What Is Crohn's Disease?
Crohn's disease is an inflammatory disease of the GI tract that causes abdominal pain, diarrhea, fatigue and weight loss. The inflammation usually involves the last part of the small intestine (terminal ileum), but any part of the GI tract from the mouth to anus can be involved. Unlike ulcerative colitis, Crohn's disease does not usually involve the rectum. The disease typically has a pattern of remissions and exacerbations, which can be mild or severe.
The intestinal lesions of Crohn's are characterized by a "skip" pattern where segments of inflamed tissue are separated by segments of apparently normal tissue. The inflammation extends through the entire thickness of the intestinal wall.
Crohn's can have many severe complications including:
- Intestinal blockage
- Hemorrhage (massive blood loss)
- Severe vitamin and mineral deficiencies that can lead to neurological problems
Crohn's disease is most common in people of European descent, with a very high frequency in the Jewish population.
What Causes Crohn's Disease?
Crohn's disease is autoimmune related, and genetics play an important role. Recent research has shown that people who have the NOD2/CARD15 gene have an increased immune response to certain bacteria and yeasts that live in the GI tract. This immune response causes inflammation that leads to destruction, ulcers and scarring of the intestines. Other triggers, such as unhealthy foods, stress and certain medications may also contribute to this disease.
Signs and Symptoms: How to Tell if You Might Have Crohn's Disease
Common signs and symptoms of Crohn's disease include:
- Abdominal tenderness and/or distention
- Abdominal mass
- Colicky abdominal pain that happens before (and gets better after) a bowel movement
- Chronic or nighttime diarrhea (usually non-bloody)
- Greasy stools
- Nausea and vomiting
- Night sweats
- Loss of appetite
- Weight loss (up to 10-20% of body weight)
- Fear of eating
- Mouth ulcers
- Sore, glossy red tongue (atrophic glossitis)
- Sores and abscesses around the anus and in the rectum
- Difficulty urinating
- Joint swelling and joint pain
- Hot, red, tender lumps or nodules over the shins (erythema nodosum)
- Eye inflammation (conjunctivitis, uveitis, scleritis)
How is Crohn's Disease Diagnosed?
Diagnosis of Crohn's is based on your symptoms, physical exam findings, lab tests and diagnostic imaging. If you have Crohn's, your blood tests may show:
- Low hemoglobin (Hbg)
- Low hematocrit (Hct)
- Low B12
- Low potassium
- Low albumin
- Low calcium
- Elevated erythrocyte sedimentation rate (ESR)
- Elevated C-reactive protein (CRP)
- Elevated white blood cells
- Positive perinuclear antineutrophil antibodies (pANCAs)
- Positive anti-Saccharomyces cerevisiae antibodies (ASCA)
To confirm the diagnosis, your gastroenterologist will order imaging such as endoscopy, colonoscopy and CT to look for ulcers, lesions and strictures in your GI tract.
What are the Conventional Treatment Options for Crohn's Disease?
The standard treatment of Crohn's is based on how mild or severe your condition is. The most commonly-prescribed medications include corticosteroids and other immune-suppressing drugs. Some people with Crohn's will require tube feeding and nutrition supplementation. Antibiotics may also be used when infection is present or suspected.
What are the Natural Treatments Options for Crohn's Disease?
At Attune, we treat Crohn's by addressing the underlying inflammation and immune system imbalance.
We begin with a comprehensive initial intake to assess your past medical history and perform comprehensive lab testing. One of the lab tests that we order for most of our patients is the GI-MAP test from Diagnostic Solutions Laboratory. This is a test in which your stool is tested for viral, bacterial and fungal infections, as well as markers of inflammation and digestion, through DNA analysis. Detecting and treating GI infections is critical, because these pathogens can be a trigger for autoimmune disease and perpetuate the cycle of inflammation.
Crohn's disease causes nutrient deficiencies, and those deficiencies result in further immune system dysregulation and poor healing. Many people with Crohn's are deficient in iron, vitamin B12, folate, calcium, vitamin D, magnesium, zinc and vitamin A. Through clinical nutrition we work to stop any further irritation to the GI tract, calm the immune response and optimize nutrient levels in the body.
Another important part of healing through nutrition is to remove foods from the diet that cause further inflammation (most notably grains, sugar and vegetable oils).
Depending on a person's health history and current medications, we may also recommend specific herbal medicines that block inflammation, balance the immune system and help to heal the digestive tract.