Chicago Health | Homepage
Crohn’s disease worsens without treatment

Crohn’s disease worsens without treatment

DEAR MAYO CLINIC: My daughter is 19 and was recently diagnosed with Crohn’s disease. What is considered a flare-up? Her symptoms seem to be quite mild so far. Is it possible that this will continue, or do they usually worsen with time?

ANSWER: Crohn’s disease is a long-term condition that causes inflammation of the digestive tract lining. This inflammation can involve any part of the digestive tract, but it’s most common in the lower portion of the small intestine and in the large intestine. Unlike ulcerative colitis (another inflammatory condition), Crohn’s disease usually affects the entire thickness of the bowel wall.

People with Crohn’s disease typically have intermittent symptoms due to active inflammation. These are called flares. The flares usually alternate with periods of remission when there’s no active inflammation or symptoms. A flare may happen if a person with Crohn’s disease doesn’t take medication as prescribed, develops certain infections, receives antibiotics, or takes pain medications, including aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen. Stress also may trigger a flare and result in symptoms of Crohn’s disease becoming worse.

The most common symptoms of a flare are abdominal pain and diarrhea. Other symptoms include rectal bleeding, nausea and vomiting, weight loss, fever, fatigue, pain and drainage around the anal area. People with Crohn’s disease may experience additional symptoms such as joint pains, painful red eyes or a skin rash. During a flare, symptoms can range from mild to severe, depending upon location of disease, length of the intestine involved and the degree of underlying inflammation. Those with early or mild disease usually have milder symptoms.

In the absence of treatment, Crohn’s disease usually tends to get worse over time and may result in serious complications. Complications can include narrowing of the intestine due to inflammation or scar tissue, called strictures; breakdown of tissue between the bowel and bladder, vagina, skin or other segments of bowel, a condition known as fistulae; and malnutrition. There’s also a risk of life-threatening complications, such as a bowel tear or perforation.

People diagnosed with Crohn’s disease in childhood or adolescence and those with perianal disease are at an increased risk of flares and disease progression. Smoking increases the risk of developing Crohn’s disease, leads to frequent flares and disease progression, and makes the need for surgery due to Crohn’s disease more likely.

Women with Crohn’s disease who would like to become pregnant should continue medical management for the disease and talk to their doctor. They should try to conceive when they are in remission, if possible. Women who conceive during a flare may continue to have symptoms throughout pregnancy. Stopping medications during pregnancy can also precipitate a flare and lead to pregnancy-related problems like miscarriage, premature delivery and low birth weight.

Without proper treatment, most people with Crohn’s disease eventually require surgery for disease-related complications. Surgery does not cure the disease, however, as Crohn’s often returns in the remaining part of the intestine. Although there is no cure, there are medications that can reduce inflammation, improve quality of life, avoid complications and prevent surgery. The goal of medical treatment is to prevent disease flares and maintain remission. The medications currently available are aminosalicylates, steroids, immunosuppressant agents and biologics.

Physicians use a combination of symptoms, lab tests, endoscopy and imaging exams to evaluate the disease and decide on the treatment that’s best for each individual. Medical therapy for Crohn’s disease often has to be taken for life. If flares continue, the physician may change medication dosages or recommend switching to a different medication. In addition to medical treatment, a healthy lifestyle, regular exercise, not smoking, yoga and meditation also may be beneficial in the management of Crohn’s disease. — Shabana Pasha, M.D., Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Ariz.

(Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. E-mail a question to MayoClinicQ&A@mayo.edu. For more information, visit www.mayoclinic.org.)

(c) 2015 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.

Similar Articles

Could It Be Crohn’s?

Could It Be Crohn’s?

Young people with the disease often go undiagnosed By Rhonda Alexander Imagine jolting awake from a deep

Can you be held responsible for your parents’ long-term-care costs?

Can you be held responsible for your parents’ long-term-care costs?

By Eleanor Laise, Kiplinger Retirement Report When an older adult racks up unpaid long-term-care bills, who's

Rare syndrome causes overly flexible joints, fragile skin

Rare syndrome causes overly flexible joints, fragile skin

Mayo Clinic Q&A DEAR MAYO CLINIC: I was recently diagnosed with vascular Ehlers-Danlos syndrome. My doctor

Calcium is crucial for long-term bone health

Calcium is crucial for long-term bone health

Mayo Clinic Q&A DEAR MAYO CLINIC: Should all postmenopausal women take calcium supplements to prevent osteoporosis,

De-stress your life

De-stress your life

By Sandra Block, Kiplinger Personal Finance How stressed-out are we? Consider this: In some cities, "rage

Articles By Category

Family Health

In The Know

CH Lifestyle

January 2017
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
December 25, 2016 December 26, 2016 December 27, 2016 December 28, 2016 December 29, 2016 December 30, 2016 December 31, 2016
January 1, 2017 January 2, 2017 January 3, 2017 January 4, 2017 January 5, 2017 January 6, 2017 January 7, 2017
January 8, 2017 January 9, 2017 January 10, 2017 January 11, 2017 January 12, 2017 January 13, 2017 January 14, 2017
January 15, 2017 January 16, 2017 January 17, 2017 January 18, 2017 January 19, 2017 January 20, 2017 January 21, 2017
January 22, 2017 January 23, 2017 January 24, 2017 January 25, 2017 January 26, 2017 January 27, 2017 January 28, 2017
January 29, 2017 January 30, 2017 January 31, 2017 February 1, 2017 February 2, 2017 February 3, 2017 February 4, 2017

Categories

Recent Comments

Swing for the fences in the fight to Sideline Pancreatic Cancer

Swing for the fences in the fight to Sideline Pancreatic Cancer

Enjoy a great night of baseball at Peoples Natural

VIEW ARTICLE
Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

A Hazy Shade of Healthcare: What does tort reform

VIEW ARTICLE

Archives