• Joel Bauer MD
  • Stephen Gorfine MD
  • David Chessin MD
  • Daniel Popowich MD

Crohn's Disease

Crohn’s Disease Treatment

What Is Crohn’s Disease & What Are the Symptoms?

Crohn’s disease is a chronic inflammatory disease that primarily impacts the gastrointestinal tract. First described in 1932 at Mount Sinai Hospital, Crohn’s disease affects patients in several different ways. The cause of Crohn’s disease is unknown but may involve genetic and environmental factors. There is no cure for Crohn’s disease.

Crohn’s disease carries various clinical manifestations, including stricture and fistula formation. It can sometimes cause life-threatening complications. Crohn’s disease can involve any portion of the digestive tract from the mouth to the anus.

Patients often come to need medical attention due to the following symptoms:

  • Chronic abdominal pain
  • Sudden weight loss
  • Diarrhea
  • Anemia
  • Fatigue
  • Vomiting
  • Unexplained pain without a change in bowel habits
  • Continued or chronic symptoms despite medication

Patients may have a form of Crohn's disease that causes strictures (narrowing) of the intestine. Strictures may lead to abdominal pain, as well as obstruction (blockage of the intestine). Intestinal obstruction may lead to the symptoms of abdominal pain, nausea, and vomiting. Alternatively, fistulizing disease causes the wall of the bowel to breakdown leading to abnormal communications (fistulas) to other parts of the bowel or other intra-abdominal structures. These can also cause intra-abdominal abscesses.

Patients with Crohn's disease also may have symptoms around their anus, including infected fluid collections (abscess) or communication between the anus or rectum and the skin (fistula). Crohn's disease may involve genetic and environmental factors in some cases. The management of the disease can include both medical and surgical therapy.

At Manhattan Surgical Associates, it is our primary goal to help patients who suffer from chronic symptoms associated with Crohn’s disease. We understand the debilitations connected to lifelong gastrointestinal complications and strive to help you live your life without painful, constant flare-ups.

Pioneers in the Field of Surgical Care Since 1964

Diagnosing Crohn’s Disease

Crohn's disease is diagnosed using a combination of patient history, physical examination, endoscopy, radiology, and pathology. Depending on patient symptoms, the evaluation may include upper endoscopy (EGD), radiographic studies (CT or MR enterography) colonoscopy, and/or capsule endoscopy (a small camera is swallowed, which transmits images of the inside of the intestine to a receiver). Endoscopy can also be important for surveillance of patients with the disease to evaluate any development of pre-cancerous or cancerous tumors.

Radiology tests that may be ordered include abdominal X-rays and contrast X-rays. Contrast X-rays involve drinking a radio-opaque solution while the radiologist takes images of the intestines using a technique called fluoroscopy. Patients often may undergo a CT scan of the abdomen and pelvis to look for segments of involved intestine or the complications of the disease, such as obstruction, perforation, abscess, or fistula.

When patients have endoscopy or surgery for diagnosis of Crohn’s disease, tissue is often submitted to the pathologist for evaluation. Often, the pathologist aids in making the diagnosis of Crohn's disease.

Undergoing Treatment for Crohn’s Disease

Although there is currently no cure for Crohn’s disease, the goal of therapy is to induce remission. Treatments ameliorating symptoms, pain, and chronic complications vary between patients. Based on the location of the disease, severity of the symptoms, and the presence of complications such as obstruction, perforation, abscess, or fistula, treatment to slow the progression of the disease can range greatly. Often, the initial treatment is non-surgical and is commonly directed by a Gastroenterologist.

Patients suffering with Crohn’s disease can expect the following methods of non-surgical, medical treatment:

  • Aminosalicylates
  • Antibiotics (such as Cipro and Flagyl)
  • Steroids
  • 6-MP/azathioprine
  • Methotrexate
  • Remicade® (infliximab)
  • Humira® (adalimumab)
  • Cimzia® (certolizumab pegol)
  • Entyvio® (vedolizumab)

Indications for surgery include worsening symptoms despite adequate medical therapy, intolerance of medical therapy, complications of the disease (obstruction, perforation, abscess, or fistula), and difficulty maintaining nutrition. Depending on the location of the Crohn's disease, intestinal resection (removal) may be recommended. This may be performed using laparoscopy or an open technique. For strictures, stricturoplasty (suturing the intestine in a manner to increase the diameter of the intestine) may also be used.

In highly selected patients with isolated Crohn's disease of the large intestine, restorative proctocolectomy (J-pouch procedure) is an option. For perianal Crohn's disease, drainage of abscesses, placement of a seton (soft rubber band to facilitate drainage of infected fluid), and more complex flap or plug procedures may be recommended.

Call Manhattan Surgical Associates to Learn More: (646) 798-4606

We offer cutting-edge therapies and surgical methods to help our patients achieve remission. Take the first step and regain control over inflammation or prevent other painful symptoms associated with Crohn’s and other digestive inflammatory diseases by scheduling a one-on-one consultation with us today.

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