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Cheat Sheet

Crohn’s & Colitis For Dummies

From Crohn's and Colitis For Dummies by Tauseef Ali, David T. Rubin (Foreword by)

Crohn’s disease and ulcerative colitis are the two major types of inflammatory bowel disease. They’re part of a group of disorders in which the small and large intestines become inflamed. The exact cause is a mystery, but scientists have discovered some clues as to what may cause Crohn’s and colitis. The symptoms of the diseases can vary in each individual, but some symptoms are more common than others. The good news is, you can take steps to reduce your symptoms and keep them from interfering with your life.

The Major Causes of Crohn’s and Colitis

People all around the world from different ethnicities and races are affected by Crohn’s disease and ulcerative colitis. The exact cause is still a mystery, but scientists have hit on some clues:

  • A faulty immune system: Scientists believe there could be a fault in the immune system that allows bacteria to invade the intestines and cause inflammation. The inflammation lasts longer than it would in a healthy person, because the immune system of someone with Crohn’s or colitis isn’t capable of flipping the inflammation switch.

  • Environmental factors: Smoking, diet (such as those high in refined sugars, animal proteins, and fats), certain drugs (such as non-steroidal anti-inflammatory drugs, or NSAIDs, like aspirin, Advil, and Aleve; oral contraceptive pills; and antibiotics), and stress are thought to change the function of the immune system or alter the population of intestinal bacteria and cause chronic inflammation in the intestines.

    In addition, because of the improved hygiene conditions that we have today in the developed, children aren’t exposed to as many germs. So, the immune system has shifted away from fighting infection to developing autoimmune diseases like Crohn’s and colitis.

  • Genetics: Gene mutations are thought to be unique in Crohn’s and colitis patients and may be the culprit in causing defects in the immune system and other mechanisms, leading to persistent inflammation in the intestines. In addition, if you have a family history of Crohn’s and colitis, you’re more likely to have the disease yourself (especially if the family history is in a first-degree relative — parents, children, or siblings).

All these factors are just potential causes of Crohn’s and colitis. For example, plenty of people with a family history never develop the disease themselves, and plenty of people with the disease have no family history.

Common Symptoms of Crohn’s and Colitis

Crohn’s and colitis are two different diseases, but they share many of the same symptoms. Here’s a list of the common symptoms of Crohn’s and colitis:

  • Chronic diarrhea: Diarrhea is the frequent passage of watery or semi-formed stools. Everybody gets diarrhea from time to time, but chronic diarrhea (lasting longer than 30 days) is a common symptom of Crohn’s and colitis.

  • Blood in the stool: You may notice bright red blood in your stool, or your stool may be black in color (which is a sign of old, clotted blood).

  • Abdominal pain: You may experience abdominal pain, anywhere in the abdomen.

  • Rectal urgency: When you have Crohn’s or colitis, you may experience a sudden, compelling need to have a bowel movement. This is known as rectal urgency.

  • Tenesmus: Tenesmus is a constant sensation of fullness and incomplete relief during a bowel movement. You may feel like you need to go to the bathroom, but then you don’t have an actual bowel movement.

Consult your doctor right away if you experience any of the following symptoms:

  • Intolerable abdominal pain: If you develop intolerable abdominal pain, it may point toward intestinal obstruction, perforation, or severe inflammation. You may also notice other signs like nausea, vomiting, and abdominal distension.

  • Weight loss: When you have Crohn’s or colitis and you’re losing weight, that’s a sign that inflammation is still active. Most of your body energy is being diverted to control inflammation, and your nutrition isn’t keeping up with the amount of energy your body is expending.

    If you’ve had colitis for many years and you’re now starting to lose weight, this could be worrisome. Longstanding colitis puts you at risk for cancer, so be sure to notify your doctor immediately about any weight loss you experience.

  • Fever and chills: If you develop any fever with or without chills, this may point toward worsening inflammation, infection in your intestines or an intestinal abscess (collection of pus).

  • Severe bleeding: If you notice blood in your stool every time you go to the bathroom, it may be a sign of severe inflammation.

If you experience any of the signs or symptoms above, consult your doctor right away.

Eight Things That May Worsen Your Crohn’s and Colitis Symptoms

Taking your medications as prescribed is one way to keep your Crohn’s and colitis under control. However, the disease can become active despite taking medications. Certain things are known to trigger Crohn’s and colitis flares or increase your symptoms. But if you know about these triggers ahead of time — and avoid them — you can help yourself stay in remission and avoid flares. Here are the common triggers for Crohn’s and colitis:

  • Smoking: Smoking not only increases your risk of having Crohn’s disease, but also makes the disease worse, causing you to have more flares. Studies have also shown that smoking brings Crohn’s disease back after surgery.

  • Drugs: A variety of drugs can trigger Crohn’s and colitis symptoms, including frequent use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin, Advil, or Aleve. Certain antibiotics (such as ciprofloxacin and penicillin) increase your risk of having infection of your intestines, which can mimic acute flare.

    Talk with your doctor if you have any concerns about medications you’ve been prescribed. Don’t stop taking a prescribed antibiotic without consulting with your doctor first.

  • Diet: Certain foods may give you more problems than others, but everyone reacts differently to different foods — so what your sibling with Crohn’s or colitis can tolerate and what you can tolerate may be different. Pay attention to which foods are giving you trouble and avoid them in the future. Here are some common culprits:

    • Artificial sweeteners

    • Fatty foods

    • High-fiber food

    • Gas-producing food (lentils, beans, legumes, broccoli)

    • Caffeine

    • Spicy foods

    • Nuts and seeds

    • Dairy products (if you’re lactose intolerant)

    • Wheat and other products (if you’re sensitive to gluten)

  • Alcohol: Studies have not shown that drinking adversely affects the inflammation in Crohn’s and colitis patients. Alcohol does, however, irritate the intestines and can worsen symptoms of diarrhea in some patients. It can also interact with certain medications you may take for your disease, such as metronidazole and methotrexate.

  • Dehydration: Active disease makes you go to the restroom frequently, causing you to lose water and salt and putting you at risk for dehydration. Dehydration itself can cause stress to your body functions and cause more weakness and inability to cope with illness. And a vicious cycle starts. . . . Bottom line: Stay hydrated by drinking at least eight 8-ounce glasses of clean water a day.

    The amount of water you need may vary depending on your age, weight, activity level, and body fluid losses (such as water lost during diarrhea). Talk with your doctor and dietitian about your total daily water requirement.

  • Depression: Studies have shown that depression can cause disease flare. You can have more symptoms and an increase in inflammation of the intestines when you’re depressed. Your doctor may prescribe an antidepressant to treat depression and, thus, reduce the symptoms of your Crohn’s or colitis. Be sure to talk with your doctor if you’re feeling depressed.

  • Lack of sleep: Sleep can affect the immune system, and poor sleep or sleep deprivation can activate inflammation. Poor sleepers tend to have more inflammation of their intestines and are at risk for future flares. Getting an uninterrupted seven to eight hours of sleep can keep your symptoms at a bay.

  • Stress: Stress has a negative impact on the immune system. Physical and emotional stress has been shown to cause disease flare and an increase in symptoms. Nobody has a stress-free life, but do what you can to keep your stress at a minimum, even if that means taking a yoga class or dropping the kids off at your health club’s daycare center while you sit in the sauna for 30 minutes. (Just make sure to stay hydrated if you’re sweating out your stress.)

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