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Crohn’s Disease Symptoms, Risk Factors + How to Treat
July 18, 2016
It’s estimated that 1.4 million Americans (around 0.5 percent of the U.S. population) suffer from inflammatory bowel disease (IBD), whether in the form of Crohn’s disease or ulcerative colitis. (1) Crohn’s disease is a type of IBD characterized by inflammation of the lining of the GI (gastrointestinal, or digestive) tract, abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.
Worst of all, when left untreated, Crohn’s can cause serious complications due to malabsorption of important nutrients and prolonged autoimmune/inflammatory responses that degenerate healthy tissue throughout the body.
It’s estimated that 75 percent of people with Crohn’s disease eventually undergo surgery — and that up to 38 percent of people who have surgery for Crohn’s experience a recurrence of symptoms within just one year! Although most doctors will tell you that the causes of Crohn’s aren’t entirely clear, that there is currently “no known cure” for IBD, and that taking prescription medications is likely necessary to control your symptoms, emerging research is showing that this might not always be the case.
Experts now believe that a combination of genetic factors, chronic stress, an inflammatory diet, exposure to certain infections or viruses, along with several other risk factors, are to blame for the majority of IBD cases. (2) In fact, a breakthrough study released in September 2016 suggests that a specific fungus may trigger Crohn’s disease. (3)
Today, there is hope for IBD sufferers in the form of holistic medicines, lifestyle changes, dietary interventions and stress-reducing techniques. Many people battling Crohn’s and colitis are able to effectively manage symptom flareups by eliminating highly gaseous and inflammatory foods, learning to manage their stress response, paying attention to their own “biofeedback,” and supplementing with beneficial probiotics, herbs, enzymes and minerals.
Crohn’s Disease Symptoms
Crohn’s affects every person differently, and the inflammation associated with Crohn’s disease can impact various parts of the digestive tract depending on the individual. Often inflammation spreads deep into the layers of the GI tract tissue, which causes changes to bowel movements and disturbs normal nutrient absorption.
The most common areas affected by Crohn’s disease are the last parts of the small intestine and the colon. In some people with Crohn’s disease, only the last segment of the small intestine (ileum) is affected. In others, the disease is confined to the colon (part of the large intestine).
Crohn’s disease symptoms can range from mild to severe depending on which tissues become inflamed and how severe the inflammation becomes. Crohn’s symptoms usually develop gradually but sometimes come on suddenly with little-t0-no warning. It’s also common to have periods of remission, meaning times when you experience no signs or symptoms for several weeks or months. Unfortunately, following remission, the majority of people with experience symptoms once again.
According to the Crohn’s and Colitis Foundation of America, when Crohn’s is active, signs and symptoms may include: (4)
- Diarrhea and loose stools — People with mild-moderate Crohn’s might produce 4–6 bowel movements per day, while those with severe Crohn’s can have six or more. Fluid loss associated with diarrhea is a risk factor for dehydration, electrolyte imbalances and other complications. Experts believe that the reason frequent diarrhea occurs in people with Crohn’s is because their intestines respond to inflammation by producing extra salt and water, which overwhelms the capacity of the intestines to absorb enough fluid to give stool bulk.
- Intestinal cramping and abdominal pain — Inflammation and ulceration can affect the normal movement of contents through your digestive tract and may lead to pain and cramping of muscles within the digestive system. Muscles within the intestinal walls are prone to spasms when they become inflamed, which causes contractions that contribute to Crohn’s disease symptoms ranging from light discomfort to severe pain.
- Nausea and vomiting — Sometimes scar tissue forms within the intestinal tract which contributes to swelling and blocks part of the channels where food normally passes through. This can be responsible for stomach aches, vomiting, acid reflux and reduced appetite.
- Fever and fatigue — Many people with Crohn’s disease experience a low-grade fever, likely due to inflammation or infection. You may also feel tired or have low energy, due to fluid loss, malnutrition, anemia and other effects of developing nutrient deficiencies.
- Blood in your stool — As food moves through the inflamed intestines, it can aggravate tissue and cause bleeding. You might notice bright red blood in the toilet bowl or darker blood mixed with your stool. It’s also possible to have bleeding inside the GI tract that isn’t visible within stool (occult blood).
