How Is Crohn's Disease Diagnosed?
A variety of diagnostic procedures and lab tests are used to distinguish Crohn's disease from other inflammatory gastrointestinal conditions like ulcerative colitis.
First, your doctor will review your medical history. A specialist called a gastroenterologist may perform a colonoscopy or sigmoidoscopy to obtain bowel tissue for analysis. Other tests your health care provider may order include:
- Blood tests, including blood counts (often high white blood cell counts -- a sign of inflammation -- and low red blood cells counts -- a sign of anemia from blood loss -- are present).
Stool samples to rule out infections as the cause of diarrhea.
Special X-rays (such as a CT scan or MRI) of both the upper and lower gastrointestinal tract may be ordered as well to confirm the location of the inflammation.
What Triggers a Worsening of Crohn's Disease?
Crohn's disease is characterized by periods of having symptoms, which can last for days, weeks or months, interspersed with periods of remission when no symptoms are present. Remissions can last days, weeks, or even years.
Factors that worsen Crohn's disease include:
- Infections (including the common cold)
- Cigarette smoking
- Certain anti-inflammatory drugs (such as aspirin and ibuprofen)
How Is Crohn's Disease Treated?
Though treatments cannot cure Crohn's disease, they can help most people lead normal lives.
Crohn's disease is treated primarily with medications, including:
- Anti-inflammatory drugs, such as salicylates. Examples include Azulfidine (sulfasalazine), Dipentum (olsalazine), and Pentasa (mesalamine). Side effects include gastrointestinal upset, headache, nausea, diarrhea, or rash.
- Corticosteroids, a more powerful type of anti-inflammatory drug. Examples include prednisone or Solu-Medrol (methylprednisolone), and Entocort (budesonide). Side effects, if taken for long periods of time, can be severe and may include bone thinning, muscle loss, skin problems, and increased risk of infection. Entocort has fewer side effects.
- Immune system modifiers such as Imuran (azathioprine)or Rheumatrex (methotrexate). It can take up to six months for these drugs to work. These drugs are associated with increased risk of infections that can be life-threatening.
- Antibiotics such as Flagyl (metronidazole), Cipro (ciprofloxacin), and others. Flagyl can cause a metallic taste in the mouth, nausea, and tingling or numbness of the hands and feet. Cipro can cause nausea and has been associated with rupture of the Achilles tendon.
- Antidiarrheal drugs.
- Biologic therapies, such as Cimzia (certolizumab pegol), Humira (adalimumab), and Remicade (infliximab). Remicade neutralizes the activity of a substance called tumor necrosis factor alpha (TNF-alpha). This substance is overproduced by people with Crohn's and plays an important role in causing the inflammation associated with Crohn's disease. The drug is given intravenously (through the vein). Side effects include life-threatening infection, infusion reaction, headache, stomach upset, fatigue, fever, pain, dizziness, rash, and itching.