Crohn's and Colitis For Dummies, 2nd Edition
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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

The exact cause of Crohn’s and colitis is still a mystery, but scientists have hit on some clues:

  • A faulty immune system: Scientists believe that a fault in the immune system could weaken the body’s defense system and allow 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 can’t flip the inflammation switch to off.
  • Environmental factors: Smoking; a diet high in refined sugars, animal proteins, and fats; certain drugs, such as antibiotics; and stress are thought to alter the population of intestinal bacteria and cause chronic inflammation in the intestines.

    In addition, because of the improved hygiene conditions in the developed world, children aren’t exposed to as many germs as they used to be 20 years ago. 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 your family history includes a first-degree relative, such as a parent, child, or sibling.

All these factors are just potential causes of Crohn’s and colitis. Plenty of people with a genetic mutation or family history never develop the disease themselves, and plenty of people with the disease have no genetic mutation or 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 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.
  • 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, 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: Developing any fever with or without chills may point to 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, you may have a severe inflammation.

If you experience any of the preceding signs or symptoms, 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, it makes the disease worse, causing you to have more flares. Studies have also shown that smoking brings Crohn’s disease back after surgery. The relationship between smoking and ulcerative colitis is interesting. Many patients get their first attack of colitis after quitting smoking. But that doesn’t mean resuming will cure your colitis.
  • Drugs: Various 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 an infection of your intestines, which can mimic acute flare.

    Talk with your doctor if you have any concerns about the 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. 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, such as lentils, beans, legumes, and 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 per night can keep your symptoms at 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 to 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.)

About This Article

This article is from the book:

About the book authors:

Tauseef Ali, MD, is an expert in the field of inflammatory bowel disease. Currently, he serves as a faculty member in the Section of Digestive Diseases and Nutrition at the University of Oklahoma College of Medicine. He is also the director of the OU Physicians Inflammatory Bowel Disease Center. Dr. Ali has served as an academic editor-in-chief of the World Journal of Gastroenterology.

Tauseef Ali, MD, is an expert in the field of inflammatory bowel disease. Currently, he serves as a faculty member in the Section of Digestive Diseases and Nutrition at the University of Oklahoma College of Medicine. He is also the director of the OU Physicians Inflammatory Bowel Disease Center. Dr. Ali has served as an academic editor-in-chief of the World Journal of Gastroenterology.

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