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Diseases & Conditions

Crohn's Disease Overview

Crohn’s disease is a chronic inflammation of the digestive tract. Inflammation begins at the surface of the tissue and, over time, penetrates into the deep tissue layers of the affected area. Usually, the lower portion of the small intestine and/or the large intestine are affected, but any part of the digestive system can be involved.

Crohn’s disease is believed to be caused by a disorder of the immune system, the body’s natural defense against infection. It is commonly thought that the immune system triggers an inflammatory response in other parts of the body, causing the disorder.

Prevalence

The disease occurs with the same frequency in men and women. It also seems to be more common in people who live in northern climates and in those who live in an urban area or an industrialized country.

Typically, a person begins to notice symptoms of Crohn’s disease between ages 16 and 40. When Crohn’s disease occurs in children, it can cause delayed development and growth.

Once it develops, Crohn’s disease can recur at any time over a lifetime. Some people experience long periods without symptoms, known as remission. However, there is no way to predict if or when remission will occur or how long it will last.

Symptoms

Symptoms of Crohn’s disease vary greatly from person to person, depending on what section of the digestive tract is affected.

The most common symptoms are abdominal pain, cramping and diarrhea.

Symptoms can also include:

  • Fever
  • Weight loss
  • Rectal bleeding
  • Abscesses
  • Fissures
  • Bloating
  • Lump in the lower right abdomen
  • Joint pain

Crohn’s disease disrupts bowel function and can lead to some serious complications:

  • Tissue lining of the bowel can swell, thicken or scar and block bowel movement.
  • Ulcers, or open sores, can develop deep in the tissue and cause infection, severe pain and diarrhea.
  • The bowel may become unable to absorb nutrients from digested food, leading to nutritional problems.
  • Abnormal passageways (fistulas) may develop from one part of the bowel to another or from the bowel to a nearby structure such as the vagina or bladder.

Other potential complications include arthritis, kidney stones, gallstones, inflammation of the eyes and mouth, skin rashes and skin ulcers.

Treatment

There is no cure for Crohn’s disease, but medical treatment can be very effective in managing early Crohn’s disease and relieving symptoms. Cleveland Clinic specialists use a combination of the latest drug therapy, diet, and exercise to control inflammation, treat symptoms and correct nutrition problems.

Inflammation is part of the body’s natural immune response to a virus, bacteria or – when the immune system disfunctions – its own tissue. Suppressing the immune response with drugs reduces inflammation.

The main classes of medications used for treatment include:

  • Anti-inflammatory drugs
  • Antibiotics to treat any infections
  • Immune system suppressors

As many as 75 percent of people with Crohn’s disease eventually have surgery. Surgery can control bleeding and repair complications such as abscesses, perforations and blockages. When performed by an experienced colorectal surgeon, surgery for Crohn’s disease is safe and does not cause further complications.

Surgical Treatments

Cleveland Clinic colorectal surgeons offer the latest surgical treatments for Crohn’s disease, with an emphasis on a conservative approach.

These surgical treatments can provide long-term symptom relief and reduce or eliminate the need for medication:

  • Resection involves removing the diseased portion(s) of the intestine and reconnecting the two healthy ends. It is the most commonly used surgical treatment.
  • Strictureplasty is the surgical widening of sections of the intestine that have become narrowed due to scarring.

Whenever possible, Cleveland Clinic surgeons use small incision (laparoscopic) surgical techniques with Crohn’s disease patients to shorten the hospital stay, reduce postoperative pain and speed recovery.

Even at the hands of the most experienced surgeon, surgery is not a cure for Crohn’s disease. In many patients, the inflammation returns in another section of the bowel and they eventually need another operation. But other patients never require another operation and can manage their disease with medication alone for the rest of their lives.

Advanced Cases

For patients with advanced Crohn’s disease or those who do not respond to medical treatment, a gastroenterologist and colorectal surgeon experienced in managing Crohn’s disease are best equipped to help patients decide the next step in treatment. Cleveland Clinic surgeons are experienced in treating these patients. Even patients who have had previous resections for Crohn’s disease can be treated successfully to minimize symptoms and improve their quality of life.

Cleveland Clinic colorectal surgeons also are experienced in a variety of techniques that preserve fecal continence in patients with Crohn’s disease of the anus or rectum. The leading techniques for this type of surgery were pioneered here.