Crohn’s is a shitty disease… in more ways than one, but once you understand what it is, and how it affects you, you can start to fight back. Ralph Waldo Emerson once said “Knowledge is the antidote to fear”, so allow me to administer the first dose.
Crohn’s and Colitis are considered chronic conditions, simply meaning “on going” or “lifelong” and fall under the umbrella term of Inflammatory Bowel Disease, or IBD. These autoimmune diseases cause inflammation throughout the digestive tract, and often require some hefty treatments to get them under control.
Many people do confuse IBD, with IBS, which stands for Irritable Bowel Syndrome; although they sound similar, they are two very different beasts, with IBD carrying more clout in terms of the severity of symptoms, and the need for medical/surgical interventions. If you have Crohn’s or Colitis, you have Inflammatory Bowel Disease, and that shit ain’t no IBS.
It is also worth noting that Inflammatory Bowel Disease, in any form, is not infectious, so you cannot pass it on to those around you, no matter how hard you try.
So how will Crohn’s disease affect me?
The main weapon of Crohn’s disease, is that it uses your body’s natural defence system against you. Working correctly, your immune system will react to bad bacteria in your gut, and use inflammation to disable or remove it. However, when Crohn’s disease is present, it tricks your immune system into overacting and attacking all the bacteria in your gut; good or bad, and then inhibits your ability to shut off your defences. As such the inflammation continues to aggravate your gut, even when the perceived threat has been quelled. This is often referred to as a Crohn’s flare up.
The majority of people tend to experience cycles of the disease, in which they will move from having flare ups of inflammation, to taking medication or undergoing surgeries to treat the symptoms, into periods of remission where their symptoms are no longer present. Quite how long or short each cycle is, will depend on the individual, and how aggressive their Crohn’s disease decides to be.
The inflammation caused by Crohn’s disease is most commonly found towards the end of the small intestine, or on the join between the large and small intestines, a place called the Terminal Ileum. However, unlike Ulcerative Colitis, Crohn’s disease isn’t bound to one area of the bowel and can cause inflammation at any point along the pathway from your mouth to your bum, also known as the Gastro Intestinal Tract. Persistent or prolonged periods of inflammation can also cause scarring, resulting in parts of the bowel becoming increasingly narrow and making it difficult for food to pass through them.
Although a bit bleak, the literature surrounding Crohn’s disease suggests that it affects different people in different ways. Some people may only experience mild symptoms, others may get hit harder, but respond well to medication, whilst others may find their disease, and its symptoms change over time. Your best defence against Crohn’s disease is knowing what ‘could’ happen! That way, if something does change, you can spot it, act quickly, and start fixing it, before it takes you down.
So, what causes Crohn’s Disease?
As a collective, we still do not fully understand ‘exactly’ what causes Inflammatory Bowel Diseases like Crohn’s and Colitis to manifest, but… stick with me, as the current model does suggest that there are three main variables that always need to be present:
- A genetic tendency to IBD
- A confused immune system responding incorrectly
- An environmental trigger
Everyone’s variables are going to be slightly different, but the basic formula seems to be the same. After some reflection, I believe my Crohn’s formula looks a little like this:
Despite what you may hear from those around you, there is no scientific evidence to suggest any particular diet or food group causes, or cures Crohn’s disease. So, if someone tells you there is, calmly throw a salad at them, and walk away!
What we do know for sure is that everyone is different. Foods that irritate one person, may be fine for another. Personally, pastry is my nemesis, hospitalising me on two separate occasions, yet a large meat-based, BBQ pizza, can get through my guts, pain free, every time.
What sort of symptoms can I expect with Crohn’s Disease?
The slightly annoying thing with Crohn’s disease is that it is very individualised, with symptoms differing in characterises and severity from person to person. Thankfully, there are some core symptoms to look out for:
- Abdominal pain: Cramping around the stomach is a clear sign that your guts are inflamed. This is often accompanied by loud gurgling noises, bloating, and sensitivity to touch. Imagine trapped wind, and multiply that by a million, and you are half way.
- Diarrhea: Frequent and often frantic trips to the toilet are a strong indication of active Crohn’s disease. Your bowel movements may also be accompanied by some mucus, pus or blood, as your bowels are raw and inflamed. Poo is definitely not taboo when it comes to Crohn’s disease, so make sure you share all of the gritty details with your doctor.
- Constipation: Intense difficulty passing a poop can also being a key symptom of active Crohn’s disease, often coupled with nausea and bloating, as nothing is moving through you. This could be due to active inflammation in your colon, or Inflammation/strictures further back.
- Tiredness and fatigue:Whether you are in remission, or experiencing a flare up, fatigue is now a recognised symptom of Crohn’s disease. This could be due to fluid or blood loss as a result of diarrhea, the ongoing struggle of coping with severe pain, or simply that your body is working overtime to cope with the active symptoms of your disease.
- Weight Loss: As the gut becomes inflamed and damaged, it loses its ability to absorb nutrients from the foods you are eating and can make gaining or maintaining a healthy weight quite challenging. The pain associated with eating can also lead some sufferers to avoid eating altogether, or necessitate the need to adhere to very restricted diets until symptoms subside.
- Anemia (a reduced level of red blood cells): As with the points above, if you are struggling to absorb nutrients, and are losing blood when you poop, you are likely going to develop anaemia. This can lead to tiredness, fatigue and feeling very weak, so it is key to raise this with your doctors ASAP.
- Feeling generally unwell: Although a bit vague, some people may experience a raised temperature, feel feverish, or simply unable to focus or concentrate on anything meaningful as the disease becomes active.
Despite there being no long-term cure, there are a number of treatments that can help suffers of Crohn’s disease reclaim a good quality of life. Some of these fight the symptoms, whilst others offer more long-term effects by either augmenting the immune system or by surgically removing the diseased bowel all together.
We shall touch on all of these treatments and more in a future essay, but for now, I shall leave you with this: You are stronger than you realise, and much stronger than this shitty disease! Use my ramblings as the first brick in building your fortress of knowledge, and go kick your Crohn’s disease in the arse.