Crohn's Disease: 11 Things Doctors Want You to Know

  • Confident Man Smiling and Looking Away
    Treatment for Crohn’s disease has come a long way.
    Crohn’s disease is a complex disorder that causes inflammation in your digestive tract, leading to a wide range of symptoms from mild to severe. Today, though, doctors can choose from many treatments that are available to help get your symptoms under control. Here’s what practicing physicians who treat Crohn’s disease want you to know about the condition, what new research is finding, and how to find the most effective treatment for you.





  • Woman with doctor
    1. “This is an exciting time for managing patients with Crohn’s.”
    The development of new, targeted drugs for Crohn’s has altered the treatment landscape. Many people who may simply have had to cope with symptoms now can find relief and even remission. “This field has exploded in the last 20 years,” says Patricia Kozuch, MD, a gastroenterologist with Jefferson Health in Philadelphia. “The field is moving forward and there are new options available now that weren’t available 2 or 3 years ago—and more are coming,” adds Francis Farraye, MD, and co-director of the Center for Digestive Disorders at Boston Medical Center.





  • smiling woman taking vitamins
    2. “Biologics are a game changer for Crohn’s.”
    One class of drugs has made the most significant difference in treating Crohn’s. “The biggest change is the introduction of biologics,” says Steven Brant, MD, a gastroenterologist with The Johns Hopkins Hospital in Baltimore. They do more than make you feel better, he says. They can “heal the mucosa (intestinal lining), and really decrease perforating disease.” Perforations–holes in the organs–often require surgery to repair. “The use of biologics can get two-thirds of patients with early Crohn’s into remission,” says Dr. Farraye. But he cautions, “In patients who have had Crohn’s for years, rates of remission are going to be lower.”





  • Large Group of Happy People smiling and embracing.
    3. “Crohn’s varies from person to person.”
    Crohn’s is a diverse disease that can appear anywhere along the digestive tract, causing inflammation, abscesses and, in severe cases, fistulas, which are abnormal holes that form between organs. “You have a spectrum of someone being asymptomatic to someone who is hospitalized,” says Douglas Wolf, MD, a gastroenterologist with Atlanta Gastroenterology Associates. The condition comes and goes, and someone with Crohn’s can look and feel perfectly normal between flares. “There can be a disconnect between how people appear and what’s going on inside,” adds Dr. Kozuch.





  • Young Asian woman suffering from stomach pain talking to doctor
    4. “The earlier we see you for Crohn’s, the better.”
    Doctors want to start treating Crohn’s as soon as possible after a diagnosis. “If you treat people earlier, you can manage them better,” says Dr. Wolf. If your bowel habits change, or if you have abdominal pain or bloody stools, see a doctor. “The sooner treatment begins, the better chance we have of decreasing the need for steroids, surgery and hospitalizations, as well as avoiding damage to the bowel wall that can’t be undone,” says Dr. Kozuch. 





  • Man with doctor
    5. “Know your IBS from your IBD.”
    IBS and IBD are two specific conditions, with different symptoms and treatment. IBS stands for irritable bowel syndrome, while IBD, which includes Crohn’s disease and ulcerative colitis, stands for inflammatory bowel disease. “In IBD, there’s visible inflammation of the intestines, while in IBS the problem is more of a functional disorder,” explains Dr. Farraye. “In other words, if you look at the lining of the intestine with an endoscope, it looks normal with IBS, but it doesn’t function normally.”




  • Worried Woman Waiting
    6. “You didn’t cause your Crohn’s.”
    Though doctors aren’t sure what exactly causes the disease, they think it’s due to a combination of factors. They do know, however, that it’s not the result of your behavior. “It’s a misconception that something you did or didn’t do brought on your Crohn’s. That’s not true,” says Dr. Farraye. Nor is it your imagination. “Crohn’s disease is a real, active, organic disease,” says Dr. Wolf. Stress can cause flares, but “the key is that actual inflammation, ulceration and related tissue damage causes symptoms,” he adds. “It’s not a psychosomatic condition.”





