Crohn’s disease

Crohn’s disease is a chronic, non-infectious inflammatory condition affecting the digestive tract. It is a form of inflammatory bowel disease (IBD) that can cause inflammation anywhere from the mouth to the anus.

Around 1 in 1,000 people in the UK have Crohn’s disease, with 3,000 to 6,000 new cases diagnosed each year. The ileum (the last part of the small intestine) is the most commonly affected area, but inflammation can also occur in the colon, rectum, and anal region.

In severe cases, Crohn’s disease can lead to narrowing of the bowel (strictures), abscesses, and fistulas.

What causes Crohn’s disease?

The exact cause of Crohn’s disease is unknown, but it is believed to involve an abnormal immune response. Key risk factors include:

Genetics – Having a close family member with Crohn’s disease increases your risk
Immune system – The immune system attacks the bowel lining, causing inflammation
Smoking – A major risk factor for developing and worsening Crohn’s disease
Ethnicity – More common in people of Caucasian descent compared to those of Black or Asian backgrounds

Symptoms of Crohn’s disease

Symptoms vary depending on the area of the digestive tract affected. The most common symptoms include:

Cramping abdominal pain – Often worsens after eating
Frequent diarrhoea – Loose stools, sometimes containing blood and mucus
Unintended weight loss
Fatigue and weakness
Mouth ulcers
Abscesses, infections, or fistulas around the anus

Less common symptoms can include:

Joint pain and swelling
Skin rashes and ulcers
Eye inflammation

Crohn’s disease symptoms can overlap with other conditions such as ulcerative colitis and irritable bowel syndrome (IBS), making accurate diagnosis essential.

How is Crohn’s disease diagnosed?

Crohn’s disease is most commonly diagnosed between the ages of 10 and 40, but it can be confirmed at any age. There is no single test for diagnosis, and multiple investigations may be required.

Your doctor may recommend:

Blood tests – To check for inflammation and infection
Stool tests – To rule out infections that could cause similar symptoms
Flexible sigmoidoscopy or colonoscopy – A camera examination of the bowel to assess inflammation and take biopsies
MRI enteroclysis – A non-invasive scan to assess the small intestine
CT scan – Helps detect inflammation, strictures, and abscesses in the bowel
MRI scan – Particularly useful for evaluating fistulas and abscesses around the anus

Treatment for Crohn’s disease

Treatment aims to control inflammation, relieve symptoms, and prevent complications.

Medical treatment

You may be prescribed:

5-ASA drugs – Anti-inflammatory medications for the bowel
Steroids – Used in short courses to reduce inflammation during flare-ups
Immunosuppressants (e.g., azathioprine) – Help regulate immune response
Biologic therapies (anti-TNF drugs like infliximab) – Target specific immune system proteins to reduce inflammation
Antibiotics – Used to treat infections, abscesses, or fistulas

Surgical treatment

Surgery is not a cure for Crohn’s disease, but it may be required if:

There is narrowing or blockage (stricture) in the bowel
There are abscesses or fistulas that do not respond to medication
There is severe inflammation that does not improve with medical treatment

Common surgical procedures include:

Right hemicolectomy – Removal of the right side of the colon
Ileocolic resection – Removal of the last part of the small intestine and the first part of the colon
Left hemicolectomy – Removal of the left side of the colon
Sigmoid colectomy – Removal of the sigmoid colon
Subtotal colectomy or pan-proctocolectomy – Removal of most or all of the colon
Loop ileostomy – A temporary or permanent stoma to allow the bowel to rest

Perianal Crohn’s disease treatment

If you have abscesses or fistulas around the anus, you may need:

Drainage procedures to remove pus from abscesses
Seton placement – A drainage tube to keep fistulas open and promote healing

Lifestyle advice for managing Crohn’s disease

Stop smoking – Smoking increases the risk of flare-ups and complications

Monitor your diet – Some foods, like high-fibre or fatty foods, may worsen symptoms

Manage stress – Psychological stress can trigger flare-ups

Get in touch to make a private appointment request with the Rapid Access Bowl Clinic, or call our team on 0161 495 7046 who will be happy to help.