Crohn’s disease is a lifelong disease.
With treatment, inflammation can be managed.
Most people experience periods of remission, which can be followed by flare-ups.
The course and severity of the disease varies widely from person to person, which is one of the reasons it’s difficult to treat.
These factors can play a role:
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen can worsen Crohn’s disease. If you need pain relief, ask your doctor about other options.
• Smoking can result in Crohn’s disease flare-ups. It also increases the risk of needing surgery.
• Stress can exacerbate symptoms of Crohn’s disease.
Having Crohn’s disease increases your risk of developing colon cancer. Therefore, it’s recommended that you undergo a colonoscopy every one to two years. Surgery may become indicated to remove a section of the bowel if the following complications arise:
• Bowel obstruction
• A non-healing fistula
• Severe side effects from medication
• Severe symptoms that can’t be controlled with medication
A bowel obstruction may be due to prolonged inflammation that causes the intestinal wall to thicken. Thickening of the intestinal wall may promote the development of scar tissue, which ultimately narrows the width of the intestinal wall, forming a stricture. Strictures can block digestive contents in the gut, which may require surgery to rectify.
Some people have inflammatory strictures, where inflammation, not scar tissue, narrows the intestines. Often, medication can reduce the inflammation and resolve this type of stricture. Symptoms include severe cramping, abdominal pain, nausea, vomiting and constipation.
Ulcers may form as a result of chronic inflammation. A fistula is a complication that arises when an ulcer extends completely through the intestinal wall and creates an abnormal connection between two different body parts. For example, fistulas can develop between your intestine and skin, or between your intestine and another organ.
Fistulas that develop in the abdomen are of concern, as the food you eat may not be absorbed properly. In some instances, a fistula can become infected. This can then form an abscess – a life-threatening complication, if not treated. Fistulas near or around the anal area (peri-anal fistulas) are the most common kind in people with Crohn’s disease.
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