Crohn’s Disease

Talking about bowel problems with your healthcare provider might seem embarrassing, but it’s important. The first step toward making life more manageable? It’s getting diagnosed early and starting treatment. And it can reduce your risk of complications, like blockages, ulcers or even cancer.

So, giving your provider a heads up on what’s going on is the No. 1 thing you’ll do at your appointment. Chances are you’ve had ongoing diarrhea and cramps in your belly. And maybe you’ve been losing weight. After your provider listens to your symptoms, they’ll ask about your medical history and do a physical exam. They may also order one or more of these tests:

• Blood tests: A high number of white blood cells can mean you have an infection or inflammation. Low red blood cells (anemia) is common if you have Crohn’s.
• Stool test: This test looks for bacteria or parasites in your stool (poop). It can also rule out infections that can cause chronic diarrhea.
• CT scan: A CT scan makes images of your digestive tract so your provider can see how much inflammation is in your intestines.

After these tests are complete, your provider will schedule a colonoscopy to look inside your colon (large intestine). They may also do an upper gastrointestinal (GI) endoscopy to look at other parts of your digestive system. These tests can show inflammation, tissue damage or other IBD complications, such as strictures (narrowing in the intestines) and fistulas.

Crohn’s disease affects everyone differently, so there’s no standard treatment that will work for everyone. At Cleveland Clinic, we develop your personalized treatment plan based on your test results and conversations with your provider. We work closely with you to decide on treatment options to control inflammation so you don’t have symptoms.

Medical options for Crohn’s disease

Treatments for Crohn’s disease vary depending on your symptoms and how severe your Crohn’s is. For mild inflammation, our registered dietitians help create an eating plan that avoids foods that can irritate your digestive system. They might also suggest not eating or drinking for a few days to give your intestines a rest and settle down the inflammation. During this time, you may get the nutrition you need through an IV, drink only a certain liquid or have a feeding tube.

There are also several medications that can control inflammation, manage symptoms and prevent further damage to your digestive tract. They include:

• Antibiotics, which can prevent or treat infections.
• Antidiarrheal medications, which can stop really bad diarrhea.
• Biologics, which can calm your immune system.
• Corticosteroids or immunomodulators, which can control inflammation.

Surgery for Crohn’s disease

Your care team may recommend surgery if other treatments don’t relieve your symptoms or if you have a more severe form of Crohn’s. Surgery may also be needed to repair blockages or bleeding. If you need surgery, we’ll try to save as much of your intestines as possible. We use minimally invasive techniques (performing through small incisions) when possible. This reduces scarring and helps you recover faster.

Surgeries for Crohn’s disease include:

• Abscess drainage: Abscesses are small collections of pus that can cause infections. In this procedure, surgeons drain the abscess to relieve pain and other symptoms.
• Fistula removal: Surgeons remove the fistulas (openings that connect two organs that don’t usually connect) to stop food and liquid from going outside the normal digestive pathway.
• Strictureplasty: Crohn’s disease can cause scarring inside your intestines that can narrow the passageway, creating a blockage. This procedure repairs the parts of your intestines that have narrowed to keep digestive contents flowing.
• Small bowel resection: Resection surgery removes a damaged portion of your small intestine. Then, the surgeon stitches together the two healthy sides of your intestine to reconnect them (called an anastomosis).
• Ileostomy or colostomy: This surgery creates an opening to the outside of your body (ileostomy or colostomy) with an ostomy bag attached to collect poop. You empty the bag throughout the day. An ileostomy typically restores your health and quality of life, and may be temporary or permanent.

Even after surgery, symptoms of Crohn’s disease can return. After surgery, our gastroenterologists often follow up with medications to reduce inflammation and minimize your risk of additional flare-ups.

Taking the Next Step

If you have Crohn’s disease, or think you might, don’t delay. Reach out to your healthcare provider and get the help you need. Cleveland Clinic IBD specialists are ready to help empower you to take back control of your life. Give us a call today.