Question 1

What Is Crohn’s Disease?

Accepted Answer

Crohn's disease is a chronic condition that causes inflammation in any part of the gastrointestinal tract, from the mouth to the anus. It commonly affects the small intestine and the beginning of the large intestine. It is a type of inflammatory bowel disease (IBD). Crohn's disease is characterised by periods of flare-ups, where symptoms worsen, followed by periods of remission, where symptoms improve or disappear. It typically requires lifelong management and can significantly impact a person's quality of life.

Question 2

Types of Crohn’s Disease

Accepted Answer

Crohn's disease presents in five main types, each characterised by inflammation in different parts of the gastrointestinal tract. These types include: (1) Ileocolitis - Inflammation occurs at the end of the small intestine (ileum) and extends to a portion of the large intestine (colon). (2) Ileitis - Inflammation affects the last section of the small intestine (ileum). (3) Crohn's (Granulomatous) Colitis - Inflammation is limited to the colon. (4) Gastroduodenal Crohn’s - Inflammation involves the stomach and the beginning of the small intestine (duodenum). (5) Jejunoileitis - Inflammation occurs in the middle part of the small intestine (jejunum).

Question 3

What are the Risk Factors for Crohn’s Disease?

Accepted Answer

Several factors can increase the risk of developing Crohn's disease, including: (1) Family History - Having a parent, child, or sibling with the disease increases the risk of developing Crohn's disease. (2) Smoking - Tobacco use is linked to an increased risk, as well as more severe symptoms and a higher likelihood of needing surgery. (3) Environmental Factors - Factors such as microbiota, microorganisms, stress, and diet have been associated with the risk of developing Crohn's disease. (4) Age - While Crohn's disease can occur at any age, most cases are diagnosed in early adulthood. (5) Medication - Certain medications have been identified as potential risk factors for developing Crohn's disease.

Question 4

What are the Signs and Symptoms of Crohn’s Disease?

Accepted Answer

The symptoms of Crohn's disease can manifest gradually or suddenly, ranging from mild to severe. Common ones include: (1) Diarrhoea - Persistent or recurring diarrhoea, which may be bloody in some cases. (2) Abdominal Pain and Cramping - Often located in the lower right side of the abdomen. (3) Weight Loss - Unintentional weight loss due to decreased appetite and malabsorption of nutrients. (4) Fatigue - Generalised fatigue and weakness, possibly due to anaemia or the systemic effects of chronic inflammation. (5) Fever - Low-grade fever, especially during flare-ups of the disease. (6) Perianal Disease - Inflammation around the anus, leading to pain, drainage, abscesses, and fistulas. (7) Reduced Appetite - Loss of appetite or feeling full quickly, potentially contributing to weight loss. (8) Nausea and Vomiting - Common symptoms, especially during active disease periods. (9) Joint Pain - Inflammation in the joints, resulting in pain and discomfort.

Question 5

How Is Crohn’s Disease Diagnosed?

Accepted Answer

Doctors initially conduct a thorough physical examination to assess symptoms and signs of Crohn's disease. They may also require additional tests before confirming the diagnosis. These tests include: (1) Blood Tests - Blood tests may be ordered to check for anaemia, infection, inflammation, and other indicators of disease activity. (2) Stool Sample Analysis - Examination of a stool sample can help rule out other causes of gastrointestinal symptoms, such as infections or malabsorption issues. (3) Colonoscopy - This procedure allows the doctor to examine the entire colon and the end of the small intestine (terminal ileum) using a flexible tube with a camera. (4) Imaging Studies - CT scans, MRI, and capsule endoscopy may be used to visualise the digestive tract and assess the extent and severity of inflammation.

Question 6

What are the Treatments for Crohn’s Disease?

Accepted Answer

Treatment options for Crohn’s disease are tailored to each individual, focusing on reducing inflammation, preventing complications, and promoting long-term remission. (1) Dietary Adjustments - Dietary adjustments may include avoiding certain foods like carbonated drinks, high-fibre items, and nuts while increasing fluid intake and eating smaller, more frequent meals. Keeping a food diary can help identify trigger foods. Some people may benefit from specialised diets, such as high-calorie, lactose-free, low-fat, low-fibre, or low-salt diets. (2) Medications - Treatment for Crohn's disease typically involves medication aimed at reducing inflammation, often by suppressing the immune system. Nonsteroidal anti-inflammatory drugs and anti-diarrheal medicines can help manage symptoms and complications. Additionally, antibiotics may be necessary if an infection occurs. (3) Bowel Rest - In severe cases, bowel rest may be recommended, involving the consumption of only certain liquids or no food or drink at all to allow the intestines to rest. This can be done at home or in the hospital and may last from a few days to several weeks. (4) Surgery - Surgery becomes an option when other treatments fail to provide sufficient relief. It may involve removing damaged sections of the digestive tract to address complications like fistulas, life-threatening bleeding, obstructions, or severe side effects from medications.

Question 7

Complications of Crohn’s Disease

Accepted Answer

Crohn's disease can lead to various complications, such as: (1) Bowel Obstruction - Crohn's disease can cause a narrowing of the intestines, leading to blockages and severe abdominal pain. (2) Ulcers - Inflammation in the digestive tract can result in the formation of ulcers, which may lead to bleeding or perforation. (3) Fistulas - Abnormal connections between different parts of the intestine or between the intestine and other organs, potentially leading to infections or abscesses. (4) Anal Fissures - Tears or cracks in the lining of the anus, causing pain and bleeding during bowel movements. (5) Malnutrition - Difficulty absorbing nutrients due to inflammation or damage to the intestines, leading to weight loss and nutritional deficiencies. (6) Thromboembolic Disease - Crohn's disease can increase the risk of conditions such as deep vein thrombosis, stroke, or pulmonary embolism.

Question 8

Is there a cure for Crohn’s disease?

Accepted Answer

Currently, there is no cure for Crohn’s disease. However, medical interventions can help alleviate symptoms and prevent complications.

Question 9

How common is Crohn’s disease?

Accepted Answer

Crohn's disease is relatively uncommon. However, its prevalence appears to be increasing in Asia, with around 2,000 patients in Singapore today.

Question 10

Will I require surgery for Crohn’s disease?

Accepted Answer

While medications are usually the first line of treatment, those who do not respond to conservative treatments will require surgery. Many patients with Crohn’s disease will require surgery at some point, eventually. Your gastroenterologist will assess your situation to determine if surgery is necessary.

Question 11

How can I manage pregnancy with Crohn’s disease?

Accepted Answer

While fertility is not affected by Crohn’s disease, the risks associated with pregnancy alongside active Crohn’s disease are higher. This includes an increased risk of miscarriage, premature delivery and low birth weight of the baby. Therefore, patients who plan to become pregnant should work closely with their doctors to ensure a safe pregnancy as far as possible.

Crohn's Disease

What Is Crohn’s Disease?

Types of Crohn’s Disease

Risk Factors for Crohn’s Disease

Signs and Symptoms of Crohn’s Disease