Crohn’s disease

Crohn’s Disease is an inflammatory disease of the gastrointestinal tract (GI tract).  Unlike Ulcerative Colitis, which effects only the rectum and large intestine (colon), Crohn’s Disease can effect any portion of the GI tract, from the mouth to the anus.  Most often it can be found in the lower end of the small intestine, called the ileum.  It also differs from Ulcerative Colitis in that the inflammation of Crohn’s Disease effects the full thickness bowel, as opposed to just the inner lining, as happens in Ulcerative Colitis.  This explains why, in Crohn’s Disease, the inflammation may extend right through the GI tract and cause inflammation or tunnels (fistulas) into adjacent organs in the abdominal cavity, something that almost never happens in Ulcerative Colitis.  Another difference is that in Ulcerative Colitis, removal of the rectum and colon results in a total cure of the disease, whereas in Crohn’s Disease the inflammation may develop elsewhere even after surgery has apparently removed all detectable disease.  So surgery, and all current treatments do not cure Crohn’s Disease, they merely control it.  In Crohn’s Disease, the inflamed bowel wall gradually becomes thickened and the actual passageway (lumen) of the bowel can become narrowed so that the patient develops intestinal obstruction.  This does not happen in Ulcerative Colitis.  Intestinal obstruction is one of the most common reasons for surgery in Crohn’s Disease.

Crohn’s Disease may cause abscesses or more complex problems such as fistulas in the anal area.  In fact, this may be the initial way that it declares itself.  Some patients will have Crohn’s trouble only in the anus, but most patients with Crohn’s involvement in the anus will be found to have inflammation elsewhere (usually the small intestine) upon careful questioning for symptoms, or by way of diagnostic tests.

© Pezim Clinic, Vancouver, British Columbia, Canada