Sebastian River Medical Center
Q&A with Tania Lopez, DO
What is Crohn’s Disease?
Crohn’s Disease is a chronic disease that causes inflammation in the gastrointestinal tract. It is a type of Inflammatory Bowel Disease (IBD), as is Ulcerative Colitis (UC). Ulcerative Colitis is limited to inflammation in the large intestine and only affects the innermost layer of the bowel. Crohn’s disease, on the other hand, may affect any part of the gastrointestinal tract- from the mouth to the anus – and can affect the full thickness of the bowel wall. The main symptoms of Crohn’s Disease include abdominal pain, diarrhea (which may or may not be bloody), fatigue, and weight loss. It may also involve other parts of the body outside the gastrointestinal tract such as the joints, eyes, skin, kidneys (kidney stones), and lungs.
When being tested for Crohn’s, your gastroenterologist will perform a thorough history and physical exam, along with blood and stool tests. Typically, imaging (particularly of the small bowel as the majority of this is not easily accessible by endoscopy), along with upper endoscopy and/or colonoscopy will be required for diagnosis.
How do I Manage Crohn’s Disease?
Unfortunately, there is no cure for Crohn’s Disease. The disease course can vary among patients. For many patients, it is a chronic, long term disease, although it may be intermittent. For others, it may be continuous and progressive.
There is no set management or treatment regimen that will work for every patient. What works for one patient may not work for another. Management may involve the use of medications, which essentially aim to control and reduce the inflammation happening in the bowel. These medications can include anti-inflammatories (steroids, aminosalicylates), immunomodulators (azathioprine, methotrexate), and biologics (Huimra, Remicade, Entyvio, etc.).
Surgery may also become necessary for the management of Crohn’s Disease. Studies have shown that up to 70% of patients with Crohn’s may eventually require surgery. Fortunately, these numbers are decreasing over the past several years given our improved medical treatments.
IBD (both Crohn’s and Ulcerative Colitis) affect an estimated three million Americans. Patients can have symptoms for many years before being diagnosed. With the proper management, treatment and monitoring, patients can substantially improve their quality of life and live full, healthy lives. Always work closely with your gastroenterologist and medical team to devise the best treatment strategy for you
What are the Nutritional Guidelines for Managing Crohn’s Disease?
There is no one set diet recommended for the management of Crohn’s. Nutrition is aimed at avoiding specific food triggers for the individual patient, while at the same time ensuring patients are obtaining adequate nutrition.
Food diaries may sometimes be helpful to identify and avoid foods causing and/or worsening symptoms. Smaller, more frequent meals throughout the day may also be better tolerated. Some studies are currently ongoing on specialized diets such as Specific Carbohydrate Diet (SCD), Mediterranean Diet, and the use of exclusive enteral nutrition. Although these diets may show some promise, compliance is a big issue, not to mention their restrictive nature which may sometimes worsen a patient’s nutritional status. Crohn’s patients are at risk for nutritional/vitamin deficiencies, weight loss and malnutrition, so it is important to always discuss any new dietary changes with your physician or a registered dietician.
Do Support Services Exist to Help in the Management of Crohn’s?
Having a support group of like-minded peers can help you overcome the hardships and trials of living with a chronic disease. Sometimes it is hard for family and friends to relate, so having a group to turn to has helped patients better cope with their disease.
The Crohn’s & Colitis Foundation of America’s website, http://www.crohnscolitisfoundation.org, has information on how to find a virtual support group.
Tania Lopez, DO
Gastroenterologist
Sebastian Office – 772-589-0580
Vero Beach Office– 772-567-4825
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