Crohn’s Disease – Severe, Painful, and Misunderstood

Severe cramps, having to run to the bathroom every few minutes, fatigue – these are classic symptoms of a food poisoning. However, if you experience them for more than a few days, run to the doctor – it may be the first sign of Crohn's disease.

The signs

Some very serious digestive conditions masquerade as banal diarrhea and are often misdiagnosed. A mysterious disease that affects over 500 thousand people in the US, Crohn’s can be debilitating and even life-threatening. It usually flares up suddently in young people… and never really goes away. Here are the main symptoms (a detailed list can be found here):

• Intestinal pain
• Diarrhea and cramping
• Extreme fatigue
• Weight loss
• Joint pain
• Sores around eyes and mouth

People with Crohn’s disease often find it difficult to study or keep a job because of their frequent bathroom breaks. Travelling becomes a challenge, too, since such patients must always have quick access to a toilet. Finally, up to 50% of people living with Crohn’s need at least one surgery. But what is the cause of all this suffering?

The body attacking itself

Crohn’s is most probably an autoimmune disease – something causes the body to view its own intestinal lining as an enemy. Immune cells are sent to fight the “danger”, and the products of their activity cause an inflammation. While Crohn’s is not caused by bad diet or an infection, it is often triggered by a certain episode – a food poisoning or a reaction to antibiotics. Most people live through multiple flare-ups separated by periods of relative normalcy.

Treatable but not curable

While scientists are searching for a cure, doctors have to apply many methods to make living with Crohn’s disease bearable.

1. Anti-inflammatory drugs, like corticosteroids (more on drug treatment here).
2. Pain medications based on acetaminophen but NOT ibuprofen, which makes the disease worse.
3. Immunosuppressants – however, they can make the body less resistant to disease in general.
4. Diet – often certain foods, such as dairy or sugar, can trigger a flare-up.
5. Anti-diarrhea drugs – usually used only for bad flare-ups, they don’t treat the condition, but can be necessary when one needs to travel.
6. Surgery – up to 50% if Crohn’s patients require at least one surgery to have the damaged portion of the intestine removed (more info here).

A glimmer of hope?

It seems that Crohn’s disease is caused by particular bacteria living in the gut. Our microbiome consists of hundreds of species, but a new study  specifies three culprits: E.coli, Erratia marcescens, and Candida tropicalis. Now scientists are looking for a way to remove these microorganisms from the intestinal flora. Another treatment may be offered by the new field of bioelectronics. A small device is implanted on the vagus nerve, programmed to block the commands the brain gives to the immune system. This can prevent the inflammation in the first place (details here). We may soon have a new treatment for this debilitating disease, but meanwhile do not ignore the symptoms and get a colonoscopy and a biopsy if you suspect you might have Crohn’s; and be very understanding towards those who suffer from this condition: remember that they live in pain.