- Ulcers and mouth sores — Chronic inflammation can cause open sores and burning sensations within the stomach, esophagus, mouth and anus. Most often ulcers form in the lower small intestines, the colon and the rectum. You may have ulcers in your mouth similar to canker sores. These are often a side effect of a rundown immune system and inflammation that has spread to other tissue.
- Reduced appetite and weight loss — Abdominal pain and cramping and the inflammatory reaction in the wall of your bowel can affect both your appetite and your ability to digest and absorb food.
- Perianal disease — You might have pain or drainage near or around the anus due to inflammation from a tunnel into the skin, which is called a fistula. Fistulas cause abnormal connections between different organs and sometimes cause food particles to make their way to the colon before they normally should.
- Other signs of inflammation — It’s possible to experience inflammation of skin, eyes and joints, liver or bile ducts. Other symptoms related to IBD can include kidney stones, gallstones, hemorrhoids, anal skin tags, joint pain, skin rashes and even a high risk for developing colon cancer.
- Developmental delays — Some children who develop Crohn’s at a young age also experience delayed growth or sexual development. This is due to immune system dysfunctioning and the inability to absorb a normal amount of vital nutrients. Blood loss and fluid loss are other symptoms that can cause complications in children with Crohn’s.
Crohn’s Disease Risk Factors & Causes
Wondering what puts someone at risk for Crohn’s disease symptoms? Although the exact causes of Crohn’s are not entirely clear, and a multitude of factors seem to play a role in developing IBD, research shows that these are some of the most common risk factors:
- Age — Crohn’s disease can occur at any age, but you’re more likely to develop the condition when you’re on the younger end of the spectrum. Most people who develop Crohn’s disease are diagnosed before the age of 30.
- Ethnicity — Although Crohn’s disease can affect any ethnic group, Caucasians and people of Eastern European (Ashkenazi) Jewish descent have the highest risk. American Jewish people of European descent are four to five times more likely to develop IBD than the general population.
- Diet — Eating a diet that lacks essential nutrients but is high in spicy foods, fried foods, processed foods, dairy products, sugar and/or artificial sweeteners, alcohol and/or caffeine can all contribute to an environment that encourages the development of Crohn’s disease. A 2018 study published in Inflammatory Bowel Diseases revealed that artificial sweeteners sucralose (or better known as Splenda) and maltodextrin intensify Chrohn’s disease symptoms such as gut inflammation. The study uncovered these findings in mice with Chrohn’s-like diseases. (5)
- Oral contraceptives — Studies have linked birth control pills and the development of Crohn’s disease. Two large studies of U.S. women found that oral contraceptive use was associated with higher risk of Crohn’s disease. (6)
- Antibiotics — There’s evidence that the use of antibiotics may increase the risk of development of Crohn’s disease. (7)
- Virus and infection exposure − Experts now believe that IBD might sometimes be linked to unknown viruses or bacterial infections that cause high levels of inflammation and autoimmune reactions.
- Stress — The association of stress with Crohn’s disease is controversial, but there is no doubt that stress can make symptoms worse and trigger flareups. When you’re stressed out, your normal digestive process changes, and it changes in a negative way. Your stomach empties more slowly but secretes more acid. Stress can also speed or slow the passage of intestinal contents. It may also cause changes in intestinal tissue itself.
- Family history — You have an increased risk of developing Crohn’s if you have a close relative (such as a parent, sibling or child) with the disease. As many as one in five people with Crohn’s has a family member with the disease. (8) A gene known as NOD2 has been identified in recent years that is more commonly found in people with Crohn’s and families that have a history of the disease.
- Smoking — Crohn’s disease is on the extremely long list of negative side effects for cigarette smoking. It’s the most important controllable risk factor for developing the disease. If you have Crohn’s and smoke, you really need to quit.
- Nonsteroidal anti-inflammatory medications — These include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox), diclofenac sodium (Voltaren, Solaraze) and others. They can all lead to inflammation of the bowel that makes Crohn’s disease worse. (9)
- Where you live — If you live in an industrialized country or urban area, you’re more likely to develop Crohn’s disease. This suggests that environmental factors, including a diet high in fatty or refined foods, play a role in Crohn’s disease. People living in northern climates also seem to be at greater risk.
