Crohn’s disease: types and control tips

There are several types of Crohn’s disease depending on the intestinal segments affected. Fortunately, it is possible to control the symptoms of this condition.

Last update: May 18, 2022

Did you know that there are several types of Crohn’s disease? To begin with, it should be remembered that this condition, together with ulcerative colitis, is part of inflammatory bowel disease (IBD)a disorder characterized by chronic inflammation of the gastrointestinal tract.

Today it is a common condition in modern and industrialized countries. Studies estimate an incidence of 0.1 to 16 cases per 100,000 inhabitants worldwide. In addition, it tends to present in the second and fifth decades of life, especially in males.

In general, it is an insidious, progressive and disabling disease, whose main symptom is diarrhea with or without blood. Early diagnosis and lifestyle changes favor symptom relief and condition a better quality of life. Next, we detail its main characteristics.

Why does Crohn’s disease occur?

Today, there is no specific cause of inflammatory bowel disease (IBD). The researchers suggest that dietary habits, lifestyle and stress are aggravating factors of the disease, but are not directly responsible for its appearance.

Regardless, it is believed that the main cause of Crohn’s disease It is a problem in the functioning of the immune system. Research shows that it is produced by a disproportionate immune response of the intestinal mucosa against an environmental stimulus in a genetically susceptible person.

In general, enteropathogens, such as bacteria and viruses, generate the triggering stimulus for the abnormal response.

Although the exact cause is not established, Crohn’s disease is associated with a disproportionate immune response.

common symptoms

Crohn’s disease (CD) is characterized by an inflammatory process that it compromises the entire thickness of the intestinal wall in an asymmetrical and segmental manner. This can occur throughout the entire digestive tract, although it is more common in the terminal ileum and colon.

Symptoms vary according to the affected gastrointestinal segment and the severity of the clinical picture. Some of the most common manifestations are the following:

  • Diarrhea.
  • Blood in the stool.
  • Abdominal pain.
  • Weight loss and appetite.
  • Anemia.
  • Fever.
  • Asthenia and weakness.

Similarly, extraintestinal signs may occur, such as joint problems and red eye, common in colonic CD. In most cases, symptoms appear for 4 to 6 weeks, with periods of remission and exacerbation of the disease.

The 5 types of Crohn’s disease

In general, Crohn’s disease is classified into 5 types according to its location in the gastrointestinal tract. Each group is associated with different symptoms, as well as a higher or lower risk of long-term complications.

1. Ileitis

It occurs at the level of the terminal ileum, the final section of the small intestine. This type of CD occurs in 10 to 30% of affected people, according to studies. In general, it is characterized by the appearance of cramps and discomfort in the lower right quadrant of the abdomen and above the groin. In addition, persistent diarrhea is common.

Crohn’s disease at the level of the ileum can be complicated by strictures and intestinal fistulas. Stenoses are common and are caused by an abnormal reduction in intestinal diameter caused by inflammation or mucosal scarring. For their part, fistulas are channels that connect the intestine with other structures and increase the risk of sepsis.

2. Colitis

Crohn’s colitis is called “granulomatous colitis.” This involves one or several regions of the colonwithout affecting the small intestine. It is the second of the most common types of Crohn’s disease, occurring in 20 to 30% of people.

This form is characterized by the appearance of blood in the stool, weight loss, loss of appetite, fever, joint pain, skin lesions and eye disorders. In addition, people can develop perianal disease, as well as fistulous complications and intestinal ulcers.

3. Ileocolitis

It is the most common form of Crohn’s disease, occurring in up to 60% of affected people, according to research. In the same the terminal ileum and some areas of the colon are involvedespecially the cecum and ascending colon.

In general, it is characterized by diarrhea, fever, weight loss and cramps in the lower abdomen. Crohn’s ileocolitis can be complicated by intestinal obstruction, abscesses and fistulas in the digestive tract.

4. Jejunoiliitis

It is the inflammation in patches that affects the ileum and the jejunum, at the level of the small intestine. This is one of the less common types of Crohn’s disease. Cramping in the upper and middle part after eating, as well as diarrhea, are common. In severe cases, intestinal fistulas can occur.

5. Gastroduodenal

It is one of the rarest types of CD, which affects one or more areas of the esophagus, stomach, and duodenum. It can occur in combination with any of the above forms.

In general, it is accompanied by continuous and recurring discomfort in the upper abdomen. In addition, some people may experience nausea and vomiting if complicated by strictures of the intestinal loops.

Forms of Crohn’s disease according to the evolutionary pattern

As we will see, this condition can also be classified according to its presentation and behavior. These types of Crohn’s disease are based on the degree of compromise of the intestinal wall and include the following forms:

  • Inflammatory: it is the classic and initial pattern of CD in any of its locations. People have bowel swelling and ulcers, without strictures or fistulas. In general, the greater the extension of the inflammatory process, the more severe the clinical picture will be.
  • Stenosing: It occurs in the face of fibrosis and scarring of the intestinal mucosa, which causes the narrowing of the lumen of the digestive tract and the decrease in its mobility. This pattern usually presents with colic and cramps in the abdomen, increased bowel sounds, diarrhea and vomiting. In severe cases, it can lead to intestinal obstruction.
  • Piercing: It occurs in the presence of fistulas or abscesses that compromise the entire thickness of the intestinal wall. Fistulous channels may appear within the abdomen or communicate with the skin of the sacrum and perineum. In case of abscesses, there will be intense pain and high fever.
Given the clinical manifestations of Crohn’s disease, the ideal is to go to a specialist to obtain adequate and personalized treatment.

Treatment of Crohn’s disease

Currently, there is no definitive cure for this digestive disorder. However, it is possible to control your symptoms and reduce the risk of long-term complications. Treatment options range from lifestyle changes to the use of medications and certain surgical procedures.

In this sense, the most used medications for the management of this condition include the following options:

  • Anti-inflammatories.
  • Corticosteroids.
  • Antibiotic.
  • Antidiarrheals.
  • Immunosuppressants.

In this way, it is possible to reduce inflammation and relieve most symptoms. Besides, the doctor may also indicate dietary supplements in case of nutritional deficiency.

On the other hand, some people require a surgical approach if medications are not effective. In most cases, surgery corresponds to the removal of the affected part of the intestine. This procedure allows to alleviate the symptoms for several years.

Some tips for managing Crohn’s disease

People with Crohn’s disease they can have a good quality of life and control the intensity of the symptoms with some changes in their habits. In this sense, it is advisable to follow the following advice:

  • Follow the doctor’s recommendations in detail.
  • Do not abandon medical treatment upon improvement of symptoms.
  • Avoid taking medications without a prescription.
  • Maintain a balanced diet abundant in proteins and vitamins.
  • Avoid excessive intake of saturated fats, full-fat dairy products, foods rich in sugar and red meat.
  • Increase consumption of sources of probiotics, such as natural yogurt and kimchi.
  • Practice activities to reduce stress.
  • Perform meditation and relaxation exercises, like yoga.
  • Reduce the consumption of cigarettes and alcohol.
  • Seek support from friends and family.

Timely diagnosis and treatment is key to a better quality of life

As you can see, there are several types of Crohn’s disease that can be identified according to the section of the affected intestine and the symptoms that occur. In this sense, early treatment of clinical manifestations is essential to cope with the disease and avoid the appearance of serious complications over time.

Suspecting this disease, do not hesitate to seek professional care. Specialist doctors are the only ones trained to diagnose this condition and provide the best treatment options.

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