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Small Bowel Crohn’s Disease

Medically Reviewed by Minesh Khatri, MD on May 16, 2020

Crohn’s disease can cause inflammation in any part of your gastrointestinal tract. Most commonly, people have it in their small bowel, also called your small intestine. This is referred to as small bowel Crohn’s disease.

The small bowel is the tube that food goes through after it leaves your stomach. It’s about 20 feet long. This area of your digestive tract breaks down and absorbs nutrients from food. It has three sections: the duodenum, the jejunum, and the ileum.

Around one-third of people with Crohn’s disease have inflammation only in their ileum. The ileum is the longest and deepest part of your small bowel. It absorbs most of the nutrients you get from food.

Symptoms

The most common symptoms include:

These are all signs that inflammation in your small bowel is keeping it from absorbing nutrients the way it should.

Crohn’s that affects other places in your digestive tract, such as your stomach or large intestine, is more likely to cause nausea, vomiting, and a lack of appetite.

Small bowel Crohn’s can cause:

  • Inflammation
  • Ulcers
  • Strictures (narrowing that can cause blockage in your intestine)
  • Bleeding

Diagnosis

First, your doctor will take your complete medical history, ask you about your symptoms, and examine you. In order to see whether you have small bowel Crohn’s specifically, they may suggest you have an exam called a capsule endoscopy.

During a capsule endoscopy, you swallow a small pill-sized capsule with a tiny camera inside it. As the capsule makes its way through your digestive tract, it takes over 50,000 pictures. A recording device you wear on a belt collects the pictures. A specialist looks at the pictures to see what’s happening in your small bowel.

If the doctor thinks that your small bowel has narrowed, they may choose a different exam to make sure nothing will get blocked in your digestive tract. Called a double balloon enteroscopy, a doctor will use a long, flexible tube with a balloon on the end. They insert the scope either into your mouth or your colon or both. This makes it possible to see the entire length of your small bowel. As the scope moves, the balloon helps open parts of your small bowel that may be hard to get through because of narrowing.

Treatment

There’s no cure for any form of Crohn’s disease. But your doctor can prescribe medication to help manage symptoms. These include:

Your doctor may also recommend some over-the-counter treatments such as:

Nutritional therapy can help you get the nutrients you need. This may involve a low-fiber diet, a feeding tube, or injections.

In rare cases, you may have surgery for small bowel Crohn’s. Typically, you would need surgery only if medications aren’t working or you have a stricture in your bowel.

WebMD Medical Reference

Sources

SOURCES:

Seattle Children’s: “How the Small Intestine Works.”

Gut: “Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy.”

University of Michigan Medicine: “Crohn's Disease and the Small Bowel.”

UPMC Children’s Hospital of Pittsburgh: “Difference Between Small and Large Intestine.”

Medscape: “What is the usual presentation of Crohn disease of the small intestine?”

Johns Hopkins Medicine: “Balloon-Assisted Enteroscopy.”

Mayo Clinic: “Crohn’s Disease.”

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