  • Woman with stomach pain
    7. “See a specialist if you have Crohn’s.”
    If your primary care doctor thinks you may have the disorder, it’s important to work with a specialist– a gastroenterologist—who knows the condition well. “There’s an art to treating this disease,” says Dr. Brant. “The treatment has gotten much more sophisticated, so it’s important to see someone who’s really interested and engaged,” says Dr. Wolf. “The doctor has to take into consideration where the disease is and the severity of it to be able to choose which medicine is best, so one size does not fit all. That’s the importance of seeing a gastroenterologist with expertise in caring for patients with Crohn’s,” says Dr. Farraye.



  • patient talking to doctor
    8.“Don’t be embarrassed about Crohn’s symptoms.”
    Your doctor has chosen to specialize in intestinal conditions. “As gastroenterologists, we deal with intimate and personal issues such as bowel function. We’re not embarrassed, nor should the patient be embarrassed,” says Dr. Farraye. “Be sure to tell us all your symptoms and let us decide, with you, which are the key ones that need to be addressed. Bring a list of symptoms and questions you want addressed, and feel free to bring a partner.”





  • man-relaxing-on-couch
    9. “You play a part in treating your Crohn’s disease effectively.”
    “Patients really need to communicate with their doctors what’s going on,” says Dr. Brant. “It’s hard for patients to accept, but there’s no wishing it away. The disease can wax and wane and they can deny that it’s there, but it tends to come back.” Learning to manage stress is one key to keeping Crohn’s under control. “It’s important to learn coping skills, because if you’re anxious about the disorder, it makes it harder for the doctor to sort out what symptoms are related to active Crohn’s and what might be related to other issues,” says Dr. Farraye.





  • Healthy eating fit woman
    10. “Probiotics may help you feel better, but be realistic about their potential.”
    Many people with Crohn’s take probiotics, which are known to help digestion. Researchers are studying “targeted” probiotics for the treatment of Crohn’s, but they are years away from developing approved therapies. “Probiotics may help symptoms but not change the course of the disease. But they’re available and I encourage people to try them and see if they are helpful. But I also caution them that [probiotics are] not likely to be a mainstay treatment,“ says Dr. Wolf.





  • Woman having cup of coffee outdoors
    11. “There’s support available to help you cope with Crohn’s.”
    Living with abdominal pain and the urgent need to move your bowels can be challenging, but you can find solutions. “I would encourage patients to use the resources of the Crohn’s and Colitis Foundation. They are wonderful, whether someone is newly diagnosed or have longstanding disease and have a question about their condition,” says Dr. Farraye. “Other people with Crohn’s have good strategies and are dealing with similar things, so find support groups, whether they’re face-to-face or virtual,” adds Dr. Wolf. Seeking support and working closely with your gastroenterologist are two productive paths to living well with Crohn’s.





Things Doctors Want You to Know About Crohn’s Disease
Contributors
  • Francis Farraye, MD, MSc

    Co-director of the Center for Digestive Disorders at Boston Medical Center and professor of medicine at Boston University School of Medicine.

    View My Profile on Healthgrades
  • Steven Brant, MD

    Professor of medicine in the Division of Gastroenterology at The Johns Hopkins Hospital and director of the Meyerhoff Inflammatory Bowel Disease Center in Baltimore, MD.

  • Patricia Kozuch, MD

    Assistant professor of medicine at Thomas Jefferson University Hospital in Philadelphia. She completed her medical degree at the Cornell University Medical College and her fellowship in gastroenterology at Albert Einstein College of Medicine/Montefiore Medical Center.

    View My Profile on Healthgrades
  • Douglas C. Wolf, MD
    Gastroenterologist with Atlanta Gastroenterology Associates and former senior associate of medicine in digestive diseases at Emory University Hospital in Atlanta.
    View My Profile on Healthgrades

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
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Last Review Date: 2019 May 22
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