How is Crohn's disease diagnosed?
A thorough physical exam and a series of tests may be
required to diagnose Crohn's disease.
Blood tests may be done to check for anemia, which could
indicate bleeding in the intestines. Blood tests may also
uncover a high white blood cell count, which is a sign of
inflammation somewhere in the body. By testing a stool sample,
the doctor can tell if there is bleeding or infection in the
intestines.
The doctor may do an upper gastrointestinal (GI) series to
look at the small intestine. For this test, the patient drinks
barium, a chalky solution that coats the lining of the small
intestine, before x rays are taken. The barium shows up white on
x-ray film, revealing inflammation or other abnormalities in the
intestine.
The doctor may also do a colonoscopy. For this test, the
doctor inserts an endoscope--a long, flexible, lighted tube
linked to a computer and TV monitor--into the anus to see the
inside of the large intestine. The doctor will be able to see
any inflammation or bleeding. During the exam, the doctor may do
a biopsy, which involves taking a sample of tissue from the
lining of the intestine to view with a microscope.
If these tests show Crohn's disease, more x rays of both the
upper and lower digestive tract may be necessary to see how much
is affected by the disease.
[Top]
What are the complications of Crohn's disease?
The most common complication is blockage of the intestine.
Blockage occurs because the disease tends to thicken the
intestinal wall with swelling and scar tissue, narrowing the
passage. Crohn's disease may also cause sores, or ulcers, that
tunnel through the affected area into surrounding tissues such
as the bladder, vagina, or skin. The areas around the anus and
rectum are often involved. The tunnels, called fistulas, are a
common complication and often become infected. Sometimes
fistulas can be treated with medicine, but in some cases they
may require surgery.
Nutritional complications are common in Crohn's disease.
Deficiencies of proteins, calories, and vitamins are well
documented in Crohn's disease. These deficiencies may be caused
by inadequate dietary intake, intestinal loss of protein, or
poor absorption (malabsorption).
Other complications associated with Crohn's disease include
arthritis, skin problems, inflammation in the eyes or mouth,
kidney stones, gallstones, or other diseases of the liver and
biliary system. Some of these problems resolve during treatment
for disease in the digestive system, but some must be treated
separately.
[Top]
What is the treatment for Crohn's disease?
Treatment for Crohn's disease depends on the location and
severity of disease, complications, and response to previous
treatment. The goals of treatment are to control inflammation,
correct nutritional deficiencies, and relieve symptoms like
abdominal pain, diarrhea, and rectal bleeding. Treatment may
include drugs, nutrition supplements, surgery, or a combination
of these options. At this time, treatment can help control the
disease, but there is no cure.
Some people have long periods of remission, sometimes years,
when they are free of symptoms. However, the disease usually
recurs at various times over a person's lifetime. This changing
pattern of the disease means one cannot always tell when a
treatment has helped. Predicting when a remission may occur or
when symptoms will return is not possible.
Someone with Crohn's disease may need medical care for a long
time, with regular doctor visits to monitor the condition.