For some people, symptoms are severe and can be debilitating, while others experience long bouts of remission in which their symptoms are mild to moderate. Crohn's disease is not fatal, and many people diagnosed with Crohn's are able to lead active, productive lives.

* Crohn's disease is also sometimes referred to as ileitis, regional enteritis, or colitis. Although Crohn's disease is the general term used to describe the condition, doctors use these specific terms to differentiate the portion of the bowel that is involved.

Crohn's, Ulcerative Colitis, and IBD

Crohn's disease is categorized, along with ulcerative colitis, as inflammatory bowel disease (IBD), a term used to describe a number of inflammatory diseases affecting the GI tract. But while Crohn's disease and ulcerative colitis have similar symptoms, clear pathological distinctions exist between the two. Crohn's disease involves all layers of the intestine. In Crohn's, normal, healthy sections of bowel may lie between patches of diseased bowel. In contrast, ulcerative colitis affects only the innermost lining of the colon, and is continuous throughout the colon. In spite of these differences, doctors are challenged with making an accurate diagnosis in 10 to 20 percent of patients.

Complications of Crohn's Disease

The complications that patients of Crohn's disease experience depends on the location and severity of the disease. Some complications can be serious, while others are manageable with the help of treatment plans prescribed by a doctor.

Serious Complications

• Obstruction - The swelling and scarring associated with Crohn's disease can obstruct the intestine. When this occurs, a patient may experience painful cramps, or vomiting due to food that is not able to bypass the obstruction. Patients who experience an obstructive episode are usually hospitalized and given intravenous fluids and salts to compensate for fluid losses.
• Fistulas - Sometimes ulcers caused by Crohn's disease channel through the gut wall to adjacent organs including the skin, bladder, vagina, intestine, and perianal areas.
• Abscesses - A fistula that tracks into the abdominal cavity may produce infection and form an abscess. Abscesses may also occur in the pelvic tissues or the perineum, if a fistula fails to drain. Abscesses can be difficult for doctors to diagnose; however, after they are located, they should be drained. This may require surgery. Patients are usually given a course of antibiotics to reduce the risk of further infection.
• Free Perforation - In rare cases, deep, penetrating ulcers tunnel through the layers of the gut into the abdominal cavity. Signs of free perforation include sudden, severe abdominal pain; shock; and excessive abdominal tenderness. The infection that results is called peritonitis, and requires emergency surgery in which the leak is sealed and the abdominal cavity is cleansed to stop infection.
• Hemorrhage - In other rare cases, a bleeding ulcer may burrow through the gut wall and shear an artery. This produces a life-threatening hemorrhage that may require blood transfusions and special measures to promote blood clotting. Sometimes emergency surgery is required.

Chronic Complications

• Anemia - Anemia in Crohn's disease may be the result of chronic blood loss; bone marrow depression; or failure to absorb iron and folic acid, which are important in stimulating the production of red blood cells. Certain medications, such as sulfasalazine, may also exacerbate anemia. To combat most cases of anemia, doctors often prescribe supplements, and recommend a diet rich in iron.
• Malnutrition - Loss of protein, low energy levels, tissue breakdown due to steroid use, poor diet, and in some cases, failure to absorb nutrients, result in weight loss and nutritional deficiencies. Doctors often prescribe nutritional supplements to avoid the complications that result from deficiencies in vitamins A, D, E, and K.
• Growth Retardation - About one third of children diagnosed with Crohn's disease experience growth retardation, which may be permanent. For children who have not yet reached their growth spurts, and for whom modifications in diet have not been successful, surgery to remove the affected section of bowel may provide hope.

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