Conventional medicine says that the exact cause of Crohn’s disease remains unknown. However, I believe improper diet and stress are often at the root of Crohn’s disease for many sufferers. Even if Crohn’s runs in your family, with the right Crohn’s disease diet and lifestyle changes, you don’t have to follow your family history’s footsteps.
Some other possible causes include:
- Heredity — In 2001, Nod2, the first gene linked to Crohn’s disease, was discovered. Crohn’s disease is more prevalent in people who have family members with the disease. However, most people with Crohn’s disease don’t have a family history of the disease, which means in the majority of vases other factors must be involved.
- Virus or bacteria — It’s theorized by some that a virus or bacterium may trigger Crohn’s for some people. How? When your immune system tries to fight off these disease-causing invaders, an abnormal immune response causes the immune system to attack the cells in the digestive tract, leading to Crohn’s disease.
6 Natural Treatments For Crohn’s Disease
Living with IBD can be hard, but many people find that dietary changes, reducing stress and preventing malnutrition makes a significant difference in symptoms. Here are several of the most impactful ways to lower Crohn’s disease symptoms:
1. Eat a Crohn’s disease diet
This includes removing dairy, experimenting with removing gluten/most grains, avoiding excess sugar, reducing intake of all processed/packaged foods, eating more prebiotic and probiotic foods, and avoiding caffeine and alcohol as much as possible.
2. Monitor your symptoms & biofeedback
Every person with Crohn’s has a different experience and “triggers,” so it’s ultimately up to you to monitor how you feel when making dietary or lifestyle changes. Some people find that consuming high amounts of fiber and FODMAP foods (those which contain certain types of carbohydrates that can be hard to digest) worsens symptoms. Pay attention to which types of fruits, veggies, grains and beans are problematic. It’s also smart to limit consumption of raw fruits and veggies, and to reduce intake of gas-causing “cruciferous veggies” (broccoli, kale, cauliflower, etc.).
3. Drink plenty of fluids
Drinking plenty of water and other low-sugar, hydrating beverages helps to offset fluid loss caused by diarrhea. Drink at least eight 8-ounce glasses of plain water daily. You can also sip on soothing herbal tea or water infused with fruit throughout the day. Meanwhile, it’s important to avoid caffeine, sugary drinks and dairy.
4. Supplement
Because malabsorption/malnutrition is a serious concern for those with Crohn’s, it’s beneficial to take supplements including vitamin B12, a multivitamin, iron, a probiotic and omega-3 fish oils.
5. Reduce & manage stress
Stress tends to worsen digestion overall, increases muscle tension, cramping and spasms, and can raise inflammation. (10) Proven stress relievers include mind-body exercises like yoga, meditation, journaling, exercising, spending time outdoors and getting enough rest/sleep.
6. Try to avoid taking antibiotics, contraceptives and NSAID medications/drugs
These are known risk factors for IBD and can interfere with normal digestion and gut health.
7. Replenish good bacteria in the gut
A 2017 study performed by University of North Carolina Lineberger Comprehensive Cancer Center researchers found that a protein called NLRP12 correlates with inflammation in the body. (11) Analysis found low levels of NLRP12 in twins with ulcerative colitis, but not in twins without the disease. When NLRP12 was low, there were lower levels of friendly bacteria as well as high levels of harmful bacteria and inflammation.
Research is still necessary and treatment seems far off in the distance, but researchers believe they could add back more of the friendly bacteria in people with inflammatory bowel diseases with reduced NLRP12 expression to reduce inflammation and restore healthy bacteria, offering treatment to Crohn’s and other inflammatory bowel diseases.
Crohn’s Disease vs. IBS
Is it Crohn’s disease or irritable bowel syndrome? It can be tough to tell, since both are forms of IBD. Here are a few distinguishing characteristics of each.
IBS is much more common than Crohn’s. How much more common? As many as one in five American adults has signs and symptoms of irritable bowel syndrome, where less than 1 in 100 is diagnosed with Crohn’s.
