What is it
It is a chronic inflammatory disease of autoimmune origin (sometimes also called ileocolitis) that usually affects the small intestine and/or colon.
More rarely, it also affects other parts of the gastrointestinal tract (duodenum, cecum, stomach and esophagus).
The disease is characterized by periods of exacerbation of symptoms interspersed with periods of relative normality.
Causes
The causes of Crohn’s disease are not known, but it is known that a genetic predisposition is involved that leads the immune system to react excessively to food, infectious or environmental stimuli to the point of damaging the intestinal wall.
The state of chronic inflammation induces an edema of the intestinal mucosa, a hypertrophy of the intestinal musculature and the formation of fibrotic tissues that can obstruct the lumen.
Characteristic of the disease is the clear delimitation of the diseased intestinal segments, which are located next to normal deliveries.
Most common symptoms
Weight loss, chronic diarrhea, abdominal pain (often in the lower right quadrant of the abdomen) are the most common symptoms, sometimes accompanied by fever.
Sometimes, especially in children, the initial symptoms are represented by arthritis, erythema nodosum (subcutaneous reddish nodules) or fever of unknown origin, accompanied by a delay in development.
Complications
Intestinal obstruction, the formation of fistulas and abscesses are the most common complications.
Particularly frequent is the formation of fistulas in the and rectal regions, but these can also occur in the bladder. More rarely, perforation of the intestine or the development of cancer is observed.
In the acute phases of advanced and severe forms, complications such as thrombosis and embolism may also occur.
The alteration of the metabolism of the intestine also makes it easier for kidney stones to form.
It is not uncommon for patients with Crohn’s disease to also experience arthritis, ankylosing spondylitis, sacroiliitis, uveitis and sclerosing cholangitis.
The coexistence of these diseases is linked to genetic factors common to all these disorders, whose course is also independent of that of Crohn’s disease.
Treatment
The therapy is symptomatic and is aimed at alleviating disorders and reducing the risk of complications.
In the acute phases, corticosteroid therapy relieves pain, reduces diarrhea and fever and allows some appetite recovery. For the treatment of fistulas and abscesses, antibiotics are prescribed.
For long-term treatment, immunosuppressive drugs can be resorted to, the use of which requires careful medical supervision.
In a large number of cases, especially in the face of repeated episodes of intestinal obstruction or intractable intestinal abscesses, it is eventually necessary to resort to surgery for the removal of the injured parts of the intestine.
Sometimes, if the surgery is challenging, it is necessary to perform a temporary colostomy. Although it does not lead to a definitive cure, usually after surgery the symptoms do not occur for years.
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Foods “yes” and those “no”
There is no single diet suitable for all patients with Crohn’s disease. To identify the foods to avoid it can help, in a submissive phase, to follow exclusion diets.
In principle, the possible foods to keep an eye on and those which are considered “acceptable”, but which it is still advisable to test with an exclusion diet, are the following.
| Foods to “Watch” | “acceptable” foods |
|---|---|
| Fresh bread (white and wholemeal) | Crackers, rusks, breadsticks |
| Cabbage, cauliflower, Brussels sprouts, legumes, asparagus, beets, onions, leeks, tomatoes, spinach | Lean white or red meat, grilled or steamed |
| Milk, dairy products, cheeses | Defatted cooked or raw ham |
| Fatty meats | Grilled or boiled lean fish |
| Sausages, lard | Zucchini, carrots, fennel, lettuce, aubergines |
| Fish | Probiotic yogurt (if there is no lactose intolerance) |
| Egg | |
| Fried and elaborate dishes | |
| Sweets, cocoa, chocolate | |
| Fruits (moderate consumption, especially bananas and citrus fruits) | |
| Alcohol, coffee, caffeinated sodas, sodas (even water) |
When to see your doctor
In the presence of symptoms such as chronic diarrhea or persistent abdominal pain, it is advisable to contact the family doctor. In children, also in case of growth difficulties accompanied by symptoms of arthritis or erythema nodosum.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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