IBS symptoms can be similar to those of IBD at times, but tend to be much less severe. The most common IBS symptoms include:
- Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
- Abdominal pain or cramping that improves with bowel movements
- A bloated stomach feeling
- Gas
- Mucus in the stool
As for Crohn’s disease, the most common symptoms include:
- Severe diarrhea (not constipation)
- Abdominal pain and cramping
- Fever and fatigue
- Blood in stool
- Ulcer and mouth sores similar to canker sores
- Reduced appetite and weight loss
Crohn’s Disease Data & Facts
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- According to the Centers for Disease Control and Prevention, 201 per 100,000 adults suffer from Crohn’s in the U.S.
- Estimated 1.4 million Americans suffer from Crohn’s disease or ulcerative colitis, which is 0.5 percent of the U.S. population.
- Ethnicity: Crohn’s occurs more in people of Caucasian and Ashkenazic Jewish origin than in other racial and ethnic subgroups.
- Location: There appears to be a north-south gradient worldwide, where populations in higher latitudes (i.e., Scandinavia, Canada and Australia) have higher incidence rates than populations in lower latitudes (i.e., Southern U.S., Spain and Italy). The highest rates occur in Canada.
- Sex: In the U.S., males and females are equally affected.
- Kids: Most people with an IBD like Crohn’s are diagnosed after age 15, but Crohn’s can be diagnosed at a younger age, although it’s rare in children younger than 8 years old. An estimated 50,000 children (under age 20) in the U.S. have IBD, representing 5 percent of all IBD patients. In children, Crohn’s disease occurs twice as frequently as ulcerative colitis. Slightly more boys than girls develop IBD (especially Crohn’s disease) in childhood.
- It is estimated that 75 percent of people with Crohn’s disease eventually undergo surgery. Up to 38 percent of people who have surgery for Crohn’s disease experience a recurrence in the first year after surgery. Smoking is the strongest risk factor for postoperative recurrence.
- In general, morbidity and mortality rates are higher for people who have Crohn’s disease compared to the unaffected population.
Crohn’s Disease Precautions
So to be sure you are dealing with Crohn’s disease, you should definitely seek medical attention — especially if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn’s disease, such as:
- Abdominal pain
- Blood in your stool or irregular poop
- Ongoing bouts of diarrhea
- Unexplained fever lasting more than a day or two
- Unexplained weight loss
Some of the more significant concerns with a bad case of Crohn’s disease include (14):
- Medication risks — Before you agree to any prescription medications, you should know that certain Crohn’s disease drugs act by blocking functions of the immune system that are associated with the risk of developing cancers, such as lymphoma and skin cancers. These medications also increase the risk of infection in general.
- Malnutrition — Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. It’s also common to develop anemic symptoms due to low iron or vitamin B12 caused by the disease.
- Colon cancer — Having Crohn’s disease that affects your colon increases your risk of colon cancer. General colon cancer screening guidelines for people without Crohn’s disease call for a colonoscopy every 10 years beginning at age 50.
- Other health problems – Crohn’s disease can cause issues in other parts of the body, like anemia, osteoporosis, and liver or gallbladder disease.
If Crohn’s disease diet and lifestyle changes, drug therapy, or other treatments don’t relieve your Crohn’s symptoms, then your doctor may likely recommend surgery. Up to one-half of individuals with Crohn’s disease require at least one surgery. However, surgery does not cure Crohn’s disease! (15)
Death due specifically to Crohn’s disease or its complications is uncommon. However, people with Crohn’s disease have a slightly higher overall mortality rate than the general healthy population. The increase in deaths is largely due to conditions such as cancer (particularly lung cancer), chronic obstructive pulmonary disease, gastrointestinal diseases (both including and excluding Crohn’s disease), and diseases of the genital and urinary tracts. (16)
Final Thoughts on Crohn’s Disease Symptoms
- Crohn’s disease is a type of Inflammatory Bowel Disease (IBD) that is caused from inflammation of the intestines and GI tract.
- Symptoms of Crohn’s can be severe and include frequent diarrhea, fluid loss, cramping and spasms of the digestive tract, fatigue, weight loss, malnutrition, and other complications.
- Causes of Crohn’s are not entirely known, but include a poor diet, chronic stress, genetic factors, and an over-worked immune system due to viruses or bacteria.
- Natural treatments for Crohn’s include eating a healing Crohn’s diet, managing stress, supplementing, and avoiding intake of medications or antibiotics that can worsen symptoms.